Management of Incus Dislocation From Attempted Foreign Body Removal With Alligator Forceps

Middle ear trauma from foreign body (FB) impaction or its removal can lead to tympanic membrane (TM) perforations and ossicular chain disruption. We present a case of a 29 year-old male who developed acute right-sided hearing loss, aural fullness, and tinnitus after an attempt at removing a cotton-tipped applicator (Q-tip) impaction in the ear canal. Physical examination revealed a dislocated incus protruding through the TM, and audiometry confirmed moderate conductive hearing loss. The patient underwent tympanoplasty with ossicular chain reconstruction with incus interposition, which resulted in significant hearing improvement and resolution of tinnitus. This case highlights the importance of proper diagnosis and intervention in trauma-related ossicular dislocation.