Ossiculoplasty for Trauma

Most traumatic ossicular chain injury results from blunt head trauma associated with temporal bone fracture, though penetrating, barotraumatic, and iatrogenic causes are also encountered. Dislocation of the IS joint is the most common lesion, followed by IM separation and a stapes superstructure fracture. Management depends on the mechanism and severity. High-resolution temporal bone computed tomography aids in localizing disruption and identifying delayed ossicular fixation. Surgical reconstruction with autologous or artificial materials typically achieves postoperative air-bone gaps of 10 to 20 dB. Long-term hearing stability depends on prosthesis position, eustachian tube function, and the integrity of the stapes superstructure.