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[Treating traumatic ossicular chain disruption with epitympanum approach following tympanotomy].

OBJECTIVE
To evaluate the therapeutic effects of epitympanum approach tympanotomy in treating traumatic ossicular chain disruption.


METHOD
Ten patients with temporal bone fracture and trauma of ear, whose CT scan of temporal bone showed that Malleoincudal joint irregular shape in the axial view and incudostapedial joint dislocation in the coronal view, were included in this study, Virtual endoscopy showed Malleoincudal joint separation, incudostapedial joint dislocation and interruption, ossicular chain disruption in all patients. The surgical approach was opening the atticus via temporal line, remaining the intact posterior and superior wall of external acoustic meatus, exposing the atticus and posterior tympanic cavity sufficiently, and treating the lesions of ossicular chain.


RESULT
One patient with the long process of the incus fracture, adopted the fitted incus prosthesis between the handle of the malleus and the head of the stapes. Six patients with Malleoincudal joint separation or incudostapedial joint dislocation, 3 patients with incus body dislocation completely, adopted incus positioning two articulation decis. The air-conducting hearing levels had an enhancement of 25-50dB in average after surgery.


CONCLUSION
The effect of intact canal wall epitympanum approach ossicular reposition in treating traumatic ossicular chain disruption is satisfying.