Malleus head fixation: histopathology revisited

• Published in: Acta oto-laryngologica Vol. 126; no. 4; pp. 353 - 357
• Main Authors: Martin, Christian, P. Timoshenko, Andrei, Dumollard, Jean-Marc, Tringali, Stéphane, Peoc'H, Michel, Prades, Jean-Michel
• Format: Journal Article
• Language: English
• Published: Stockholm Informa UK Ltd 01.04.2006; Taylor & Francis; Taylor and Francis
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Cholesteatoma, Middle Ear - complications; Cholesteatoma, Middle Ear - pathology; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Hearing Loss, Conductive - etiology; Histological study; Humans; Male; Malleus - pathology; Malleus - physiopathology; Malleus - surgery; Medical sciences; Middle Aged; Non tumoral diseases; ossicular ankylosis; Otorhinolaryngology. Stomatology; Otosclerosis - complications; Otosclerosis - pathology; Otosclerosis - physiopathology; Otosclerosis - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the ear, the auditive nerve and the facial nerve; Tomography, X-Ray Computed; Treatment Outcome; Tympanic Membrane - pathology; Tympanoplasty; tympanosclerosis; Human; Ankylosis; Malleus; Middle ear disease; Anatomic pathology; Fixation; Histopathology; Treatment; Histological study; Ear ossicles; Tympanoplasty; Surgery; ENT disease; ossicular ankylosis; Tympanosclerosis
• ISSN: 0001-6489; 1651-2251
• DOI: 10.1080/00016480500390345

Conclusions. Malleus head fixation is a rare but not exceptional pathology. It may be apparently congenital or acquired, and can be associated with stapes fixation. In the acquired secondary process two histological types of malleus head fixation were found: the first corresponded to non-tympanosclerotic bone remodeling and the second to localized tympanosclerosis. Objective. To describe the histopathologic features of malleus head fixation and to correlate them with its clinical appearance. Material and methods. Ten patients with surgically proven malleus head fixation were included in this series. A fixed malleus head was resected via a transcanal approach in six patients, and attic bony fragments fixing the malleus head were removed via a mastoidectomy without disruption of the ossicular chain in four. Histopathologic studies were performed for both types of malleus head fixation. Results. Three types of acquired malleus head fixation were defined in accordance with the surgical and histopathological findings. Histologically, the first type presented with normal bone tissue, the second was characterized by non-tympanosclerotic bone remodeling and the third presented with a localized tympanosclerotic focus in the tympanic cavity.