Ossicular fixation caused by bone dust after saccus decompression surgery.
OBJECTIVE
To highlight the clinical and histologic features of ossicular fixation produced by bone dust during mastoid surgery.


BACKGROUND
Bone dust deposition in the middle ear may occur during temporal bone surgery, but the ossicular fixation that may result from it remains underreported.


METHODS
A case is reported of delayed conductive hearing loss after saccus decompression surgery resulting from ossicular fixation by bone dust deposition.


RESULTS
Six months after the initial surgery, the patient experienced a 45 dB conductive hearing loss. The findings on second-look tympanotomy were stapes fixation and round window niche occlusion by newly formed tissue. Histologic examination of the latter showed fibrosis and new bone formation in reaction to particles of bone dust. New bone formation is a frequent concomitant of fibrosis in the middle ear and is probably not a growth from the bone dust.


CONCLUSIONS
The use of high-speed drilling of bone in temporal bone surgery carries the risk of bone dust particle deposition in the middle ear. Measures are discussed that can be used to prevent this complication.
Devesa
P Martinez
PM
Royal National Throat, Nose and Ear Hospital, London, UK. pablo@2oto.fsnet.co.uk
Michaels
L
L
Wright
A
A
D001301:Audiometry, Pure-Tone; D001842:Bone and Bones; D019299:Decompression, Surgical; D004391:Dust; D004429:Ear Ossicles / Q000473:pathology / Q000601:surgery; D018159:Endolymphatic Hydrops / Q000601:surgery*; D004712:Endolymphatic Sac / Q000601:surgery*; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008416:Mastoid / Q000601:surgery; D008575:Meniere Disease / Q000601:surgery*; D010040:Otosclerosis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012444:Saccule and Utricle / Q000601:surgery*; D013701:Temporal Bone / Q000601:surgery*
D004391:Dust