title: [Attical fixation of the malleus head associated with obstruction of the round window niche by a high jugular bulb].
abstract: OBJECTIVE
  To report the case of a 52 year-old-woman presenting with a left mixed hearing loss. Surgical exploration revealed an attical fixation of the malleus head associated with obliteration of the round window by a high jugular bulb.
  
  
  METHODS
  Surgical exploration revealed this rare association. Attical fixation of the malleus head was treated by a partial prosthesis. The mobility of the chain was normal at the end of the surgical exploration but it was not possible to search for the round window sign because the niche of the round window was obliterated by an high Jugular bulb.
  
  
  RESULTS
  Audiogram was unchanged even if CT-scan confirm the good position of the partial prosthesis.
  
  
  CONCLUSIONS
  Surgical treatment of an attical fixation of the malleus head do not seem to be necessary if it is associated with a simultaneous obliteration of the round window. Indeed, obstruction of the round window by a high Jugular bulb can caused a conductive hearing loss.
authors.affiliation: Service d'ORL et de Chirurgie Cervico-faciale, C.H.U. Bellevue, Boulevard Pasteur, 42055 Saint-Etienne Cedex 02.
authors.forename: S
authors.initials: S
authors.lastname: Tringali
authors.forename: P
authors.initials: P
authors.lastname: Bertholon
authors.forename: C
authors.initials: C
authors.lastname: Martin
mesh_terms: D005260:Female; D005924:Glomus Jugulare / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000601:surgery; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008307:Malleus / Q000601:surgery*; D008875:Middle Aged; D009998:Ossicular Prosthesis; D012405:Round Window, Ear / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed