title: Malleus head fixation: histopathology revisited.
abstract: 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.
  
  
  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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Saint-Etienne University Hospital Center, Saint-Etienne, France. christian.martin@chu-st-etienne.fr
authors.forename: Christian
authors.initials: C
authors.lastname: Martin
authors.forename: Andrei P
authors.initials: AP
authors.lastname: Timoshenko
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Dumollard
authors.forename: Stéphane
authors.initials: S
authors.lastname: Tringali
authors.forename: Michel
authors.initials: M
authors.lastname: Peoc'h
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Prades
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000473:pathology; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology; D006801:Humans; D008297:Male; D008307:Malleus / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D008875:Middle Aged; D010040:Otosclerosis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology; D014433:Tympanoplasty