Malleus head fixation: histopathology revisited.
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.
Martin
Christian
C
Department of Otolaryngology-Head and Neck Surgery, Saint-Etienne University Hospital Center, Saint-Etienne, France. christian.martin@chu-st-etienne.fr
Timoshenko
Andrei P
AP
Dumollard
Jean-Marc
JM
Tringali
Stéphane
S
Peoc'h
Michel
M
Prades
Jean-Michel
JM
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