title: Surgical Management and Hearing Outcome of Traumatic Ossicular Injuries.
abstract: OBJECTIVE
  The purpose of this study was to investigate etiological, clinical, and pathological characteristics of traumatic injuries of the middle ear ossicular chain and to evaluate hearing outcome after surgery.
  
  
  METHODS
  Thirty consecutive patients (31 ears) with traumatic ossicular injuries operated on between 2004 and 2015 in two tertiary referral otologic centers were retrospectively analyzed. Traumatic events, clinical features, ossicular lesions, treatment procedures, and audiometric results were evaluated. Air conduction (AC), bone conduction (BC), and air-bone gap (ABG) were analyzed preoperatively and postoperatively. Amsterdam Hearing Evaluation Plots (AHEPs) were used to visualize the individual hearing results.
  
  
  RESULTS
  The mean age at the moment of trauma was 27.9±17.1 years (range, 2-75 years) and the mean age at surgery was 33.2±16.3 years (range, 5-75 years). In 10 cases (32.3%), the injury occurred by a fall on the head and in 9 (29.0%) by a traffic accident. Isolated luxation of the incus was observed in 8 cases (25.8%). Dislocation of the stapes footplate was seen in 4 cases (12.9%). The postoperative ABG closure to within 10 and 20 dB was 30% and 76.7%, respectively.
  
  
  CONCLUSIONS
  Ossicular chain injury by direct or indirect trauma can provoke hearing loss, tinnitus, and vertigo. As injuries are heterogeneous, they require a tailored surgical approach. In this study, the overall hearing outcome after surgical repair was favorable.
authors.affiliation: Sint-Augustinus Hospital, European Institute for ORL-HNS, Wilrijk (Antwerp), Belgium. delrue.stefan@gmail.com.
authors.forename: Stefan
authors.initials: S
authors.lastname: Delrue
authors.forename: Nicolas
authors.initials: N
authors.lastname: Verhaert
authors.forename: Joost van
authors.initials: JV
authors.lastname: Dinther
authors.forename: Andrzej
authors.initials: A
authors.lastname: Zarowski
authors.forename: Thomas
authors.initials: T
authors.lastname: Somers
authors.forename: Christian
authors.initials: C
authors.lastname: Desloovere
authors.forename: Erwin
authors.initials: E
authors.lastname: Offeciers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications; D004429:Ear Ossicles / Q000293:injuries*; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000601:surgery*; D014950:Wounds, Penetrating / Q000150:complications / Q000601:surgery*; D055815:Young Adult