case_images: PMC7396058_01
case_images: Preoperative and postoperative hearing levels: (a) preoperative pure-tone audiometry (PTA) showing bilateral conductive hearing impairment; (b) postoperative PTA showing an improvement in hearing in the right ear.
case_images: CRIOT2020-8828969.001.jpg
case_images: PMC7396058_01_CRIOT2020-8828969.001.jpg
case_images: fig1
case_images: Pure-tone audiometry showed an air-bone gap of 42.5 dB in the right ear and 56.3 dB in the left ear (Figure 1).
case_images: Axial view of preoperative temporal bone CT: (a) a bony bar from the posterior wall of the tympanic cavity connects to the malleus neck (arrow); (b) the long process of the incus is poorly visualized, suggesting incudostapedial disconnection (arrow).
case_images: CRIOT2020-8828969.002.jpg
case_images: PMC7396058_01_CRIOT2020-8828969.002.jpg
case_images: fig2
case_images: Computed tomography (CT) revealed a bony bar connecting the malleus neck to the posterior tympanic wall and a long, thin process of the incus in the right ear (Figure 2).
case_images: Intraoperative findings of the right middle ear: (a) the malleus neck connects to the posterior wall of the tympanic cavity via a bony bar (arrow), which is located inside the chorda tympani (arrowhead); (b) the malleus bar is shown by the arrow. The lenticular process of the incus is absent, and the long process is disconnected from the stapes (arrowhead).
case_images: CRIOT2020-8828969.003.jpg
case_images: PMC7396058_01_CRIOT2020-8828969.003.jpg
case_images: fig3
case_images: At the right tympanoplasty (see the video in the supplemental files), we found a thick bony bar adjacent to the chorda tympani (Figure 3). The handle and neck of the malleus were disconnected, and the long process of the incus was short and connected to the stapes via fibrous tissue (Figure 3(b)).