Traumatic Stapes Luxation into the Vestibule

Abstract

We report a rare case of traumatic stapes luxation into the vestibule. A 31-year-old female visited an emergency room with sudden onset of vertigo and conductive hearing loss after accidental penetrating injury to the right ear. Temporal bone computed tomography detected pneumolabyrinth, with a shade of whole intact stapes in the vestibule. Under exploratory tympanotomy, we observed a separated incudostapedial joint, and the stapes was depressed into the vestibule. The stapes was pulled out to the middle ear, and stapedectomy was performed; the crus were cut, the suprastructure was removed, and the fractured footplate and the long process of the incus were connected with a piston wire. The stapes footplate was sealed with soft tissue and surgical glue. Vertigo rapidly subsided after surgery, and hearing was improved to normal range. However, hearing loss at high frequencies was not recovered, probably because of inner ear damage due to the stapes depressed into the vestibule or surgical manipulation within the vestibule. Traumatic ossicular dislocation is not an uncommon occurrence in otolaryngologic practice, but stapes luxation is rare. Here, we report a rare case with successful repair. This report could serve as a basis for proper treatment in similar cases in the future.