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Misplaced incus: an unusual complication of a temporal bone fracture
  1. Katherine Pollaers1,
  2. Christopher Broadbent1 and
  3. Jafri Kuthubutheen2
  1. 1 Ear Nose and Throat Department, Royal Perth Hospital, Perth, Western Australia, Australia
  2. 2 Department of Otolaryngology Head Neck and Skull Base Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
  1. Correspondence to Dr Katherine Pollaers, katherine.pollaers{at}


A 24-year-old man sustained significant injuries as a result of a motor bicycle accident. CT scans demonstrated multiple intracranial injuries including bilateral temporal bone fractures. On emergence from sedation, the patient reported right-sided hearing loss which was attributed to ossicular chain disruption after the incus was found to be in the external auditory canal. Unexpectedly, the initial conductive hearing loss resolved with conservative management and an ossicular chain reconstruction was not required. This is an unusual case of impressive long-term good hearing outcomes following complete dislocation of the incus and extrusion from the middle ear.

  • ear, nose and throat/otolaryngology
  • otolaryngology/ENT

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  • Contributors JK and KP: prepared the manuscript. CB: provided audiology input and audiograms.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.