Hi,
Thank you for your query.
1. The benefit of any exploratory tympanotomy must outweigh the risk of worsening the hearing or
tinnitus (ringing sound in the ear).
2. An HRCT (
High Resolution CT) and an MRI study of the Temporal Bones will demonstrate any ossicular discontinuity without opening the ear surgically.
3. A
conductive hearing loss of more than 60 dB will be seen with complete ossicular discontinuity. Hearing loss will be more in the higher frequencies. A tympanogram may show a hypermobile ear drum.
4. An incomplete ossicular discontinuity may cause a fluctuating hearing loss.
5. Treatment should be conservative, however, any ossicular fracture is unlikely to heal. There will usually be union by
fibrosis and there may also be
bone necrosis if the delicate blood supply to the distal part of the ossicle bone is destroyed.
6. In the event that a surgery is planned, the ossicular chain may have to be replaced, resulting in some amount of hearing loss as the lever ratio of the ossicles cannot be replaced with conventional techniques.
7. The management of tinnitus depends upon its severity on a scale of 1 to 10.
Regards.