Congenital fixation of the malleus and incus is an uncom-mon cause of conductive hearing loss. Congenital malleusbar is a term coined by Nomura et al.1to describe a barof bone extending from the malleus neck to the posteriorbony annulus. The bar fixes the malleus and ossicular chainin place. Preoperative evaluation of congenital malleus barby using temporal bone CT is difficult.1To date, congenitalmalleus bar has only been reported in the setting of congen-ital aural atresia or a narrow external auditory canal. In thestudy by Carfrae et al.,2a patient was found to have bilat-eral malleus bar and congenital aural atresia. Rehabilitationinvolves drilling or excising the bony or fibrous connectionthat impairs ossicular mobility. However, the drill-inducedhigh noise levels are harmful to the inner ear, and drillingat the malleus bar can induce sensorineural hearing loss andtinnitus. Despite these adverse effects of drilling, the highnoise levels during ear surgery cannot be reduced to anygreat extent. Trauma to the inner ear can only be avoided by minimizing noise. We report a case of congenital malleusbar with a normal external auditory canal that was treatedusing a fine microcurette and an interfaced silastic sheet.The conductive hearing loss improved after surgery.
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