Bilateral Oval and Round Window Atresia on CT Temporal Bone: A Rare Anomaly Clinically Mimicking Otosclerosis in an Adult.

We present a rare adult case of bilateral oval and round window atresia. Clinical and audiologic findings were suggestive of otosclerosis. High resolution CT Temporal bones showed unequivocal findings of bilateral oval and round window atresia. Atresia of these windows is a rare temporal bone anomaly. Presentation as an adult can confound the clinicians and warranting a closer look on the CT for atretic windows and subtle signs of otosclerosis in patients with conductive hearing loss.

Incudostapedial joint arthroplasty using temporalis fascia/perichondrium ties.

Incudostapedial joint dislocation is the most frequently found ossicular chain defect. In these cases reconstitution of joint capsule is important in maintaining joint integrity. But reconstruction of dislocated incudostapedial joint is a challenging procedure as this joint is devoid of any muscular or soft tissue support. Here we describe a technique designed to reposition the incudostapedial joint in its anatomical position using temporalis fascia or perichondrium. Data have been collected and analyzed from 42 patients with incudostapedial joint discontinuity. The fascial ties used for reconstruction of joint capsule ensure a dynamic union of the repositioned incus with stapes, leading to a significant improvement in conductive hearing loss.