gms | German Medical Science

The chronic otitis media is the most frequent cause of unilateral or bilateral hearing loss. Another cause of a rare and especially unilateral hearing loss could be a fracture of the petrous bone.

We report of a ten years old girl who presented a unilateral hearing loss for seven months on the right ear. The clinical examination showed an intact and nonirritated tympanic membrane. The pure tone audiogram revealed a conductive hearing loss of 40–50dB on the right side. On the left side no kind of hearing loss could be found. The tympanogram of the right side revealed an open curve shape. This could be a sign for a lack of contact between the ossicular chain of the middle ear.

Soon afterwards we performed a high-resolution CT-scan of the petrous bone. All mastoid cells were filled up with air and no hint for a fracture could be found. All bony structures of the petrous bone were configurated normally. Because of the persisting hearing loss the decision for an exploratory tympanotomy was made.

Intraoperative a dehiscence in the posterior wall of the external ear channel was found.

That was a clear sign for an undergone traumatisation of the petrous bone. Furthermore a luxation between the incus and the stapedial bone could be seen.

To reconstruct the auditory ossicle a tympanoplasty III (PORP Titan-Implantat 2,5 mm length) was implemented.

Afterwards the parents were consulted and an accident as possible event for the traumatisation could be determined. At that time a handball was thrown from a short distance directly on the child´s right ear. A medical consultation didn´t follow then.

In conclusion to that anamnesis should be deepened with regard to a trauma in cases of persisting conductive hearing loss and an open curve shape in the tympanogram.