Author(s)
Ryan Bishop, BS
Rishabh Sethia, MD
Edward Dodson, MD
Mai-Lan Ho, MD
Prashant Malhotra, MD
Affiliation(s)
Ohio State University College of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to recognize the imaging findings associated with pneumatized incus and differentiate this condition from other middle ear pathology.
Objectives: To describe a case of a child presenting with bilateral hearing loss found to have pneumatization of the right incus.
Study Design: Case report.
Methods: Using an illustrative case report, we describe the epidemiology, pathophysiology, diagnosis, and clinical implications of a pneumatized ossicle.
Results: Pneumatization of the ossicles is a rare anatomic variant that is thought to arise during development of the middle ear bones. The diagnosis is typically revealed on computed tomography scan of the temporal bone, which demonstrates air space within the involved ossicle. Awareness of this normal anatomic variant may prevent misdiagnosis of pathological changes of the middle ear bones, including congenital malformation of the ossicles or acquired ossicular chain erosions. The diagnosis may also become relevant when considering ossicular reconstruction, as the involved bone may show a greater propensity for fracture. In patients that demonstrate a pneumatized ossicle during evaluation of hearing loss, further evaluation is indicated to determine the true cause of hearing loss and to guide continued management.
Conclusions: While considered a normal anatomic variant, the diagnosis of ossicular pneumatization carries some clinical significance. In children presenting with hearing loss, a pneumatized ossicle should be differentiated from middle ear disease. This finding should prompt further testing to identify the true cause of hearing loss and prevent impairments in speech and language development, cognition, and learning.