Abstract：
Isolated malleus fractures are a rare occurrence with few reported cases in the literature. Symptoms include sudden otalgia, hearing loss, tinnitus and aural fullness. Work-up and diagnosis are based on a combination of thorough anamnesis and careful otoscopic evaluation or high-resolution computer tomography. We present two cases of isolated malleus handle fractures who were diagnosed based on a combination of pneumatic otoscopy and tympanometry. Both fractures were surgically repaired using hydroxyapatite bone cement as showcased in the supplemental video material. Post-operative audiometry showed improvement in the pure-tone-average of both patients as well as normalisation of tympanometry. Isolated malleus fracture should be suspected in cases of sudden hearing loss and tinnitus following digital manipulation of the outer ear canal together with a conductive hearing loss with a mostly high-frequent air-bone-gap and hypercompliant tympanometry with hypermobility of the tympanic membrane on pneumatic insufflation. Surgical repair of the fracture using bone cement has good hearing outcomes and leads to improvement in auditory symptoms.
摘要：
孤立的锤骨骨折很少发生，文献中报道的病例很少。症状包括突发性耳痛,听力损失,耳鸣和听觉丰满。检查和诊断是基于彻底的回忆和仔细的耳镜评估或高分辨率计算机断层扫描的组合。我们介绍了两例孤立的锤骨处理骨折，这些骨折是根据气动耳镜检查和鼓室术诊断的。如补充视频材料所示，两种骨折均使用羟基磷灰石骨水泥进行手术修复。术后测听显示，两名患者的纯音平均值均有所改善，鼓室测压恢复正常。在数字操作外耳道后突然出现听力损失和耳鸣的情况下，应怀疑孤立的锤骨骨折，以及传导性听力损失，主要是高频空气-骨间隙和高顺应性鼓室测量，鼓膜在充气吹气时活动过度。使用骨水泥对骨折进行手术修复具有良好的听力效果，并导致听觉症状的改善。
