Isolated fracture of the manubrium of the malleus

W. Chien, M. J. McKenna, J. J. Rosowski, S. N. Merchant

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Objective: To describe a series of five patients with isolated fracture of the manubrium of the malleus. Design: Retrospective case series. Subjects: Five patients aged 44-64 years with isolated fracture of the manubrium who presented to our institution over a five-year period (2000-2005). Results: All patients presented with a history of digitally manipulating the external auditory canal, leading to the manubrial fracture, which we presume was due to a suction-type mechanism. Otomicroscopy often revealed a break in the smooth contour of the manubrium. All patients had air-bone gaps on audiometry, especially at higher frequencies. Tympanometry showed hypermobility of the tympanic membrane in four patients who were tested. Laser-Doppler vibrometry revealed increased umbo velocity in four out of five patients. Four patients were treated conservatively. One patient underwent exploratory tympanotomy with successful ossiculoplasty. Conclusions: Isolated fracture of the manubrium is a rare condition which may present as sudden-onset hearing loss after digital manipulation of the external auditory canal. The diagnosis can be made on the basis of otomicroscopy, audiometry, tympanometry and laser-Doppler vibrometry. Conservative treatment is often successful.

Original languageEnglish (US)
Pages (from-to)898-904
Number of pages7
JournalJournal of Laryngology and Otology
Issue number9
StatePublished - Sep 2008
Externally publishedYes


  • Conductive Deafness
  • Fracture
  • Malleus

ASJC Scopus subject areas

  • Otorhinolaryngology


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