Congenital Absence of Stapes: A Case Report

Abstract The congenital anomalies of the ossicular chain of the middle ear can exhibit various manifestations. Congenital middle ear anomalies are a rare cause of conductive hearing loss, with stapes fixation being the most common ossicular malformation. Among them, the congenital absence of the stapes is a rare condition. A 21-year-old male presented with decreased hearing in his right ear since childhood. Based on the clinical and audiological report, stapes fixation was suspected. An exploratory tympanotomy was performed, and there was congenital absence of stapes with malformed incus. The incus remnant was refashioned and placed over the oval window region. Postoperative audiogram did not show improvement in hearing. Reconstruction in cases of congenital absence of stapes is a challenge. The clinician should consider the various differential diagnosis of ossicular malformations when stapes fixation is suspected as the clinical diagnosis. This will help in better counseling of different options for surgical management and postoperative hearing outcomes.