Repair of a malleus handle fracture using glass ionomer luting cement

Abstract

Isolated fracture of the manubrium of the malleus is a rare clinical entity. Clinical suspi- cion is paramount. The usual clinical presentation is acute otalgia followed by tinnitus and fluctuating hearing loss after a brisk introduction and withdrawal of a finger into the external auditory canal. On physical examination, the eardrum looks normal on otoscopy. Only in pneumatic otoscopy or otomicroscopy with Valsalva an abnormal motility of the manubrium could bee seen. High-resolution computed tomography (CT) or cone beam CT is able to show the fracture line. Several treatment options have been proposed, such as interposition of bone or cartilage between the manubrium and the incus, total or partial ossicular replacement prosthesis; and the use of bone cement. Glass ionomer luting cement, with wide use in dentistry, has been used in several otolo- gical procedures with good biocompatibility and results, however, to our best knowled- ge, it has not been used to repair this type of fractures, so we present this novel material in three cases.