Ossicular discontinuity may be caused by:

Ossicular discontinuity often results from a disruption in the continuity of the ossicular chain, which consists of three tiny bones in the middle ear: the malleus, incus, and stapes. Head trauma is a common cause of ossicular discontinuity, as physical impact can lead to fractures or dislocation of these bones. This traumatic injury can create a gap in the ossicular chain, impairing the efficient transmission of sound vibrations from the middle ear to the inner ear.

While otitis media, otosclerosis, and fixation can affect hearing and, to some extent, the ossicles, they generally do not lead to a discontinuity in the same direct way that trauma to the head does. Otitis media can cause fluid accumulation and possibly lead to ossicular necrosis but doesn't typically result in the acute and clear separation seen in trauma. Otosclerosis involves abnormal bone growth around the stapes, potentially leading to its fixation rather than discontinuity. Fixation refers to the inability of the ossicles to move freely, not a physical separation. Therefore, head trauma stands out as the primary cause of ossicular discontinuity.