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JAAPA : Official Journal of the... Feb 2017Otosclerosis is a complex and progressive disease of pathological bone remodeling that affects the otic capsule of the temporal bone, resulting in hearing loss. Although...
Otosclerosis is a complex and progressive disease of pathological bone remodeling that affects the otic capsule of the temporal bone, resulting in hearing loss. Although traditional diagnostic methods are still used, improvements in technology and research have paved the way for additional diagnostic techniques and advancements. The traditional treatment of otosclerosis, stapes surgery, is now being augmented or replaced by innovations in hearing aid technology and cochlear implants. Earlier diagnosis of otosclerosis can occur through understanding of the cause, risk factors, and current diagnostic testing.
Topics: Acoustic Impedance Tests; Audiometry; Hearing Aids; Hearing Loss, Conductive; Humans; Otosclerosis; Stapes Surgery; Tomography, X-Ray Computed
PubMed: 28060022
DOI: 10.1097/01.JAA.0000511784.21936.1b -
Otolaryngologic Clinics of North America Apr 2018Diagnostic audiologic procedures for otosclerosis are effective tools in identifying this condition. Audiometric data usually demonstrate a conductive hearing loss at... (Review)
Review
Diagnostic audiologic procedures for otosclerosis are effective tools in identifying this condition. Audiometric data usually demonstrate a conductive hearing loss at the early stages of otosclerosis. Modern middle ear analysis procedures are becoming more popular in the better diagnosis of otosclerosis. In clinical practice, cochlear otosclerosis can also be observed. Audiologic rehabilitation of otosclerosis includes fitting of hearing aids and implantable hearing devices. Current hearing technology enables patients who do not pursue surgical correction to function well and significantly improve their communication and quality of life. Otosclerosis may also be associated with annoying tinnitus, and tinnitus management is important in the rehabilitation process.
Topics: Acoustic Impedance Tests; Audiometry, Pure-Tone; Audiometry, Speech; Cochlear Implants; Cognitive Behavioral Therapy; Ear, Middle; Hearing Aids; Hearing Loss, Conductive; Humans; Otosclerosis; Tinnitus
PubMed: 29397946
DOI: 10.1016/j.otc.2017.11.007 -
RoFo : Fortschritte Auf Dem Gebiete Der... Aug 2020Otosclerosis is an important cause of hearing loss and a widespread pathology in ENT medicine. Although a high diagnostic value of CT with impact on therapy is... (Review)
Review
BACKGROUND
Otosclerosis is an important cause of hearing loss and a widespread pathology in ENT medicine. Although a high diagnostic value of CT with impact on therapy is emphasized in the literature, the disease is seldom seen in the radiological routine diagnostics due to ENT findings often being diagnostic. Radiologists detect it rather more often in cases of unclear hearing loss or cochlear implant candidates. The findings may be very subtle. They require a target search and an optimal imaging technique.
METHODS
This review article is based on a selective search of the literature in PubMed without any time frame restrictions as well as on the long clinical experience of the authors.
RESULTS
The paper focuses on imaging aspects of otosclerosis: current role, advice for imaging technique, characteristic imaging signs, radiological differential diagnoses and findings after stapedoplasty. Pathology, clinical signs and therapeutic options are summarized briefly.
CONCLUSIONS
With an optimal technique and sufficient radiological experience otosclerosis can be correctly diagnosed by imaging in a high percentage of cases. Radiology plays the key role in the diagnosis of retrofenestral otosclerosis. It can provide valuable information for the management of complications after stapedotomy.
KEY POINTS
· X-ray cross-sectional imaging continues to be the method of first choice in the radiological diagnostics of otosclerosis. · With an optimal imaging technique and sufficient experience otosclerosis can be radiologically detected. · In complications after stapedoplasty, causes can be identified supporting the indication for a reoperation.
CITATION FORMAT
· Kösling K, Plontke SK, Bartel S. Imaging of otosclerosis. Fortschr Röntgenstr 2020; 192: 745 - 753.
Topics: Cochlear Implants; Diagnosis, Differential; Hearing Loss; Humans; Otosclerosis; Postoperative Complications; Reoperation; Stapes Mobilization
PubMed: 32215901
DOI: 10.1055/a-1131-7980 -
Otolaryngologic Clinics of North America Apr 2018Otosclerosis/otospongiosis is a primary osteodystrophy of the otic capsule that affects genetically predisposed individuals and leads to progressive hearing loss.... (Review)
Review
Otosclerosis/otospongiosis is a primary osteodystrophy of the otic capsule that affects genetically predisposed individuals and leads to progressive hearing loss. Diagnosis is usually clinical, based on the findings of anamnesis, physical examination, and audiometric evaluation. However, high-resolution computed tomography scan and MRI have played an important role in the diagnosis and therapeutic approach of otosclerosis and in assisting in the differential diagnosis. The therapeutic approach is aimed at preventing, or at least minimizing, disease progression while attempting to restore hearing. The use of sodium fluoride and bisphosphonates can be an important adjunct, perhaps even primary treatment, in managing active lesions.
Topics: Diphosphonates; Hearing Loss; Hearing Tests; Humans; Magnetic Resonance Imaging; Otosclerosis; Randomized Controlled Trials as Topic; Sodium Fluoride; Tomography, X-Ray Computed
PubMed: 29502728
DOI: 10.1016/j.otc.2017.11.006 -
Otolaryngologic Clinics of North America Apr 2018The management of stapes fixation using transcanal endoscopic ear surgery is a viable alternative approach. The advantages of transcanal endoscopic ear surgery are... (Review)
Review
The management of stapes fixation using transcanal endoscopic ear surgery is a viable alternative approach. The advantages of transcanal endoscopic ear surgery are improved visualization and illumination of the stapes and oval window regardless of the size and geometry of the external auditory canal. Footplate work and prosthesis placement pose significant but surmountable challenges using transcanal endoscopic ear surgery secondary to the lack of depth perception. Several recent studies demonstrate the efficacy and safety of transcanal endoscopic ear surgery.
Topics: Endoscopy; Humans; Operative Time; Otosclerosis; Postoperative Complications; Stapes Surgery
PubMed: 29395112
DOI: 10.1016/j.otc.2017.11.011 -
JAMA Sep 2021
Topics: Deafness; Famous Persons; History, 18th Century; History, 19th Century; Music; Osteitis Deformans; Otosclerosis; Syphilis
PubMed: 34546309
DOI: 10.1001/jama.2020.18134 -
Otology & Neurotology : Official... Jan 2021To investigate the evolving prevalence of otosclerosis in a large urban population.
OBJECTIVE
To investigate the evolving prevalence of otosclerosis in a large urban population.
METHODS
A retrospective review of patients in a large, urban, public health system was conducted from January 2010 to August 2019 to identify subjects with otosclerosis. Diagnostic testing included audiometry and computed tomography scans. Sex, age at diagnosis, treatment received, race, ethnicity, and country of birth were analyzed for each subject and compared with all eligible patients in the reference population.
RESULTS
A total of 134 patients from a reference population of 672,839 were diagnosed with otosclerosis and analyzed. The otosclerosis patients were predominantly Hispanic (73%), of which the majority were foreign born (87%). The average age at onset was 46 years and 59% were women. The overall prevalence of otosclerosis was 20 of 100,000 patients. The crude prevalence of otosclerosis by ethnicity was 43 of 100,000 for Hispanics, 12.6 of 100,000 for Caucasians, and 3 of 100,000 for African Americans. Within the Hispanic population, the prevalence of otosclerosis was 60 of 100,000 for foreign-born individuals and 16 of 100,000 for those born in the USA (odds ratio [OR] = 3.69, [95% confidence interval [CI], 2.02-6.76], p < 0.0001). Prevalence was not significantly different among Caucasians and US-born Hispanics.
CONCLUSION
Otosclerosis in the studied population was most common among Hispanic patients, though it was strongly influenced by country of birth. The "imported" otosclerosis cases are best explained by environmental influence rather than ethnic susceptibility. This discrepancy is likely due to variance in measles immunization rates among North and Central American countries before 1990.
Topics: Female; Hispanic or Latino; Humans; Male; Otosclerosis; Retrospective Studies; Urban Population; White People
PubMed: 33201078
DOI: 10.1097/MAO.0000000000002870 -
Otolaryngologic Clinics of North America Apr 2018Controversies have been associated with the etiology, diagnosis, evaluation, and management of otosclerosis since Valsalva first described stapes fixation as a cause of... (Review)
Review
Controversies have been associated with the etiology, diagnosis, evaluation, and management of otosclerosis since Valsalva first described stapes fixation as a cause of hearing loss. Although the exact mechanism of the bone remodeling associated with otosclerosis remains uncertain, stapedotomy has been accepted as the surgical treatment of most patients with stapedial otosclerosis. There remains a disparity of opinion, however, regarding the role of preoperative imaging, surgical technique, implant selection, and medical therapy for cochlear otosclerosis. In addition, opinions vary regarding the optimal postoperative care of patients undergoing stapedotomy and a patient's ability to participate in activities that may result in barotrauma.
Topics: Audiometry, Pure-Tone; Barotrauma; Diphosphonates; Hearing Loss, Conductive; Humans; Laser Therapy; Ossicular Prosthesis; Otosclerosis; Stapes; Stapes Surgery; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 29502731
DOI: 10.1016/j.otc.2017.11.017 -
Otolaryngology--head and Neck Surgery :... Dec 2019The objective of this study was to provide a proof of concept and to assess the success and safety of stapes surgery for otosclerosis under local anesthesia in an...
OBJECTIVE
The objective of this study was to provide a proof of concept and to assess the success and safety of stapes surgery for otosclerosis under local anesthesia in an office-based setting (OBS) as compared with a hospital operating room setting (ORS).
STUDY DESIGN
Retrospective cohort study.
SETTING
We reviewed all patients who underwent stapes surgery by the same surgeon from October 2014 to January 2017 at our tertiary care center (ORS, n = 36, 52%) and in an OBS (n = 33, 48%).
SUBJECTS AND METHODS
The surgical technique was identical in both groups. All patients had a temporal bone computed tomography scan and audiogram within the 6 months prior to surgery. Air-bone gaps (ABGs), bone conduction, and air conduction pure tone average values were calculated. Preoperative results for pure tone average, bone conduction, ABG, and word recognition scores were compared with early (4 months) and late (12 months) follow-up audiograms. Intra- and postoperative complications were compared.
RESULTS
Both groups were comparable in terms of demographic characteristics and severity of disease. The mean 1-year postoperative ABG was 5.66 dB (95% CI = 4.42-6.90) in the ORS group and 6.30 dB (95% CI = 4.50-8.10) in the OBS group ( = .55). ABG improved by 24.27 dB (95% CI = 21.40-27.13) in the ORS group and 23.15 dB (95% CI = 18.45-27.85) in the OBS group ( = .68). Complication rates did not differ, although this study remains underpowered.
CONCLUSIONS
In this small group of patients, the success of stapes surgery performed in an OBS and its complications were comparable to those of an ORS, thus providing an alternative to patients on long operating room waiting lists.
Topics: Ambulatory Surgical Procedures; Female; Hospitalization; Humans; Male; Middle Aged; Otosclerosis; Patient Selection; Postoperative Complications; Proof of Concept Study; Retrospective Studies; Stapes Surgery; Treatment Outcome
PubMed: 31570044
DOI: 10.1177/0194599819877652 -
The Journal of Laryngology and Otology Mar 2022Otosclerosis affects women twice as often as men, especially during fertile age. A role of female hormones has been claimed, but controversy still exists regarding the...
OBJECTIVE
Otosclerosis affects women twice as often as men, especially during fertile age. A role of female hormones has been claimed, but controversy still exists regarding the influence of pregnancy. The purpose of this research was to analyse the role of pregnancy on the course of otosclerosis.
METHOD
PubMed was searched in May 2019 using the terms 'otosclerosis AND pregnancy', 'otosclerosis AND pregnant', 'otosclerosis AND parous', 'otosclerosis AND parity', and 'otosclerosis AND puerperium'. Age at diagnosis, number of pregnancies and the temporal relationship of the disease with childbearing were considered.
RESULTS
From 65 articles, 11 were chosen for review. They described 2323 women affected by otosclerosis: 1805 had at least 1 pregnancy, while 518 did not. During childbearing, otosclerosis began in 1 per cent of pregnant women, worsened in 21 per cent and worsened during puerperium in 4 per cent. Often, the authors reported hearing change with pregnancy without details, so a further group has been considered composed of women belonging to any of the groups just mentioned or to another group of women not further characterised. Overall, hearing change occurred during pregnancy in 44 per cent. A statistically significant correlation emerged between hearing change and number of pregnancies (p = 0.003).
CONCLUSION
Because of wide data heterogeneity and the difficulty in analysing a single factor, absolute statements could not be formulated. According to this review, pregnancy seems to have a worsening effect on the course of otosclerosis.
Topics: Female; Humans; Otosclerosis; Pregnancy; Pregnancy Complications
PubMed: 34819176
DOI: 10.1017/S0022215121003601