-
Otology & Neurotology : Official... Jul 2019We hypothesize that internal auditory canal (IAC) diverticula occur independent of otosclerosis as demonstrated by temporal bone histopathology.
HYPOTHESIS
We hypothesize that internal auditory canal (IAC) diverticula occur independent of otosclerosis as demonstrated by temporal bone histopathology.
BACKGROUND
Diverticula at the anterior-inferior aspect of the IAC have been described histologically in the setting of cavitary otosclerosis. Recent radiographic studies show the prevalence of IAC diverticula that is higher than what can be accounted for by cavitary otosclerosis alone.
METHODS
We examined hematoxylin and eosin temporal bone histopathology slides with otosclerosis involving the IAC. We also examined bones from normal hearing subjects with normal histologic findings. Temporal bones were included if donors were more than 18 years of age at time of death and adequate horizontal cuts were available to evaluate the area of interest.
RESULTS
IAC diverticula were found in 33 of 47 (70%) temporal bones with IAC otosclerosis and in 5 of 20 (25%) normal temporal bones. The difference in mean pure tone averages (PTA) in the normal temporal bones with (PTA 7.3 ± 7) and without (PTA 8 ± 2) diverticula was not statistically significant (p = 0.86).
CONCLUSION
IAC diverticula which have been previously demonstrated to occur in the setting of cavitary otosclerosis can also occur independent from otosclerosis. Subjects with diverticula but without other temporal bone pathology have normal hearing thresholds.
Topics: Aged; Diverticulum; Ear, Inner; Female; Hearing; Hearing Tests; Humans; Male; Otosclerosis; Temporal Bone
PubMed: 31157724
DOI: 10.1097/MAO.0000000000002256 -
Indian Journal of Otolaryngology and... Dec 2022Otosclerosis is one of the common otologic diseases. The mechanism and the probable site of vestibular involvement are not yet fully understood. The present study aimed...
AIM
Otosclerosis is one of the common otologic diseases. The mechanism and the probable site of vestibular involvement are not yet fully understood. The present study aimed to perform a comprehensive vestibular evaluation in patients with otosclerosis, compared to the cases without otosclerosis.
MATERIALS AND METHODS
patients underwent a comprehensive cochleovestibular evaluation, including audiometry, ocular and cervical vestibular evoked myogenic potential (o-VEMP and c-VEMP), video head impulse (vHIT) and caloric tests. The results were compared with those obtained from the non-otosclerosis control group.
RESULTS
A total of 61 individuals were included in the study who were divided into two groups of the case (50.82%) and control (49.18%). The results showed that there was a significant difference in the mean vHIT gain between the case and control groups (P < 0.05). However, the gain was still within the normal range. Besides, the patients with otosclerosis had significant bilateral or unilateral weaknesses according to caloric test results. Moreover, their o-VEMP and c-VEMP results were significantly abnormal as well (P < 0.05).
CONCLUSION
Based on the results of the present study, the vestibular system even in asymptomatic cases, is affected by otosclerosis. Furthermore, it seems that the otolithic system has a higher chance of involvement, compared to the semicircular canals.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12070-022-03147-5.
PubMed: 36514435
DOI: 10.1007/s12070-022-03147-5 -
Hearing Research Nov 2015Bone conduction (BC) hearing relies on sound vibration transmission in the skull bone. Several clinical findings indicate that in the human, the skull vibration of the... (Review)
Review
Bone conduction (BC) hearing relies on sound vibration transmission in the skull bone. Several clinical findings indicate that in the human, the skull vibration of the inner ear dominates the response for BC sound. Two phenomena transform the vibrations of the skull surrounding the inner ear to an excitation of the basilar membrane, (1) inertia of the inner ear fluid and (2) compression and expansion of the inner ear space. The relative importance of these two contributors were investigated using an impedance lumped element model. By dividing the motion of the inner ear boundary in common and differential motion it was found that the common motion dominated at frequencies below 7 kHz but above this frequency differential motion was greatest. When these motions were used to excite the model it was found that for the normal ear, the fluid inertia response was up to 20 dB greater than the compression response. This changed in the pathological ear where, for example, otosclerosis of the stapes depressed the fluid inertia response and improved the compression response so that inner ear compression dominated BC hearing at frequencies above 400 Hz. The model was also able to predict experimental and clinical findings of BC sensitivity in the literature, for example the so called Carhart notch in otosclerosis, increased BC sensitivity in superior semicircular canal dehiscence, and altered BC sensitivity following a vestibular fenestration and RW atresia.
Topics: Biomechanical Phenomena; Bone Conduction; Cochlea; Ear, Inner; Electric Impedance; Humans; Labyrinthine Fluids; Models, Biological; Oval Window, Ear; Round Window, Ear; Vibration
PubMed: 25528492
DOI: 10.1016/j.heares.2014.12.003 -
AJNR. American Journal of Neuroradiology Nov 2017Focal low-attenuation outpouching or diverticulum at the anterolateral internal auditory canal is an uncommon finding on CT of the temporal bone. This finding has been...
BACKGROUND AND PURPOSE
Focal low-attenuation outpouching or diverticulum at the anterolateral internal auditory canal is an uncommon finding on CT of the temporal bone. This finding has been described as cavitary otosclerosis in small case reports and histology series. The purpose of this study was to establish the prevalence of internal auditory canal diverticulum and its association with classic imaging findings of otosclerosis and/or hearing loss.
MATERIALS AND METHODS
Temporal bone CT scans of 807 patients, obtained between January 2013 and January 2016, were retrospectively reviewed to identify internal auditory canal diverticula and/or classic imaging findings of otosclerosis. Clinical evaluations for hearing loss were reviewed for patients with internal auditory canal diverticula and/or otosclerosis.
RESULTS
Internal auditory canal diverticula were found in 43 patients (5%); classic otosclerosis, in 39 patients (5%); and both findings, in 7 patients (1%). Most temporal bones with only findings of internal auditory canal diverticula (91%) demonstrated hearing loss, with 63% of this group demonstrating sensorineural hearing loss. The hearing loss classification distribution was significantly different ( < .01) from that in the classic otosclerosis group and in the group with both diverticula and otosclerosis.
CONCLUSIONS
Internal auditory canal diverticula are not uncommon on CT examinations of the temporal bone and most commonly occur without classic imaging findings of otosclerosis. These lesions are associated with sensorineural hearing loss, and referral for hearing evaluation may be appropriate when present.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Diverticulum; Female; Hearing Loss, Sensorineural; Humans; Labyrinth Diseases; Male; Middle Aged; Otosclerosis; Prevalence; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 28982792
DOI: 10.3174/ajnr.A5399 -
Frontiers in Radiology 2022Otospongiotic plaques can be seen on conventional computed tomography (CT) as focal lesions around the cochlea. However, the resolution remains insufficient to enable...
PURPOSE
Otospongiotic plaques can be seen on conventional computed tomography (CT) as focal lesions around the cochlea. However, the resolution remains insufficient to enable evaluation of intracochlear damage. MicroCT technology provides resolution at the single micron level, offering an exceptional amplified view of the otosclerotic cochlea. In this study, a non-decalcified otosclerotic cochlea was analyzed and reconstructed in three dimensions for the first time, using microCT technology. The pre-clinical relevance of this study is the demonstration of extensive pro-inflammatory buildup inside the cochlea which cannot be seen with conventional cone-beam CT (CBCT) investigation.
MATERIALS AND METHODS
A radiological and a three-dimensional (3D) anatomical study of an otosclerotic cochlea using microCT technology is presented here for the first time. 3D-segmentation of the human cochlea was performed, providing an unprecedented view of the diseased area without the need for decalcification, sectioning, or staining.
RESULTS
Using microCT at single micron resolution and geometric reconstructions, it was possible to visualize the disease's effects. These included intensive tissue remodeling and highly vascularized areas with dilated capillaries around the spongiotic foci seen on the pericochlear bone. The cochlea's architecture as a morphological correlate of the otosclerosis was also seen. With a sagittal cut of the 3D mesh, it was possible to visualize intense ossification of the cochlear apex, as well as the internal auditory canal, the modiolus, the spiral ligament, and a large cochleolith over the osseous spiral lamina. In addition, the oval and round windows showed intense fibrotic tissue formation and spongiotic bone with increased vascularization. Given the recently described importance of the osseous spiral lamina in hearing mechanics and that, clinically, one of the signs of otosclerosis is the Carhart notch observed on the audiogram, a tonotopic map using the osseous spiral lamina as region of interest is presented. An additional quantitative study of the porosity and width of the osseous spiral lamina is reported.
CONCLUSION
In this study, structural anatomical alterations of the otosclerotic cochlea were visualized in 3D for the first time. MicroCT suggested that even though the disease may not appear to be advanced in standard clinical CT scans, intense tissue remodeling is already ongoing inside the cochlea. That knowledge will have a great impact on further treatment of patients presenting with sensorineural hearing loss.
PubMed: 37492684
DOI: 10.3389/fradi.2022.965474 -
BMC Medical Genetics Jun 2020Otosclerosis (OTSC) is among the most common causes of a late-onset hearing loss in adults and is characterized by an abnormal bone growth in the otic capsule.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Otosclerosis (OTSC) is among the most common causes of a late-onset hearing loss in adults and is characterized by an abnormal bone growth in the otic capsule. Alteration in the osteoprotegerin (OPG) expression has been suggested in the implication of OTSC pathogenesis.
METHODS
A case-control association study of rs2228568, rs7844539, rs3102734 and rs2073618 single nucleotide polymorphisms (SNPs) in the OPG gene was performed in a Tunisian-North African population composed of 183 unrelated OTSC patients and 177 healthy subjects. In addition, a multilocus association and a meta-analysis of existing studies were conducted.
RESULTS
Rs3102734 (p = 0.013) and rs2073618 (p = 0.007) were significantly associated with OTSC, which were predominantly detected in females after multiple corrections. Among the OPG studied SNPs, the haplotypes A-A-C-G (p = 0.0001) and A-A-C-C (p = 0.0004) were significantly associated with OTSC in females. Multilocus association revealed that the SNPs: rs2073618 in OPG, rs1800472 in TGFβ1, rs39335, rs39350 and rs39374 in RELN, and rs494252 in chromosome 11 showed significant OTSC-associated alleles in Tunisian individuals. In addition, meta-analysis of the rs2073618 SNP in Tunisian, Indian and Italian populations revealed evidence of an association with OTSC (OR of 0.826, 95% CI [0.691-0.987], p = 0.035).
CONCLUSIONS
Our findings suggest that rs3102734 and rs2073618 variants are associated with OTSC in North African ethnic Tunisian population. Meta-analysis of the rs2073618 in three different ethnic population groups indicated an association with OTSC.
Topics: Alleles; Case-Control Studies; Chromosome Mapping; Epistasis, Genetic; Female; Gene Frequency; Genetic Association Studies; Genetic Loci; Genetic Predisposition to Disease; Haplotypes; Humans; Linkage Disequilibrium; Male; Models, Biological; Odds Ratio; Osteoprotegerin; Otosclerosis; Polymorphism, Single Nucleotide; Reelin Protein
PubMed: 32493243
DOI: 10.1186/s12881-020-01036-8 -
Journal of Audiology & Otology Jul 2017A free-beam-type CO laser, which use a micromanipulator mounted on a microscope as the delivery system, has the merit of not being affected by hand tremor at the time of...
BACKGROUND AND OBJECTIVES
A free-beam-type CO laser, which use a micromanipulator mounted on a microscope as the delivery system, has the merit of not being affected by hand tremor at the time of shooting. However, this delivery system has several disadvantages, including a restricted operation range and a risk of incorrect focusing. A fiber-type CO laser uses a hand-held delivery system and has the opposite merits and demerits. We compared the results of stapes surgery with free-beam and fiber type delivery systems.
SUBJECTS AND METHODS
The study enrolled 36 patients who underwent stapedotomy with free-beam- (n=26) or fiber- (n=10) type CO lasers. The air-bone (AB) gap closure, bone conduction (BC) change, and operating time were evaluated. The AB gap closure was calculated by subtracting the preoperative BC thresholds from the postoperative air conduction thresholds. The BC change was calculated by subtracting the postoperative BC thresholds from the preoperative BC thresholds.
RESULTS
The mean operating time was significantly (=0.035) shorter in the fiber-type group (72.5±8.2 min) than in the free-beam-type group (80.5±11.4 min). The mean AB gap closure did not differ significantly (=0.297) between the free-beamand fiber-type groups (5.8±10.1 and 1.4±6.8 dB, respectively). The mean BC change did not differ significantly (=0.873) between the free-beam- and fiber-type groups (2.4±6.9 and 2.8±5.3 dB, respectively). The hearing outcomes did not differ significantly between the two groups.
CONCLUSIONS
Operating times were significantly shorter using the fiber-type CO laser, while hearing outcomes did not differ significantly between the two groups.
PubMed: 28704897
DOI: 10.7874/jao.2017.21.2.103 -
European Annals of Otorhinolaryngology,... May 2023Otosclerosis can severely impact quality of life, but no questionnaire is available in French. The present study aimed to adapt and validate a French version of the...
AIMS
Otosclerosis can severely impact quality of life, but no questionnaire is available in French. The present study aimed to adapt and validate a French version of the SPOT-25.
MATERIALS AND METHODS
A controlled prospective study was conducted between September 2021 and April 2022. The translation used the "forward-backward" technique and statistical validation was performed in non-operated adult otosclerosis patients (cases) and a control group. Assessment Internal consistency, discrimination performance and test-retest reliability were assessed on global score, subscores and items.
RESULTS
Fifty-one cases and 58 control subjects filled out the test questionnaire and 35 of the 51 cases, also filled out the retest. Internal consistency on Cronbach alpha was 0.95 for the cases. Median total SPOT-25 score was 44 (range, 10-78) for cases and 2 (range, 0-33) for controls (p= P<0.0001). Test-retest reliability on intraclass correlation coefficient was excellent (ICC=0.92; [95% CI, 0.84-0.96]). Individual items all showed satisfactory performance.
CONCLUSION
The French version of SPOT-25 was short and easy to use, with satisfactory performance in assessing quality of life in otosclerosis patients.
Topics: Adult; Humans; Language; Otosclerosis; Prospective Studies; Quality of Life; Reproducibility of Results; Surveys and Questionnaires
PubMed: 36631327
DOI: 10.1016/j.anorl.2022.12.004 -
Ear, Nose, & Throat Journal Jun 2018The incidence of otosclerosis in nonendemic patients is low, and preoperative diagnosis can be challenging. The aim of this study was to evaluate computed tomography...
The incidence of otosclerosis in nonendemic patients is low, and preoperative diagnosis can be challenging. The aim of this study was to evaluate computed tomography (CT) findings in patients with otosclerosis and determine their correlation with audiometric findings and surgical outcome in a nonendemic population. We retrospectively reviewed 17 patients from August 2011 to August 2013 with surgically confirmed otosclerosis who underwent preoperative high-resolution CT scans and pre- and postoperative audiometry. Otosclerotic foci were identified on the scans. The density ratio of these foci was calculated and compared with pre- and postoperative audiometric parameters. One patient with Paget disease was excluded from the study. A total of 19 ears were operated on and included in the data analysis. CT scans were normal in 4 ears (21.1%). Hypodense lesions were detected in the remaining 15 (78.9%) ears and the region of interest mapped out. The density ratio was obtained between the hypodense area and adjacent normal labyrinthine bone. No statistically significant correlation was found between the density ratio and any of the audiometric parameters tested (p > 0.05). The diagnosis of otosclerosis in nonendemic areas is challenging. A preoperative CT scan can be useful when otosclerotic foci are present. However, the density ratio of the otosclerotic foci did not correlate with audiometric parameters or surgical outcome.
Topics: Adult; Aged; Audiometry, Pure-Tone; Female; Humans; Male; Middle Aged; Otosclerosis; Postoperative Period; Retrospective Studies; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 30036411
DOI: 10.1177/014556131809700612 -
American Journal of Otolaryngology 2022This study aimed to discuss the different surgical approach, functional hearing results, which are applied to patients operated with a diagnosis of otosclerosis in our... (Comparative Study)
Comparative Study
OBJECTIVE
This study aimed to discuss the different surgical approach, functional hearing results, which are applied to patients operated with a diagnosis of otosclerosis in our clinic.
METHODS
This study includes 92 ears of 84 patients who were operated with the diagnosis of otosclerosis. Air bone gap was calculated before and after the operation in all patients. In addition, endoscopic and microscopic methods can be compared and statistically tested whether there is a difference in air bone gap averages and surgical success. Of the 92 ears operated, 56 were right (61%) and 36 were left (39%). Otosclerosis was detected bilaterally in 61 patients (73%) and unilaterally (27%) in 23 patients. The duration of follow-up ranges from 6 month to ten years, on average 28 months.
RESULTS
In the microscopic operation group, the air pathway measurement was mean 55.58 dB preoperatively and mean 38.42 dB postoperatively, with a mean decrease of 17.16 dB determined. The decrease between the preoperative and postoperative air pathway values was determined to be statistically significant (t:7.20, p < 0.001). In the microscopic operation group, the air-bone gap value was mean 30.50 dB preoperatively and fell by 15.90 dB to 14.60 dB postoperatively. In the endoscopic group, the air-bone gap value was mean 32.32 dB preoperatively and fell by 13.51 dB to 18.81 dB postoperatively.
CONCLUSIONS
Stapes surgery is a successful method with high success rate and low complication rates in the treatment of otosclerosis. The success rate of endoscopic and microscopic stapes surgery is similar. However, endoscopic stapes surgery is specific and difficult otological surgery that must be performed by surgeons specialised on this subject.
Topics: Adult; Audiometry, Pure-Tone; Bone Conduction; Endoscopy; Female; Follow-Up Studies; Hearing; Humans; Male; Microsurgery; Middle Aged; Otosclerosis; Postoperative Complications; Postoperative Period; Stapes Surgery; Treatment Outcome
PubMed: 34543947
DOI: 10.1016/j.amjoto.2021.103242