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Acta Oto-laryngologica Jun 2021The bony otic capsule is comprised of highly mineralized and dense compact bone. It is rarely remodelled and degenerative changes, therefore, accumulate around the inner...
BACKGROUND
The bony otic capsule is comprised of highly mineralized and dense compact bone. It is rarely remodelled and degenerative changes, therefore, accumulate around the inner ear. It is also a predilection site for the pathological remodelling seen in otosclerosis. Morphometric studies have documented increased numbers of dead osteocytes and microcracks in the human otic capsule. Microcracks may disrupt the lacuno-canalicular network and cause osteocyte apoptosis ultimately breaking up the perilabyrinthine bone signalling pathways and dynamics. This may be important to understand the pathogenesis of remodelling diseases like otosclerosis.
AIMS/OBJECTIVES
This study describes the spatial and regional distribution of microcrack surface density in relation to the inner ear and compares it to that previously recorded for otosclerosis.
MATERIAL AND METHODS
Forty-two temporal bones and five ribs were used. All samples were undecalcified, bulk stained in basic fuchsin and plastic embedded. Unbiased stereology was used to estimate the true surface density of microcracks (mm/mm) in perilabyrinthine bone.
RESULTS
The surface density of microcracks accumulates around the inner ear spaces, particularly in the lateral window regions, and increases with age.
CONCLUSIONS AND SIGNIFICANCE
This study documents the spatial and temporal association between microfractures and otosclerosis in the otic capsule.
Topics: Ear, Inner; Female; Humans; Male; Otosclerosis; Ribs; Surface Properties; Temporal Bone
PubMed: 33825609
DOI: 10.1080/00016489.2021.1905875 -
Maedica Jun 2022To translate, adapt and validate in Greek the stapesplasty outcome test (SPOT)-25 quality of life questionnaire for patients with otosclerosis. SPOT-25 was translated...
To translate, adapt and validate in Greek the stapesplasty outcome test (SPOT)-25 quality of life questionnaire for patients with otosclerosis. SPOT-25 was translated to Greek and completed by otosclerosis patients on the day of diagnosis, the day before surgery and three months postoperatively. Fifty controls without any otological history, symptom or finding also completed the questionnaire. Pure-tone average was obtained both preoperatively and three months postoperatively. Test-retest evaluation on 56 patients was accepted. The Greek-SPOT-25 had an excellent internal consistency. All its items and subscales were significantly correlated between test and retest evaluation. Controls had significant lower SPOT-25 scores, and the postoperative scores were significantly lower than preoperative ones. Pure-tone average of four frequencies (PTA4) was significantly correlated to preoperative SPOT-25 total and subscales scores (P<0.001) before surgery and significantly correlated only with the "hearing function" subscale (p<0.05) postoperatively.
PubMed: 36032623
DOI: 10.26574/maedica.2022.17.2.306 -
Journal of Clinical Medicine Feb 2023Otosclerosis is an early adult-onset disease that is associated with 5-9% and 18-22% of all cases of hearing and conductive hearing loss, respectively, and it is...
Otosclerosis is an early adult-onset disease that is associated with 5-9% and 18-22% of all cases of hearing and conductive hearing loss, respectively, and it is suspected to have a viral etiology. However, the role of viral infection in otosclerosis is still inconclusive. This study aimed to investigate whether rubella infection was associated with otosclerosis risk. We conducted a nationwide case-control study in Taiwan. Data were retrospectively analyzed from the Taiwan National health Insurance Research Database. Cases consisted of all patients who were aged ≥6 years and had a first-time diagnosis of otosclerosis for the period between 2001 and 2012. The controls were exact matched to cases in a 4:1 ratio by birth year, sex, and must survive in the index year of their matched cases. Adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated by using conditional logistic regression. We examined 647 otosclerosis cases and 2588 controls without otosclerosis. Among the 647 patients with otosclerosis, 241 (37.2%) were male and 406 (62.8%) were female, with most aged between 40 and 59 years, with a mean age of 44.9 years. After adjusting for age and sex, conditional logistic regression revealed that exposure to rubella was not associated with a significant increase in otosclerosis risk (adjusted OR, 2.0; 95% CI, 0.18-22.06, = 0.57). In conclusion, this study did not show that rubella infection was associated with the risk of otosclerosis in Taiwan.
PubMed: 36902548
DOI: 10.3390/jcm12051761 -
American Journal of Otolaryngology 2021During pregnancy a woman's body undergoes many physiological changes that involve all systems and organs, including sensory ones. We conducted this systematic review to...
PURPOSE
During pregnancy a woman's body undergoes many physiological changes that involve all systems and organs, including sensory ones. We conducted this systematic review to highlight current evidence and treatment options in pregnant women with audio-vestibular disorders.
MATERIALS AND METHODS
A search was made on the following databases: PubMed, PubMed Central, Web of Science and Scopus. This research protocol was deposited in the PROSPERO Database.
RESULTS
After application of inclusion-exclusion criteria, 30 manuscripts were included in the review. Many authors (14/15) found a slight alteration of audiometric tests during pregnancy, with a reported recovery postpartum in most of the studies (5/7). Regarding sudden sensorineural hearing loss (SSNHL), we found four articles for a total of 69 patients: the treatment of choice was intravenous Dextran 40 and intra-tympanic corticosteroids. Most included studies (4/6) found neither clinical nor epidemiological associations between otosclerosis and pregnancy in large-based sample studies. Few investigations regarded Eustachian tube function and vertigo.
CONCLUSIONS
According to our results, many variations of hearing acuity during pregnancy are slight and transient and require only clinical observation. In large samples, otosclerosis appeared not to be associated with pregnancy. Clinicians should consider intra-tympanic steroids in managing SSNHL during pregnancy. Further more accurate research is needed to deepen and clarify the association between pregnancy and audio-vestibular disorders.
Topics: Adrenal Cortex Hormones; Dextrans; Female; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Infusions, Intravenous; Instillation, Drug; Otosclerosis; Pregnancy; Pregnancy Complications; Vertigo
PubMed: 34182351
DOI: 10.1016/j.amjoto.2021.103136 -
The Journal of Laryngology and Otology Oct 2021
Review
PubMed: 34702383
DOI: 10.1017/S0022215121003200 -
The International Tinnitus Journal Dec 2023The purpose of this paper is to show how temporal bone histopathology has been instrumental in adding knowledge about the origin of tinnitus in the cochlea and how it...
The purpose of this paper is to show how temporal bone histopathology has been instrumental in adding knowledge about the origin of tinnitus in the cochlea and how it will still be useful for that purpose in the future. The papers published on this subject will be reviewed, and their contributions will be highlighted. The knowledge that is now part of the subject will be pointed out, and future research on this area will be pointed out.
Topics: Humans; Tinnitus; Endolymphatic Hydrops; Cochlea
PubMed: 38050885
DOI: 10.5935/0946-5448.20230009 -
Orvosi Hetilap Dec 2019Otosclerosis is a bone remodeling disorder affecting exclusively the human temporal bone which causes small bony lesions in the otic capsule. The symptoms depend on the...
Otosclerosis is a bone remodeling disorder affecting exclusively the human temporal bone which causes small bony lesions in the otic capsule. The symptoms depend on the location and the extent of the otosclerotic foci. Hence, clinically the most relevant sign is the conductive hearing loss due to the stapedial otosclerosis with fixation of the stapes footplate. In many cases, the specific anamnestic features, the age of presentation and usually the absence of tympanic membrane pathology can provide a strong clinical suspicion for otosclerosis. Although audiometric and imaging examinations and VEMP testing can confirm our preoperative diagnosis, the histolopathologic examination of the removed stapes footplate is the most accurate way to determine the diagnosis. Orv Hetil. 2019; 160(51): 2007-2011.
Topics: Audiometry; Hearing Loss, Conductive; Humans; Otosclerosis; Stapes; Stapes Surgery
PubMed: 31838860
DOI: 10.1556/650.2019.31583 -
European Archives of... Aug 2022To analyse surgical and auditory outcomes after cochlear implantation in otosclerosis and to compare them to the outcomes in patients with post-lingual hearing loss with...
PURPOSE
To analyse surgical and auditory outcomes after cochlear implantation in otosclerosis and to compare them to the outcomes in patients with post-lingual hearing loss with different aetiology.
METHODS
Medical records of 17 subjects (22 ears) diagnosed with otosclerosis were compared to 21 controls (25 ears) matched by age, sex, duration of hearing loss and experience with cochlear implant in years. Demographic characteristics, surgical complications, facial nerve stimulation, number and reason for deactivated electrodes and auditory outcome (monosyllabic word score) were analysed. The auditory outcome was further evaluated according to the anatomical localisation of the otosclerotic lesions (grades) and compared between patients with active and deactivated electrodes.
RESULTS
Otosclerotic patients showed similar surgical outcome in comparison to the controls. A low frequency (13.6%) of facial nerve stimulation was observed in otosclerosis. A significantly higher (p = 0.014) number of deactivated electrodes (4.3%) in subjects with otosclerosis in comparison to non-otosclerosis patients (1.6%) was found. A trend of less speech discrimination of monosyllabic words (65%) in otosclerosis than in non-otosclerosis patients (80%) (p = 0.109) and no difference in the postoperative auditory assessment with regard to the disease grade and electrode disabling was found.
CONCLUSIONS
Cochlear implantation by otosclerosis provides excellent auditory outcome with a low rate of surgical complications. Alteration in fitting strategy as electrodes disabling is frequently needed to overcome complications as incomplete insertion, facial nerve stimulation and poor sound quality.
Topics: Cochlear Implantation; Cochlear Implants; Deafness; Hearing Loss; Humans; Otosclerosis; Retrospective Studies; Treatment Outcome
PubMed: 34741651
DOI: 10.1007/s00405-021-07157-x -
Acta Oto-laryngologica Mar 2023Otosclerosis is a common ear disease that causes fixation of the stapes and conductive hearing impairment. However, the pathogenesis of otosclerosis is still unknown....
BACKGROUND
Otosclerosis is a common ear disease that causes fixation of the stapes and conductive hearing impairment. However, the pathogenesis of otosclerosis is still unknown. Otosclerosis could be associated with the unique bony environment found in the otic capsule. Normal bone remodelling is almost completely absent around the inner ear after birth allowing degenerative changes and dead osteocytes to accumulate. High levels of inner ear anti resorptive osteoprotegerin (OPG) is most likely responsible for this capsular configuration. Studies have demonstrated how osteocyte lifespan variation creates occasional clusters of dead osteocytes, so-called cellular voids, at otosclerotic predilection sites in the human otic capsule. These cellular voids have been suggested as possible starting points of otosclerosis.
AIM
To describe the cellular viability in otosclerotic lesions and compare it to that of cellular voids.
MATERIALS AND METHODS
The study was based on unbiased stereological quantifications in undecalcified human temporal bones with otosclerosis.
RESULTS
Osteocyte viability was found to vary within the otosclerotic lesions. Furthermore, the results presented here illustrate that inactive otosclerotic lesions consist of mainly dead interstitial bone, much like cellular voids.
CONCLUSIONS AND SIGNIFICANCE
Focal degeneration in the otic capsule may play an important role in the pathogenesis of otosclerosis.
Topics: Humans; Bone Remodeling; Cell Survival; Ear, Inner; Osteocytes; Osteoprotegerin; Otosclerosis; Stapes; Temporal Bone
PubMed: 36639139
DOI: 10.1080/00016489.2023.2164904 -
Current Opinion in Otolaryngology &... Oct 2020This article reviews literature on the use of optical coherence tomography (OCT) in otology and provides the reader with a timely update on its current clinical and... (Review)
Review
PURPOSE OF REVIEW
This article reviews literature on the use of optical coherence tomography (OCT) in otology and provides the reader with a timely update on its current clinical and research applications. The discussion focuses on the principles of OCT, the use of the technology for the diagnosis of middle ear disease and for the delineation of in-vivo cochlear microarchitecture and function.
RECENT FINDINGS
Recent advances in OCT include the measurement of structural and vibratory properties of the tympanic membrane, ossicles and inner ear in healthy and diseased states. Accurate, noninvasive diagnosis of middle ear disease, such as otosclerosis and acute otitis media using OCT, has been validated in clinical studies, whereas inner ear OCT imaging remains at the preclinical stage. The development of recent microscopic, otoscopic and endoscopic systems to address clinical and research problems is reviewed.
SUMMARY
OCT is a real-time, noninvasive, nonionizing, point-of-care imaging modality capable of imaging ear structures in vivo. Although current clinical systems are mainly focused on middle ear imaging, OCT has also been shown to have the ability to identify inner ear disease, an exciting possibility that will become increasingly relevant with the advent of targeted inner ear therapies.
Topics: Ear Diseases; Humans; Tomography, Optical Coherence
PubMed: 32833887
DOI: 10.1097/MOO.0000000000000654