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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 -
Current Otorhinolaryngology Reports Mar 2022This review briefly covers the history of stapedectomy, discusses the indications and problems encountered with revision surgery, and provides case examples with...
PURPOSE OF REVIEW
This review briefly covers the history of stapedectomy, discusses the indications and problems encountered with revision surgery, and provides case examples with solutions.
RECENT FINDINGS
Revision surgery is challenging and successful outcome even in the most experienced specialists is 45-71%, which is far less than that of primary surgery.
SUMMARY
Careful evaluation of the reasons for reoperation, anticipation of the common problems, and patient education on reasonable expectations are all very important for success.
PubMed: 36204712
DOI: 10.1007/s40136-021-00379-x -
Romanian Journal of Morphology and... 2023Otosclerosis is a bone condition affecting the stapes bone within the otic capsule, and its exact cause is still unknown. It is characterized by a lack of proper...
Otosclerosis is a bone condition affecting the stapes bone within the otic capsule, and its exact cause is still unknown. It is characterized by a lack of proper remodeling of newly formed vascular and woven bone, leading to the development of abnormal osteons and the formation of sclerotic bone. Bilateral otosclerosis is seen in 80% of patients and 60% of otosclerosis patients have a family history of the condition. The etiology of this disease is still unknown, there are lots of theories to explain it. The histopathological (HP) studies of otosclerosis showed that osteoblasts, osteoclasts, vascular proliferation, fibroblasts, and histiocytes were observed in the stapes footplate. The onset of the symptoms occurs by the early third decade of life, usually it doesn't start later. In otosclerosis, the energy exerted by sound at the level of the tympanic membrane is reduced in the inner ear due to the fixation and rigidity of the ossicular chain, leading to hearing loss, especially for low frequencies. The primary clinical symptom of otosclerosis is conductive hearing loss but it is important to note that sensorineural hearing loss and mixed hearing loss can also occur as secondary symptoms of the condition. Another symptom present in patients with otosclerosis is tinnitus. The paper carried out a retrospective study of 70 patients diagnosed with otosclerosis in the Department of Otorhinolaryngology of Emergency City Hospital, Timişoara, Romania, between January 2021 to December 2022. Tissue fragments were processed at Service of Pathology by standard Hematoxylin-Eosin staining. The HP diagnosis was completed using Masson's trichrome staining, Giemsa histochemical staining, and immunohistochemical (IHC) reactions with anti-cluster of differentiation (CD)20, anti-CD3, anti-CD4, anti-CD8, anti-CD34, and anti-CD31 antibodies. The microscopic examination showed a chronic diffuse inflammatory infiltrate that consisted predominantly of mature T-lymphocytes, immunohistochemically positive for CD3, CD4 and CD8. There were also present rare CD20-positive B-lymphocytes. Among the lymphocytes, relatively numerous mast cells were identified, highlighted histochemically by the Giemsa staining. They had numerous purple-violet intracytoplasmic granules. In the connective tissue support, a relatively rich vascular network was identified, consisting of hyperemic capillaries, highlighted immunohistochemically with anti-CD31 and anti-CD34 antibodies. Bone tissues trabeculae showed extensive areas of fibrosis. The collagen fibers were highlighted by Masson's trichrome staining, being stained in green, blue, or bluish green.
Topics: Humans; Otosclerosis; Retrospective Studies; Stapes; Hearing Loss, Conductive; Hearing Loss, Sensorineural; Deafness
PubMed: 37518876
DOI: 10.47162/RJME.64.2.09 -
Cureus Aug 2020Otosclerosis is a common cause of conductive hearing loss which is an autoimmune inflammatory disorder related to abnormal bone remodeling of the human otic capsule that... (Review)
Review
Otosclerosis is a common cause of conductive hearing loss which is an autoimmune inflammatory disorder related to abnormal bone remodeling of the human otic capsule that has complex etiopathogenesis attributed to genetics, autoimmunity, viral infection, inflammation, hormonal factor, environmental factor, and disturbed bone metabolism. It has a prevalence of 0.3%-0.4% in Caucasians, which makes up 5-9% of all hearing loss and 18-22% of all conductive hearing loss. This review article aims to study the postulated role of sustained measles virus infection in the etiopathogenesis of otosclerosis, among others. A PubMed search of the related topic identified 97,990 articles. After we applied the inclusion and exclusion criteria, it was determined that 52 articles were relevant, which included 38 observational studies, 13 review articles, and a systematic review. Among them, 33 observational studies, 13 review articles and a systematic review spotted a positive association between persistent measles virus infection and otosclerosis. On the contrary, five observational studies reported no evidence of the association. The majority of the current literature supported the presence of the measles virus component in the otosclerotic stapes samples and its role in the etiopathogenesis of otosclerosis. Measles virus infection may have the amplitude to initiate a pathological process, which in the presence of other factors like autoimmunity and genes plays a significant role in causing otosclerosis. However, other studies have failed to show the presence of the measles virus component in otosclerotic stapes. So, more studies are needed to probe the role of persistent measles virus infection in the etiopathogenesis of otosclerosis.
PubMed: 32968571
DOI: 10.7759/cureus.9908 -
Ear, Nose, & Throat Journal Jan 2021The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult...
The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult and children. There remains a significant underutilization of cochlear implant technology in the United States, and recognition of the potential benefits of cochlear implantation for non-traditional indications is critical for encouraging the evolution of candidacy criteria. Adult cochlear implantation candidacy has progressed from patients with bilateral profound sensorineural hearing loss (SNHL) to include patients with greater degrees of residual hearing, single-sided deafness and asymmetric hearing, and atypical etiologies of hearing loss (eg, vestibular schwannoma, Ménière's disease, and otosclerosis). Indications for pediatric cochlear implantation have similarly evolved from children with bilateral severe to profound SNHL to implanting children at a younger age, including those with residual hearing, asymmetric hearing loss, inner ear malformations, as well as cochlear nerve deficiency. In this editorial, the literature investigating cochlear implantation for nontraditional indications is reviewed with an aim to use the best available evidence to encourage the evolution of candidacy criteria.
Topics: Adult; Child; Cochlear Implantation; Female; Hearing Loss; Humans; Male; Patient Selection; United States
PubMed: 32804575
DOI: 10.1177/0145561320947258