Anatomopathology of the Superstructure of the Stapes in Patients with Otosclerosis (original) (raw)
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Hearing loss is the most prevalent chronic condition which can impact the quality of life not only of the individual who has hearing loss, but also their frequent communication partners, employers, family members, friends, and acquaintances. Otosclerosis is a localized hereditary disorder affecting endochondral bone of the otic capsule that is characterized by disordered resorption and deposition of bone. An otosclerotic lesion consists of areas of bone resorption, new bone formation, vascular proliferation and a connective tissue stroma. This present work has been undertaken to evaluate the patient of clinically suspected otosclerosis on the basis of patients history, clinical examination and audiological test (pure tone audiometry and impedence audiometry) who visited in the department
Otosclerosis: Experience With Stapes Surgery
Cureus, 2020
Introduction Otosclerosis is a disorder in which the footplate of the stapes is replaced by an abnormal bone, thereby affecting sound transmission to the inner ear at the level of the oval window. The solution to this condition is to reestablish this mechanism back to normal via the ossicular chain to the inner ear. The aim of stapes surgery is to improve the hearing level to thresholds appropriate enough to obviate the need for hearing aid. The hearing improvement achieved after surgery often lasts for many years. The purpose of the current study was to review our experience and find out the rate of success related to hearing outcomes after stapedotomy.
Otosclerosis and cochlear otosclerosis: a post mortem study on temporal bones
European review for medical and pharmacological sciences
We have chosen among many temporal bones of donors deceased individuals with concomitant otosclerosis, three particular cases, one with classic otosclerosis, another with cochlear otosclerosis with concomitant oval window ankylosis and another with cochlear otosclerosis without stapes fixation. The different histopathologic features are discussed and clinical and therapeutical guidelines are proposed.
Acta Oto-Laryngologica, 2020
Background: Ultra-high-resolution computed tomography (U-HRCT) utilizes a 1024 Â 1024 matrix with 0.25-mm section thickness, offering better spatial resolution than conventional multi-detector row CT to detect anatomic data for otologic surgery. Aims: We examined stapes footplate thickness using U-HRCT in relation to stapedotomy to predict the difficulty of the surgical procedure. Materials and methods: Subjects were 12 otosclerosis patients and 25 controls who underwent diagnostic U-HRCT. A profile curve (Hounsfield units) was used to measure stapes footplate thickness along a perpendicular line across the stapes footplate in a plane parallel to the lateral semicircular canal. Results: Footplate thickness was smaller at the midpoint than just before the anterior crus and just after the posterior crus. Interobserver variability was lowest at the midpoint, where foot plate thickness was significantly greater in the affected ear in otosclerosis patients compared with controls (0.60 ± 0.09 mm vs 0.46 ± 0.04 mm; p < .001). Otosclerosis patients were detected using U-HRCT with a high area under the curve. Difficulty in the stapes opening procedure correlated with stapes footplate thickness. Conclusions: Footplate thickness on U-HRCT correlated with temporal bone anatomy and corresponded to surgical difficulty. Significance: U-HRCT-derived anatomic data is useful for evaluating the stapes.
EPIDEMIOLOGICAL AND RADIOLOGICAL PATTERNS OF OTOSCLEROSIS: A RETROSPECTIVE STUDY (Atena Editora)
EPIDEMIOLOGICAL AND RADIOLOGICAL PATTERNS OF OTOSCLEROSIS: A RETROSPECTIVE STUDY (Atena Editora), 2023
Otosclerosis is one of the main causes of deafness in adults, characterized by primary osteodystrophy of the otic capsule and sensorineural hearing loss. Even though Computed Tomography (CT) is the exam of choice, the findings can be subtle, since knowledge of radiological patterns can avoid underdiagnosis. Starting from patients with compatible clinics, a survey of the epidemiological and radiological behavior was carried out in a Brazilian public health institution, comparing it with available literature data, aiming to increase diagnostic accuracy. A total of 31 patients with compatible clinical and tomographic findings were selected, and all images and corresponding reports were reviewed. As otosclerosis was clinically suspected in both mastoids of the 31 individuals studied, even if the CT evidence was only unilateral, both petrosal bones (62 in total) were included. Parameters such as age, sex and laterality were evaluated. The disease was graded using the Symons and Fanning Classification: grade 1, exclusively fenestral; grade 2, patchy localized cochlear disease, with or without fenestral involvement, and extension to the basal cochlear gyrus or middle/apical gyrus or both basal and middle/apical gyri; grade 3, diffuse confluent cochlear involvement with or without fenestral involvement. There was a higher prevalence in females (65%), in addition to bilateral involvement (54%) and in patients in the 4th decade of life (36%), followed by patients in the 5th decade (23%) and 3rd decade (19%). Of the 62 CT scans evaluated, 48 had findings of primary osteodystrophy of the otic capsule, with grade 1 otosclerosis being the most common (62%), followed by grade 2 (24%) and, less common, grade 3 (12%). Such data are consistent with current literature. Considering that the findings of otosclerosis may be tenuous, despite clinically compatible, the study of the epidemiological and radiological profile proves to be a useful tool to improve diagnostic accuracy.
Quantitative assessment of vestibular otopathology in otosclerosis: A temporal bone study
The Laryngoscope, 2015
To determine if peripheral vestibular otopathology is present in human temporal bones with otosclerosis. Comparative human temporal bone study. Seventy-four human temporal bones from 46 subjects with otosclerosis (mean age of 61 ± 18 years) and 20 within histologically normal limits from 17 subjects (mean age of 59 ± 14 years) were included in this study. Temporal bones with otosclerosis were divided into those with and without endosteal involvement. Using differential interference contrast microscopy at 1008× magnification, type I and type II vestibular hair cell counts were performed on each vestibular sense organ in which the neuroepithelia was oriented perpendicular to the plane of section. The organ-specific cell densities (cells/0.01 mm(2) surface area) were compared between the groups with and without endosteal involvement, and also compared to counts in the nonotosclerosis control group using Student's t-test. Mean type I and type II hair cell densities of all vestibular...
African Journal of Cellular Pathology
The aim of this study was to describe the pathologic changes in temporal bones with cochlear otosclerosis that may have implications for cochlear implantation. Fifteen human temporal bones with otosclerosis were used for this study. In each temporal bone was studied: (1) medial wall of the middle ear and in particular the horizontal segment of the facial nerve canal; (2) the round window niche and the corresponding part of the scala tympani; (3) the area of the labyrinthine segment and first genu of the facial nerve. Six temporal bones revealed otosclerotic pathology spanning the otic capsule between the cochlear endosteum and the facial nerve canal. The labyrinthine facial nerve was enveloped by otosclerosis in two cases, while the horizontal segment was involved in four temporal bones. Complete obstruction of the round window niche was observed in three cases, while round window niche obstruction was observed in four temporal bones. Otosclerosis presents difficulties for implant candidates. These otosclerotic changes with obstruction are usually present at the round window or at the scala tympani. The histology described underpins the need to counsel patients regarding the possibility of facial nerve stimulation and difficult implantation.
European Archives of Oto-Rhino-Laryngology, 2009
This study investigate the eVect of stapes surgery on bone conduction (BC) improvement in otosclerotic patients with mixed hearing loss and also compare the eVect of three diVerent types of surgery (complete stapedectomy, partial stapedectomy and microfenestration stapedotomy) on this improvement. We retrospectively reviewed surgical database of 84 otosclerotic patients with mixed hearing loss. Sixty-two patients (75%) had signiWcant improvement in BC after surgery (P = 0.03). In 85% of patients with follow-up time longer than 1 year, this improvement had remained. Improvement in BC after surgery was better in partial stapedectomy group (82.6%) and complete stapedectomy group (80.8%) in comparison with microfenestration stapedotomy group (63%) (P = 0.052).