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Otosclerosis
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Otosclerosis occurs in familial and non-familial forms. The familial form accounts for 25–50% of cases and has an autosomal dominant inheritance pattern with incomplete penetrance. Whilst a number of gene associations have been noted in affected families, the genetic cause of otosclerosis remains largely unidentified.
DRCOG MCQs for Circuit C Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
HRT may be administered by oral, subcutaneous, transdermal, intranasal, sublingual or vaginal routes. Owing to the first-pass effect through the liver, higher and not lower doses of oral oestrogen are required. Varicose veins are a relative contraindication for HRT, as is hypertension, smoking, diabetes, gallstones, migraines, fibroids, previous DVT, previous myocardial infarction, endometriosis and endometrial cancer. Otosclerosis is a relative contraindication. Absolute contraindications to HRT include active thromboembolic disease, breast cancer, pregnancy, severe, active liver disease and unexplained vaginal bleeding.
Otosclerosis
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Christopher P. Aldren, Thanos Bibas, Arnold J.N. Bittermann, George G. Browning, Wilko Grolman, Peter A. Rea, Rinze A. Tange, Inge Wegner
Otosclerosis can also occur when the tympanic membrane is abnormal, such as in chronic otitis media. This is because otosclerosis will occur in the same percentage of patients with such a condition as it does in the general population (approximately 2%).85 Thus, in patients with chronic otitis media, around 2% of them will have otosclerosis as an additive component to their conductive hearing impairment. This additive component only becomes apparent when stapes fixation is identified at surgery for pathology other than otosclerosis.
Do CT values change over time and correlate with hearing in the non-surgical ears of otosclerosis patients?
Published in Acta Oto-Laryngologica, 2022
Wei Chen, Yanqing Fang, Yue Geng, Naier Lin, Yan Sha
According to the statistical data of Jonathan et al. [7], the overall incidence of otosclerosis was 20 in 100,000 and the incidence of otosclerosis had a great relationship with race. The specific cause of the disease is still unclear. Related reports were indicating that the occurrence of otosclerosis might be related to genes. For instance, Zhang et al. [8] reported that the SP1 gene may be the causative gene of otosclerosis. Clinically typical otosclerosis has the following characteristics: family history, positive Schwartze sign, intact tympanic membrane, bilateral conductive hearing loss, Carhart’s notch, loss of stapedius reflex, negative Galley test and so on. However, when the above typical clinical manifestations are lacking, HRCT can be used to assist in the diagnosis of otosclerosis. Meanwhile, the diphosphonate bone single-photon emission CT and cone-beam CT are also the modalities for the diagnosis of otosclerosis. Temporal bone HRCT can not only find the characteristic low-density bone lesions of otosclerosis but also make plans for surgical treatment according to the location and scope of the lesion [9]. With the advancement of HRCT technology in recent years, the sensitivity of HRCT in diagnosing otosclerosis had greatly improved. The study by Vicente et al. [10] reported a detection rate of 87%, which was significantly higher than the detection rate (12%) obtained by the study of Huang et al. [11] in 1991. With the optimization of the resolution and the refinement of the scanning layer thickness, the HRCT examination for the diagnosis of otosclerosis had been more reliable.
Is routine preoperative computed tomography imaging justified in otosclerosis? A retrospective single-centre analysis
Published in Hearing, Balance and Communication, 2022
Mohamed Bassiouni, Hans-Christian Bauknecht, Katharina Stölzel, Steffen Dommerich, Heidi Olze
The inclusion criteria were met in 47 ears with surgically confirmed otosclerosis in 41 patients. Twenty patients were male, and 21 patients were female. The patients’ ages ranged from 16 to 65 years (mean 41.1 ± 11.6 years). The CT imaging data sets were reviewed by a neuroradiologist and an otolaryngologist. The image analysis by both the neuroradiologist and otolaryngologist detected otospongiotic changes in 36 ears, corresponding to a sensitivity of 76.5%. The absolute interobserver agreement was 86%, with good interobserver reliability (Cohen’s k-coefficient = 0.76). The neuroradiologist’s image reading was selected as the gold standard for further group analysis. In all 36 CT-positive ears, otosclerotic foci were observed in the antefenestral region (fenestral otosclerosis). Among those 36 ‘CT-positive’ ears, five ears (13.8%) showed additional signs of retrofenestral (cochlear) otosclerosis. No temporal bones showed an enlarged vestibular aqueduct, persistent stapedial artery, or an aberrant internal carotid artery.
Relationship between short-term and mid-term hearing outcomes after stapedotomy in patients with otosclerosis: an investigation
Published in Acta Oto-Laryngologica, 2021
Yanqing Fang, Ke-guang Chen, Yu Zhao, Nikita A. Menon, Austin J. Scholp, Yilai Shu, Bing Chen
We reviewed the clinical data of 60 patients with clinical otosclerosis who underwent stapedotomy at our hospital between February 2011 and March 2018. All patients had no previous history of ear surgery. All patients underwent bilateral surgery for clinical otosclerosis. Only auditory data from the ear that underwent surgery first were included in this study. The short-term and mid-term follow-up were within 1 month and between the first month and 1 year after operation, respectively. After reviewing all cases, five were excluded for incomplete audiological data before or after the first operation. Thus, 55 cases (15 males; 40 females) were included. Twenty-four cases were on the left ear (21 on the right). The median age was 36.3 ± 10.1 years (19–60 years). Audiometry data were collected before and after operation (including both short-term and mid-term follow-up). All patients met the diagnostic criteria for clinical otosclerosis.