به نام خداوند جان و خرد

OtosclerosisBack ground:METABOLIC BONE DISEASE IN OTIC CAPSULE

1-GENETICALLY MEDIATED AUTOSOMAL DOMINANT

2-VIRUSES: MEASLES

SYMOTOMS: CHL – SNHL – MHL

AGE: 10 – 45 years

RACE – 10 % WHITE POPULATIONS

0.5% ASIANS

0.1% AFRICAN

75 – 80% BILATERAL

ETIOLOGY

1- EARLY OTOSPONGIOTIC PHASE

2- LATER OTOSCLEROTIC PHASE

PATHOPHYSIOLOGY

FREQUECY: HISTOLOGICALLY OTOSCLEROSIS: 10%

CLINICALLY OTOSCLEROSIS: 1%

MORTALITY & MORBIDITY:

1- CHL

2- SNHL

3- MHL

4-TINNITUS

5- VERTIGO

EPIDEMIOLOGY

RACE: MORE COMMON IN WHITE PERSONS

SEX: FEMALE -2

MALE -1

AGE: CLINICAL OTOSC. CAN MANFEST AS AGE

7 -8 YEARS

MOST COMMONLY IN AGE 15 – 35 YEARS

PICK INCIDECE: 3TH DECADE

1- HEARING LOSS: CHL – SNHL – MHL

2- TINNITUS

3- DIZZINESS

4- ROTATORY VERTIGO

SYMPTOMS

1- PUR TONE AUDIOMETRY

2- TYMPANOMETRY

3- TUNING FORKS TESTS: RINNE TEST WEBER

TEST

4- SCHWARTZE SIGN

PHYSICAL EXAMS

1- OTITIS MEDIA

2- CONGENTIAL STAPES FIXATIONS

3- GONGENITAL MALLEAL HEAD FIXATION

4- TYMPANOSCLEROSIS

5- PAGET DISEASE

6- OSTEOGENESIS IMPERFECTA

DIFERENTIAL DIAGNOSIS

1- CTSCAN: HALO SIGN

IMAGING STUDIES

OTHER TESTSDIAGNOSIS: COMBINATION OF

1- ADIOMETRIC TESTS:

A- CARHART NOTCH

B- SDS

C- TYMPANOGRAM

D- ABSENT STAPEDIUS REFLEX

2- HISTORICAL FEATURES

A- FINE – CUT CT SCANNING

B- VESTIBULAR TEST, NG

1- MEDICAL CARE

A- SODIUM FLUORIDE 20 – 120 mg/D

B- CALCIUM CARBONATE

C- VITAMIN D

EFFECTIVENESS:

A- DISAPPEARANCE OF SCHWARTZE SIGN

B.AUDIOMETRIC TESTS

C. FOLLOW UP CT SCANNING

2-HEARING AIDS

3-SURGICAL CARE

A- GENERAL ANEST.

B-LOCAL ANEST.

1-STAPEDECTOMY

2-STAPEDETOMY

TREATMENT

SNHL 1 – 2%

PERMANENT FACIAL N. INJURY PROBABLY <1 PER

1000 CASES

TYMPANIC MEMBRANE PERFORATIONS 1 – 2%

ALTERATION OF TASTE

DYSEQUILIBRIUM AND VERTIGO WITH NAUSEA AND

VOMITING.

TINNITUS

COMPLICATIONS

CHL 50 – 60 dB

SNHL TOTAL DEAFNESS

  

PROGNOSIS