Otosclerosis: Incidence of Positive Findings on High-Resolution Computed Tomography and Their Correlation to Audiological Test Data

Naumann, Ilka C.; Porcellini, B.; Fisch, Ugo

doi:10.1177/000348940511400910

Cited by 79 publications

(96 citation statements)

References 15 publications

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“…Lately, however, radiodiagnostic studies have approached 90 percent or higher sensitivities in diagnosing otosclerosis. The bases for diagnosing otosclerosis in literature arean increase or decrease in width of oval window and sclerotic or hypodense foci on or around footplate [5][6][7], thickened, irregular or hypodense footplate or presence of demineralized areas in temporal bone [4,8] and change in gray scale [9]. We have included the quantitative measurement of the thickness of footplate of stapes as additional decisive diagnostic indicator.…”

Section: Discussionmentioning

confidence: 99%

“…On examining images in both axial and coronal views without reconstruction, they found that 26 patients out of a total of 35 patients had a positive finding of a bony excrescence at or adjacent to the oval window. In 2001, Fraysse et al [10] described a sensitivity of 91.3% in finding otosclerosis on CT. Naumann et al [8] found a sensitivity of 85% in localizing an otosclerotic focus in 30 patients suspected to have otosclerosis in 2005, in which study they have commented upon the utility of planar reconstruction and 0.5 mm slices in increasing diagnostic yield. In the present study, multiplanar reconstruction allowed us to study the focus in the best possible plane and made detection easy and accurate.…”

Section: Discussionmentioning

confidence: 99%

“…Naumann et al [8] have explained the presence of two false negatives in their study of 44 CT scans, to be due to the fact that the inactive form of the lesion has the same density as the surrounding bone and therefore remains undetected, whereas lesions from the active otospongiotic form are more visible because they are hypodense as compared to the bone of the otic capsule. Fraysse et al [10] commented upon these 'infra-radiological' cases as being due to a beginning focus, it being present in 8.7% of the cases in their study.…”

Section: Discussionmentioning

confidence: 99%

“…Naumann et al [8] have illustrated the presence of isolated anterior oval window focus and have mentioned absence of positive radiological findings in two patients with such a locus. Vicente et al [12] describe the cases in their study to have a predominance of anterior oval window focus.…”

Section: Site Of Focusmentioning

confidence: 99%

“…They used sections of 1 or 0.5 mm with overlapping and no reconstruction. Naumann et al [8] studied the oval window by free rotation of the image at the time of reading, at the workstation. In the present study all scans were acquired in the axial plane and multiplanar reconstruction was done.…”

Section: Patient Positioningmentioning

confidence: 99%

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High Resolution Computed Tomography in Stapedial Otosclerosis

Priya

Singh

Upreti

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The value of high-resolution CT scanning in diagnosing stapedial otosclerosis and in influencing surgical planning was studied. 40 cases, consisting of patients of both genders, above the age of 14 years, with a clinical diagnosis of otosclerosis underwent HRCT of the temporal bones. Images were acquired in axial plane, with a bone algorithm, keeping slice thickness at 0.5 mm and intervals of 0.5 mm. Reconstruction of the volume data set was done to obtain overlapping slices in various planes, so as to obtain the best possible images of the footplate of stapes. The thickness of the footplate was measured and the site of lesion was noted in these images. On exploratory tympanotomy, the footplate was assessed and graded according to a visual scale. HRCT was able to diagnose stapedial otosclerosis in 85% ears. It was able to identify the presence of a thickened footplate correctly with a sensitivity of 85.3% (P value 0.16). It was able to correctly localize the site of otosclerotic focus in 85% cases (P value \0.01). Thus, an estimate of the thickness of the footplate likely to be encountered and thus the amount of drilling likely to be required to create a fenestra; and the likely site of maximum thickness could be made preoperatively. This study also established the value of multislice CT on the acquisition of such data. This method obviates the requirement of difficult patient positioning, reduces scanning time; while greatly improving the sensitivity of the scanning.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Site Of Focusmentioning

confidence: 99%

Section: Patient Positioningmentioning

confidence: 99%

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High Resolution Computed Tomography in Stapedial Otosclerosis

Priya

Singh

Upreti

et al. 2011

Indian J Otolaryngol Head Neck Surg

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Phenotype description of a Dutch otosclerosis family with suggestive linkage to OTSC7

Pauw

Huygen

Thys

et al. 2007

American J of Med Genetics Pt A

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This study reports on a clinical investigation of a Dutch family that shows suggestive linkage to OTSC7. Cross-sectional as well as longitudinal analyses of audiometric data were performed. Also, high-resolution computed tomography (CT) images of the temporal bones from genetically affected family members were obtained to study the incidence and extent of otospongiotic foci. Audiometric data showed a considerable degree of phenotypic variability. Cross-sectional regression analysis did not show age-dependent progression of bone conduction (BC), air conduction (AC), and air-bone gap (ABG) levels. Longitudinal analysis of audiometric follow-up data of one family member showed age-dependent progression of AC, BC, and ABG levels. High-resolution CT images revealed an otospongiotic focus in six of six (100%) clinically affected individuals that carried the disease haplotype. In none of the clinically unaffected family members that showed linkage to OTSC7, an otospongiotic focus was detected by CT. In conclusion, hearing impairment in the present otosclerosis family seems to be variable in terms of onset age and level of progression. Long-term audiometric data of one patient proved to be valuable in understanding progression of hearing impairment in this individual. The detection rate of otospongiotic foci in our study group is similar compared to previous reports on CT data in consecutive otosclerosis patients who had stapes replacing surgery.

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