Progressive sensorineural hearing loss and cochlear otosclerosis: A prospective study

Abstract

The association of otosclerosis with reduced bone conduction is well known but no experimental or valid clinical relationship has been established to confirm this relationship. The purpose of this presentation is to demonstrate a clinical relationship between otosclerosis and sensorineural hearing loss. Experimental proof will await the accumulation and study of temporal bones of those individuals who, in life, exhibited the clinical relationship to be developed in this dissertation. The material presented is from the author's private practice during the years 1974, 1975 and 1976. Patients presenting the clinical problem of progressive sensorineural hearing loss were examined in depth including diagnostic audiology and polytomography of the petrosa. This thesis shows that a high percentage of such diagnostic problems are due to cochlear otosclerosis, the diagnosis being clinically supported roentgenologically.

Cochlear Otosclerosis: An Undiagnosed Cause of Progressive Sensorineural Hearing Loss

“…15 In the past, Freeman also had emphasized the importance of polytomography as he could identify 53 cases of cochlear OS in his series of 100 consecutive cases of progressive SNHL. 8 In the present era, HRCT scan of temporal bone is considered to be of immense value in diagnosing cochlear OS. 16,17 Radiologically, it appears as a hypodense lesion or an area of irregularity or increased thickness in the otic capsule.…”

“…These include post meningitis cochlear ossification, post-concussion, CNS syphilis, Meniere's disease, noise exposure and endocrinopathy. 8 Early identification of any possible cause of progressive SNHL helps in initiation of treatment. High resolution computed tomography (HRCT) scan can be used to make a definitive diagnosis of cochlear OS when it is suspected to be the cause of progressive SNHL.…”

Imaging of otosclerosis

“…Although the detection of otosclerosis-related lesions has already been achieved by polytomographic examinations [24,25], and today even very small lesions can be depicted much more precisely by modern X-ray cross-sectional imaging [26][27][28][29], patients with a typical clinical otosclerosis constellation are often treated surgically without imaging. In the case of a combined or sensorineural hearing loss, a request for imaging is often made under the indication "unexplained hearing loss".…”