The Role of Imaging in the Diagnosis and Management of Otosclerosis

Abstract

This systematic review indicates that imaging has a useful role in both the diagnosis and management of otosclerosis, supported principally by Level III/IV evidence.

Diagnostic efficacy and therapeutic impact of computed tomography in the evaluation of clinically suspected otosclerosis

“…The PPV of 100 % is a reliable measure and is in keeping with previous studies [4]. Recent studies [19] have also demonstrated >90 % sensitivity of CT in diagnosing otosclerosis. There remain a small percentage of infra-radiological cases, which can only be confirmed during surgery and this is either due to small submillimetre foci, or due to foci of 'inactive disease', which have the same density as the surrounding bone [20,21].…”

Decisive Criteria Between Stapedotomy and Cochlear Implantation in Patients with Far Advanced Otosclerosis

“…Virk et al reviewed 37 articles and found that imaging has a useful role in both the diagnosis and management of otosclerosis supported by level III/IV evidence, with newer multi-detector scanners demonstrating a sensitivity and specificity in excess of 90% (19). We believe that a preoperative high-resolution CT scan is useful not only to confirm a doubtful diagnosis but also to evaluate the extension of lesions, predict surgical difficulties, and rule out purely cochlear otosclerosis or other diagnoses.…”

“…The role of CT scan in otosclerosis continues to be debated even though several recent publications and systematic reviews recommend it as the gold standard for diagnosis (18,19). Virk et al reviewed 37 articles and found that imaging has a useful role in both the diagnosis and management of otosclerosis supported by level III/IV evidence, with newer multi-detector scanners demonstrating a sensitivity and specificity in excess of 90% (19).…”

Cochlear Implant Users with Otosclerosis: Are Hearing and Quality of Life Outcomes Worse than in Cochlear Implant Users without Otosclerosis?

“…It lacks sensitivity as the presence of intraoperative ossification has frequently been reported even in the absence of any ossification on the scan [Castillo et al, 2014] but has high specificity with higher grades of otosclerotic changes on CT [Rotteveel et al, 2004]. However, studies over the last 8 years report high detection rates in excess of 90% for fenestral otosclerosis since the advent of more advanced multidetector scanners and techniques [Virk et al, 2013]. Twelve of our 22 otosclerotic subjects had been implanted before 2010, a fact that could explain why signals of ossification were not observed in some CT images.…”