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Resident's Page: Imaging
January 1999

Imaging Quiz Case 1

Arch Otolaryngol Head Neck Surg. 1999;125(1):108. doi:

Otosclerosis is the formation of highly vascularized spongy bone in parts of the temporal bone. The areas of predilection in decreasing order of incidence include the oval window, round window, footplate, internal auditory canal, and semicircular canal. When otosclerosis affects the stapes, it leads to fixation of the ossicle in the oval window. Otosclerosis has a tendency to affect women, with a male-female ratio of 1:2.1 Bilateral ear involvement is frequent. The disease tends to affect young adults, especially those in their 20s and 30s, and is hereditary in 75% of cases.1 The incidence of otosclerosis is thought to have declined since the introduction of fluoride into the water supply. Today, medical therapy is useful in inoperable cases of otosclerosis when cochlear involvement producing sensorineural hearing loss is present.2,3 Sodium fluoride works to decrease osteoclastic bone resorption and to prevent the formation of abnormal new bone. In all other cases, surgery is the desired modality of treatment. Traditional stapedectomy, in which the stapes footplate is removed, and stapedotomy, in which a small fenestra is made in the ossicle to accommodate a prosthesis, are appropriate surgical options.

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