Although otosclerosis is usually considered a bilateral disease, Stacy Guild1 in 1944 demonstrated conclusively that hi stologic otosclerosis, at least, can be unilateral. In 1,161 skulls, he found histologic otosclerosis in 49. Of the 46 positive skulls in which both temporal bones were available for study, 32 had bilateral histologic otosclerosis, and 14 had unilateral histologic otosclerosis. It was his conclusion that unilateral otosclerosis does occur and that it is not infrequent. On the basis of his findings, 30.4% of patients with histologic otosclerosis have unilateral involvement. This is, of course, in marked contrast to what is reported clinically. In Dr. Hoople's2 series, for example, 12.4% of the patients had unilateral disease. In Mr. Cawthorne's3 series 2.4% of otosclerotics had only unilateral involvement. Cawthorne felt that many patients with unilateral deafness would not seek advice. We agree with him but feel that part of the problem
DONALDSON JA, SELTERS WA. Unilateral Conductive Hearing Loss Without Middle Ear Inflammation. Arch Otolaryngol. 1961;74(6):635–638. doi:10.1001/archotol.1961.00740030648006
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