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The diagnosis of stapedial otosclerosis and of stapedial combined with cochlear otosclerosis is easily made from the history and hearing tests. The diagnosis of pure cochlear otosclerosis producing a sensorineural hearing loss without a conductive component is a more difficult problem. There are three types of cases where a pure sensorineural hearing loss is probably of otosclerotic origin: (1) when a patient has a bilaterally symmetrical sensorinueral hearing loss with unilateral stapes ankylosis; (2) when a patient has several relatives who have undergone stapes surgery and he has a pure progressive sensorineural hearing loss that began in early or middle adult life; (3) a patient with a pure progressive sensorineural loss and a strongly positive Schwartze sign.
The positive diagnosis of cochlear otosclerosis can be made by histologic section of the temporal bones after death. Recently it has become possible to make the positive diagnosis during life by polytome laminography.
Shambaugh GE. Clinical Diagnosis of Cochlear (Labyrinthine) Otosclerosis. Arch Otolaryngol. 1966;83(2):160. doi:10.1001/archotol.1966.00760020162013
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