otosclerosis

Question 1

what

Answer 1

remodelling of the small bones in middle ear

leading to conductive hearing loss

Question 2

when does it usually present

Answer 2

< 40yrs

Question 3

results from

Answer 3

combination of environmental and genetic facotrs

can be inherited in autosomal dominant pattern

more common in women

Question 4

pathophysiology

Answer 4

bones in middle ear (malleus, incus, stapes) are affected by abnormal bone remodelling and formation

esp base of stapes where it attaches to oval window

conductive hearing loss

Question 5

presentation

Answer 5

patient < 40yrs with unilateral or bilateral

• hearing loss
• tinnitus

low pitched sounds affected more

Question 6

OE

Answer 6

normal otoscopy

Weber’s heard loudest by affected ear, or normal if bilateral

Rinnes shows conductive hearing loss

Question 7

Ix

Answer 7

audiometry
tympanometry
high res CT

Question 8

initial Ix

Answer 8

audiometry

Question 9

management options

Answer 9

conservative - hearing aids

surgical - stapedectomy, stapedotomy

Question 10

Stapedectomy

Answer 10

remove entire stapes and replace with a prothesis

Question 11

Stapedotomy

Answer 11

remove part of stapes but leaving the base attached to oval window

small hole made in base for prosthetis to enter