Issue N# 4 - 2018
OTOLOGY
Surgical findings in patients with incorrect diagnosis of otosclerosis
Authors : Carvalho F, Portmann D, Montana F, Miguéis MC, Miguéis A. (Coimbra)
Ref. : Rev Laryngol Otol Rhinol. 2018;139,4:75-78.
Article published in english
Downloadable PDF document english
Summary :
Aim: Evaluate the surgical strategy and the results obtained in patients operated on for a false diagnosis of otosclerosis. Materials and methods: Retrospective study of 18 patients who underwent exploration of middle ear, with a suspicion of otosclerosis, not confirmed intraoperatively, between 2008 and 2018. Results: The study included 18 patients, mainly female (n= 12; 66.7%), with a median age of 45 years old (± 17.1). All patients consulted for hearing loss, 29.4% reported vestibular symptoms and 17.6% tinnitus. Pure tone audiometry showed a mixed hearing loss in 14 cases (77.8%), and a pure conductive hearing loss in 4 cases (22.2%). The most common surgical finding was the fixation of both ossicles, malleus and incus (n= 5). Other causes included: Lysis of the long process of incus (n= 4), attic fixation of the malleus to the tegmen (n= 3), stapes branches fibrosis (n= 2), herniation of the facial nerve (n= 2), ossification of stapes tendon and stapes suprastructure fracture in one case each. The treatment was evaluated case by case and depended on the type of alteration found. Conclusion: Although the audiogram and the CT scan currently define the provisional diagnosis, the definitive diagnosis is only confirmed during exploratory tympanotomy. The otologic surgeon should be able to identify and treat the different etiologies of a conductive hearing loss mimicking an otosclerosis.
Price : 12.00 €
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