به نام خداوند جان و خرد
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به نام خداوند جان و خرد . Otosclerosis. Back ground: METABOLIC BONE DISEASE IN OTIC CAPSULE. ETIOLOGY. 1-GENETICALLY MEDIATED AUTOSOMAL DOMINANT 2-VIRUSES: MEASLES SYMOTOMS: CHL – SNHL – MHL AGE: 10 – 45 years RACE – 10 % WHITE POPULATIONS 0.5% ASIANS 0.1% AFRICAN 75 – 80% BILATERAL.

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2572077

به نام خداوند جان و خرد


2572077

Otosclerosis

  • Back ground:

  • METABOLIC BONE DISEASE IN OTIC CAPSULE


Etiology

ETIOLOGY

1-GENETICALLY MEDIATED AUTOSOMAL DOMINANT

2-VIRUSES: MEASLES

SYMOTOMS: CHL – SNHL – MHL

AGE: 10 – 45 years

RACE – 10 % WHITE POPULATIONS

0.5% ASIANS

0.1% AFRICAN

75 – 80% BILATERAL


Pathophysiology

PATHOPHYSIOLOGY

1- EARLY OTOSPONGIOTIC PHASE

2- LATER OTOSCLEROTIC PHASE


Epidemiology

EPIDEMIOLOGY

FREQUECY: HISTOLOGICALLY OTOSCLEROSIS: 10%

CLINICALLY OTOSCLEROSIS: 1%

MORTALITY & MORBIDITY:

1- CHL

2- SNHL

3- MHL

4-TINNITUS

5- VERTIGO


2572077

RACE: MORE COMMON IN WHITE PERSONS

SEX: FEMALE -2

MALE -1

AGE: CLINICAL OTOSC. CAN MANFEST AS AGE 7 -8 YEARS

MOST COMMONLY IN AGE 15 – 35 YEARS

PICK INCIDECE: 3TH DECADE


Symptoms

SYMPTOMS

1- HEARING LOSS: CHL – SNHL – MHL

2- TINNITUS

3- DIZZINESS

4- ROTATORY VERTIGO


Physical exams

PHYSICAL EXAMS

1- PUR TONE AUDIOMETRY

2- TYMPANOMETRY

3- TUNING FORKS TESTS: RINNE TEST WEBER TEST

4- SCHWARTZE SIGN


Diferential diagnosis

DIFERENTIAL DIAGNOSIS

1- OTITIS MEDIA

2- CONGENTIAL STAPES FIXATIONS

3- GONGENITAL MALLEAL HEAD FIXATION

4- TYMPANOSCLEROSIS

5- PAGET DISEASE

6- OSTEOGENESIS IMPERFECTA


Imaging studies

IMAGING STUDIES

1- CTSCAN: HALO SIGN

  • OTHER TESTS

  • DIAGNOSIS: COMBINATION OF

  • 1- ADIOMETRIC TESTS:

  • A- CARHART NOTCH

  • B- SDS

  • C- TYMPANOGRAM

  • D- ABSENT STAPEDIUS REFLEX

    2- HISTORICAL FEATURES

    A- FINE – CUT CT SCANNING

    B- VESTIBULAR TEST, NG


Treatment

TREATMENT

1- MEDICAL CARE

A- SODIUM FLUORIDE 20 – 120 mg/D

B- CALCIUM CARBONATE

C- VITAMIN D

EFFECTIVENESS:

A- DISAPPEARANCE OF SCHWARTZE SIGN

B.AUDIOMETRIC TESTS

C. FOLLOW UP CT SCANNING

2-HEARING AIDS

3-SURGICAL CARE

A- GENERAL ANEST.

B-LOCAL ANEST.

1-STAPEDECTOMY

2-STAPEDETOMY


Complications

COMPLICATIONS

SNHL 1 – 2%

PERMANENT FACIAL N. INJURY PROBABLY <1 PER 1000 CASES

TYMPANIC MEMBRANE PERFORATIONS 1 – 2%

ALTERATION OF TASTE

DYSEQUILIBRIUM AND VERTIGO WITH NAUSEA AND VOMITING.

TINNITUS


Prognosis

PROGNOSIS

CHL 50 – 60 dB

SNHL TOTAL DEAFNESS


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