Otosclerosis

Introduction Otosclerosis is a disease of unknown cause. Pathologically, it is due to the primary localized bone resorption of bone labyrinth, and it is called "hardening" on behalf of the vascular-rich spongy bone hyperplasia. When invading the egg garden window, it can cause the humerus to be fixed, lose the sound transmission function, and make the hearing progressively decline. The incidence of otosclerosis has a lot to do with human races. The incidence of whites is high, the incidence of blacks is the lowest, and the yellows are somewhere in between. The age of onset is more and more young and middle-aged. Progressive hearing loss in both ears or in one ear is the main symptom of this disease.

Cause

The cause is unknown, and the age of onset is between 20 and 40 years old. Foreign reports have more women than men, while domestic reports have slightly more men than women. It is generally believed that the dystrophic, endocrine effects and genetic factors of the lost bone shell may be related factors for the occurrence of this disease.

an examination

Related inspection

Otolaryngology CT examination of ear, nose and throat swab bacterial culture

1. Progressive hearing loss with tinnitus. There may be Wei's misunderstanding and mild dizziness.

2. Check: The tympanic membrane is thin or normal, can be SchwArtze sign (transparent red sign), the eustachian tube is smooth.

3. In the early stage, the hearing curve was mainly low frequency, the mid-term curve was flat, the bone conduction curve had CArhArt notch (Y notch), and the late stage was mixed . Gelle's test was negative.

4. The acoustic impedance measurement method shows that the sound is reduced, the drum curve is As-type, and the sacral muscle reflex disappears.

5. The mastoid X-ray film shows good gasification, and the X-ray multi-track tomographic film can show the hardening source of the bone labyrinth.

Differential diagnosis

Otosclerosis is divided into cochlear type and vestibular window type, and vestibular ectoral ocular sclerosis has similarities in appearance and performance of tympanosclerosis in HRCT, and thickening of tibia floor at maturity. The morphological structure is filled on the vestibular window to make the vestibular window narrow or closed, but the tympanic membrane is normal, and hardened plaque does not generally appear in the tympanic membrane and/or the tympanic cavity. Most of the mastoids are gasified.

Clinical manifestation

1. Deafness: Progressive hearing loss in both ears or in a single ear is the main symptom of this disease.

2. Tinnitus: About 20%-80% of patients have tinnitus. Tinnitus is mostly low-frequency, persistent or intermittent, and high-frequency tinnitus can occur in the later stage.

3. Webster's misunderstanding phenomenon: patients in the general environment to distinguish the difficulty of speech, in the noisy environment, the ability to listen to improve, this phenomenon is called Wei's misunderstanding.

4. Dizziness: A small number of patients have a brief mild vertigo during head movements.

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