Diagnostic efficacy and therapeutic impact of computed tomography in the evaluation of clinically suspected otosclerosis

Dudau, Cristina; Salim, Fakhruddin; Jiang, Dan; Connor, Steve

doi:10.1007/s00330-016-4446-8

Cited by 31 publications

(31 citation statements)

References 20 publications

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“…Identifying retrofenestral and endosteal margin involvement remains challenging notwithstanding that retrofenesteral otosclerosis is less common than fenesteral disease[ 8 , 10 , 14 ]. Studies have reported the limitations of HRCT in diagnosing retrofenestral otosclerosis with Dudau et al[ 19 ] suggesting a sensitivity of 58%. The main areas of interest in retrofenesteral otosclerosis are the cochlear, pericochlear, and the areas anterior to the round window niche[ 1 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of high resolution computed tomography in otosclerosis

Kanzara¹,

Virk²

2017

WJCC

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AIMTo determine the sensitivity and specificity of high resolution computed tomography (HRCT) in the diagnosis of otosclerosis.METHODSA systematic literature review was undertaken to include Level I-III studies (Oxford Centre for Evidenced based Medicine) that utilised HRCT to detect histology confirmed otosclerosis. Quantitative synthesis was then performed.RESULTSBased on available level III literature, HRCT has a relatively low sensitivity of 58% (95%CI: 49.4-66.9), a high specificity, 95% (95%CI: 89.9-98.0) and a positive predictive value of 92% (95%CI: 84.1-95.8). HRCT is better at diagnosing the more prevalent fenestral form of otosclerosis but remains vulnerable to inframillimetre, retrofenestral and dense sclerotic lesions, despite the advent of more advanced CT scanners with improved collimation.CONCLUSIONWhilst the diagnosis of otosclerosis remains largely clinical, HRCT remains the gold standard imaging of choice for the middle ear and serves as a useful adjunct to the clinician, helping to delineate extent of disease and exclude other causes.

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Section: Discussionmentioning

confidence: 99%

Diagnostic performance of high resolution computed tomography in otosclerosis

Kanzara¹,

Virk²

2017

WJCC

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“…4). 15,34 In these cases, the "single window" effect might impair the transmission of acoustic energy within the cochlea by reduc-ing the compressibility of the intracochlear fluids. Moreover, this phenomenon might also compromise the results of stapedotomy.…”

Section: Correlation Between Computed Tomography and Audiometric Findmentioning

confidence: 99%

“…Nonetheless, involvement of the round window is usually seen in more extensive disease with retrocochlear foci, which might work as an important confounding factor in the analysis of the audiometric parameters. 15 In contrast, data regarding the audiological implications of more specific characteristics of the foci are conflicting. Min et al could not find a correlation between the existence of hypodensity foci on CT and the degree of HL.…”

Section: Correlation Between Computed Tomography and Audiometric Findmentioning

confidence: 99%

Imaging Studies in Otosclerosis: An Up-to-date Comprehensive Review

Mangia

Coelho²,

Carvalho

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Otosclerosis is a primary osteodystrophy of the otic capsule, frequently responsible for acquired hearing loss in adults. Although the diagnostic value of imaging investigations in otosclerosis is debatable, they might still be employed with different goals within the context of the disease. Objectives The present paper aims to review the most recent literature on the use of imaging studies in otosclerosis for the most varied purposes, from routine application and differential diagnosis to prognostic prediction and investigation of surgical failure. Data Synthesis The diagnosis of otosclerosis is usually clinical, but computed tomography (CT) is paramount in particular cases for the differential diagnosis. The routine use, however, is not supported by strong evidence. Even so, there is growing evidence of the role of this method in surgical planning and prediction of postoperative prognosis. In specific scenarios, for example when superior semicircular canal dehiscence (SSCD) syndrome is suspected or in surgical failure, CT is crucial indeed. Magnetic resonance imaging (MRI), however, has limited – although important – indications in the management of individuals with otosclerosis, especially in the evaluation of postoperative complications and in the follow-up of medical treatment in active ostosclerosis. Conclusion Imaging studies have a broad range of well-established indications in otosclerosis. Besides, although the routine use of CT remains controversial, the most recent papers have shed light into new potential benefits of imaging prior to surgery.

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“…Although the detection of otosclerosis-related lesions has already been achieved by polytomographic examinations [24,25], and today even very small lesions can be depicted much more precisely by modern X-ray cross-sectional imaging [26][27][28][29], patients with a typical clinical otosclerosis constellation are often treated surgically without imaging. In the case of a combined or sensorineural hearing loss, a request for imaging is often made under the indication "unexplained hearing loss".…”

Section: Current Statusmentioning

confidence: 99%

“…The imaging diagnosis of otosclerosis requires a cross-sectional X-ray [26][27][28][29], which can also reliably detect other middle ear pathologies causing unexplained hearing loss [26][27][28][29]. After a retrospective analysis of 259 CT scans performed on patients with clinically suspected otosclerosis, Dudau et al [29] conclude that CT is a valuable aid in the management of otosclerosis patients. They determined a positive predictive value of 100 % for CT for the diagnosis otosclerosis, a relevant alternative diagnosis in 33 % of the cases and an influence of CT findings in the indication for stapedoplasty in 45 % of the cases.…”

Section: Current Statusmentioning

confidence: 99%

Imaging of otosclerosis

Kösling

Plontke

Bartel

2020

Rofo

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Background Otosclerosis is an important cause of hearing loss and a widespread pathology in ENT medicine. Although a high diagnostic value of CT with impact on therapy is emphasized in the literature, the disease is seldom seen in the radiological routine diagnostics due to ENT findings often being diagnostic. Radiologists detect it rather more often in cases of unclear hearing loss or cochlear implant candidates. The findings may be very subtle. They require a target search and an optimal imaging technique. Methods This review article is based on a selective search of the literature in PubMed without any time frame restrictions as well as on the long clinical experience of the authors. Results The paper focuses on imaging aspects of otosclerosis: current role, advice for imaging technique, characteristic imaging signs, radiological differential diagnoses and findings after stapedoplasty. Pathology, clinical signs and therapeutic options are summarized briefly. Conclusions With an optimal technique and sufficient radiological experience otosclerosis can be correctly diagnosed by imaging in a high percentage of cases. Radiology plays the key role in the diagnosis of retrofenestral otosclerosis. It can provide valuable information for the management of complications after stapedotomy. Key points: Citation Format

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Diagnostic efficacy and therapeutic impact of computed tomography in the evaluation of clinically suspected otosclerosis

Cited by 31 publications

References 20 publications

Diagnostic performance of high resolution computed tomography in otosclerosis

Diagnostic performance of high resolution computed tomography in otosclerosis

Imaging Studies in Otosclerosis: An Up-to-date Comprehensive Review

Imaging of otosclerosis

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