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Hansen LJ, Bloch SL, Sørensen MS. Cellular voids in the pathogenesis of otosclerosis. Acta Otolaryngol 2023; 143:250-253. [PMID: 36639139 DOI: 10.1080/00016489.2023.2164904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Otosclerosis is a common ear disease that causes fixation of the stapes and conductive hearing impairment. However, the pathogenesis of otosclerosis is still unknown. Otosclerosis could be associated with the unique bony environment found in the otic capsule. Normal bone remodelling is almost completely absent around the inner ear after birth allowing degenerative changes and dead osteocytes to accumulate. High levels of inner ear anti resorptive osteoprotegerin (OPG) is most likely responsible for this capsular configuration. Studies have demonstrated how osteocyte lifespan variation creates occasional clusters of dead osteocytes, so-called cellular voids, at otosclerotic predilection sites in the human otic capsule. These cellular voids have been suggested as possible starting points of otosclerosis. AIM To describe the cellular viability in otosclerotic lesions and compare it to that of cellular voids. MATERIALS AND METHODS The study was based on unbiased stereological quantifications in undecalcified human temporal bones with otosclerosis. RESULTS Osteocyte viability was found to vary within the otosclerotic lesions. Furthermore, the results presented here illustrate that inactive otosclerotic lesions consist of mainly dead interstitial bone, much like cellular voids. CONCLUSIONS AND SIGNIFICANCE Focal degeneration in the otic capsule may play an important role in the pathogenesis of otosclerosis.
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Affiliation(s)
- Lars Juul Hansen
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Sune Land Bloch
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Mads Sølvsten Sørensen
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
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Xu K, Bai X, Chen S, Xie L, Qiu Y, Li H, Sun Y. CCDC154 Mutant Caused Abnormal Remodeling of the Otic Capsule and Hearing Loss in Mice. Front Cell Dev Biol 2021; 9:637011. [PMID: 33614666 PMCID: PMC7889813 DOI: 10.3389/fcell.2021.637011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/15/2021] [Indexed: 12/30/2022] Open
Abstract
Osteopetrosis is a rare inherited bone disease characterized by dysfunction of osteoclasts, causing impaired bone resorption and remodeling, which ultimately leads to increased bone mass and density. Hearing loss is one of the most common complications of osteopetrosis. However, the etiology and pathogenesis of auditory damage still need to be explored. In this study, we found that a spontaneous mutation of coiled-coil domain-containing 154 (CCDC154) gene, a new osteopetrosis-related gene, induced congenital deafness in mice. Homozygous mutant mice showed moderate to severe hearing loss, while heterozygous or wild-type (WT) littermates displayed normal hearing. Pathological observation showed that abnormal bony remodeling of the otic capsule, characterized by increased vascularization and multiple cavitary lesions, was found in homozygous mutant mice. Normal structure of the organ of Corti and no substantial hair cell or spiral ganglion neuron loss was observed in homozygous mutant mice. Our results indicate that mutation of the osteopetrosis-related gene CCDC154 can induce syndromic hereditary deafness in mice. Bony remodeling disorders of the auditory ossicles and otic capsule are involved in the hearing loss caused by CDCC154 mutation.
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Affiliation(s)
- Kai Xu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xue Bai
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sen Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Le Xie
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Qiu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - He Li
- Department of Otolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yu Sun
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Liao S, Lu S, Li G, Chen R. Retracted:
Increased maternal serum placental growth hormone variant in pregnancies complicated by otosclerosis. Clin Otolaryngol 2019; 44:757-761. [PMID: 31148391 DOI: 10.1111/coa.13385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/11/2018] [Accepted: 05/28/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Shutan Liao
- Rural Clinical School University of New South Wales Sydney New South Wales Australia
- The First Affiliated Hospital of Sun Yat‐sen University Guangzhou China
| | - Shan Lu
- The First Affiliated Hospital of Sun Yat‐sen University Guangzhou China
| | - Guangliang Li
- Department of ENT The First Hospital of Wenzhou Medical University Wenzhou China
| | - Ruiying Chen
- Department of ENT The First Hospital of Wenzhou Medical University Wenzhou China
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Traynor SJ, Cohen JI, Morton JI, Trune DR. Immunohistochemical analysis of Otic Capsule Osteogenesis in the Palmerston North Autoimmune Mouse. Otolaryngol Head Neck Surg 2018. [DOI: 10.1177/019459989210600207] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Autoimmunity and the immune complex disease associated with it have been hypothesized to be the cause of several idiopathic diseases of the inner ear—including the new bone formation associated with otic capsule osteogenesis and otosclerosis. The Palmerston North (PN) autoimmune mouse strain, which exhibits both spontaneous systemic autoimmune disease and otic capsule bone formation, has been proposed as a model relating these two disease processes. To investigate the potential role of immunopathologic processes in PN otic capsule lesion formation, inner ears from PN mice were immunostained for the presence of IgG and complement (C3), two immunologic markers involved in the development of the vascular and perivascular changes associated with immune complex deposition. Both systemic autoimmune disease and otic capsule bony lesions were confirmed in all animals. However, immunohistochemical analyses did not establish a direct relationship between the two conditions as complement was absent in all lesions and IgG stained positive in only one instance. These results suggest that immune complex deposition is not directly involved in the otic capsule lesions of the PN mouse, and alternate mechanisms relating autoimmune disease and otic capsule osteogenesis must be explored.
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Affiliation(s)
- Sean J. Traynor
- Department of Otolaryngology - Head and Neck Surgery, Portland, Oregon
- The Oregon Hearing Research Center, and the Department of Medicine. Division of Arthritis and Rheumatic Diseases, Portland, Oregon
| | - James I. Cohen
- Department of Otolaryngology - Head and Neck Surgery, Portland, Oregon
- The Oregon Hearing Research Center, and the Department of Medicine. Division of Arthritis and Rheumatic Diseases, Portland, Oregon
| | | | - Dennis R. Trune
- Department of Otolaryngology - Head and Neck Surgery, Portland, Oregon
- The Oregon Hearing Research Center, and the Department of Medicine. Division of Arthritis and Rheumatic Diseases, Portland, Oregon
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Wang F, Yoshida T, Shimono M, Sugimoto S, Teranishi M, Naganawa S, Sone M. Significance of internal auditory canal diverticula in ears with otosclerosis. Acta Otolaryngol 2018; 138:1066-1069. [PMID: 30682901 DOI: 10.1080/00016489.2018.1521526] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Diverticula in the internal auditory canal (IAC) have been reported in ears with otosclerosis. OBJECTIVE We evaluated hearing levels and vascular activity in ears with otosclerosis with and without IAC diverticula and clarify the significance of IAC diverticula. MATERIALS AND METHODS Sixty-one ears from 54 patients who underwent stapes surgery for otosclerosis [fenestral (48 ears) and retrofenestral (13 ears) groups] were included in the present study. Preoperative hearing levels on pure tone audiometry (PTA) and intraoperative measurements of blood flow were compared between the groups. RESULTS A total of 24 of 61 ears (39.3%) showed IAC diverticula, significantly higher than the frequency in ears without otosclerosis (3.7%). No significant differences in air- and bone-conduction thresholds on PTA were evident between ears with and without IAC diverticula in each group. Ears without IAC diverticula tended to show higher blood flow in the area anterior to the oval window than ears with IAC diverticula, but the difference was not significant. CONCLUSIONS The incidence of the IAC diverticula in otosclerosis was significantly higher than in cases without otosclerosis. The existence of IAC diverticula was not evidently related to the severity of the disease from the perspective of hearing level and vascular activity.
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Affiliation(s)
- Fei Wang
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Otorhinolaryngology, The First Affiliated Hospital of China Medical University, Otorhinolaryngology, Shenyang, China
| | - Tadao Yoshida
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mariko Shimono
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Satofumi Sugimoto
- Department of Otorhinolaryngology, Nagoya Univerisity Hospital, Nagoya, Japan
| | - Masaaki Teranishi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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de Oliveira Penido N, de Oliveira Vicente A. Medical Management of Otosclerosis. Otolaryngol Clin North Am 2018; 51:441-452. [DOI: 10.1016/j.otc.2017.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Inner ear ossification and mineralization kinetics in human embryonic development - microtomographic and histomorphological study. Sci Rep 2017; 7:4825. [PMID: 28684743 PMCID: PMC5500530 DOI: 10.1038/s41598-017-05151-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/24/2017] [Indexed: 12/18/2022] Open
Abstract
Little is known about middle and inner ear development during the second and third parts of human fetal life. Using ultra-high resolution Microcomputed Tomography coupled with bone histology, we performed the first quantitative middle and inner ear ossification/mineralization evaluation of fetuses between 17 and 39 weeks of gestational age. We show distinct ossification paces between ossicles, with a belated development of the stapes. A complete cochlear bony covering is observed within the time-frame of the onset of hearing, whereas distinct time courses of ossification for semicircular canal envelopes are observed in relation to the start of vestibular functions. The study evidences a spatio-temporal relationship between middle and inner ear structure development and the onset of hearing and balance, critical senses for the fetal adaptation to birth.
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Lombardo F, De Cori S, Aghakhanyan G, Montanaro D, De Marchi D, Frijia F, Fortunato S, Forli F, Chiappino D, Berrettini S, Canapicchi R. 3D-Flair sequence at 3T in cochlear otosclerosis. Eur Radiol 2016; 26:3744-51. [PMID: 26747254 DOI: 10.1007/s00330-015-4170-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/16/2015] [Accepted: 12/14/2015] [Indexed: 01/01/2023]
Abstract
PURPOSE To assess the capability of three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequences in detecting signal alterations of the endolabyrinthine fluid in patients with otosclerosis. MATERIALS AND METHODS 3D-FLAIR before and after (-/+) gadolinium (Gd) administration was added to the standard MR protocol and acquired in 13 patients with a clinical/audiological diagnosis of severe/profound hearing loss in otosclerosis who were candidates for cochlear implantation and in 11 control subjects using 3-T magnetic resonance imaging (MRI) equipment. The MRI signal of the fluid-filled cochlea was assessed both visually and calculating the signal intensity ratio (SIR = signal intensity cochlea/brainstem). RESULTS We revealed no endocochlear signal abnormalities on T1-weighted -/+ Gd images for either group, while on 3D-FLAIR we found bilateral hyperintensity with enhancement after Gd administration in eight patients and bilateral hyperintensity without enhancement in one patient. No endocochlear signal abnormalities were detected in other patients or the control group. CONCLUSION Using 3-T MRI equipment, the 3D-FLAIR -/+ Gd sequence is able to detect the blood-labyrinth barrier (BLB) breakdown responsible for alterations of the endolabyrinthine fluid in patients with cochlear otosclerosis. We believe that 3D-FLAIR +/- Gd is an excellent imaging modality to assess the intra-cochlear damage in otosclerosis patients. KEY POINTS • Gd-enhanced T1-weighted MRI has limited application to detect intra-cochlear damage. • 3D-FLAIR is less sensitive to flux artefacts and allows multiplanar reconstruction. • Post-Gd 3D-FLAIR is advantageous as it may highlight the BLB breakdown. • Using 3D-FLAIR -/+ Gd, we were able to identify intra-cochlear signal hyperintensities. • 3D-FLAIR might be applied for monitoring disease progression and treatment response.
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Affiliation(s)
- Francesco Lombardo
- Fondazione CNR Regione Toscana "G. Monasterio", Neuroradiology Unit, Via Moruzzi, 1, 56124, Pisa, Italy.
| | - Sara De Cori
- Fondazione CNR Regione Toscana "G. Monasterio", Neuroradiology Unit, Via Moruzzi, 1, 56124, Pisa, Italy
| | - Gayane Aghakhanyan
- Fondazione CNR Regione Toscana "G. Monasterio", Neuroradiology Unit, Via Moruzzi, 1, 56124, Pisa, Italy
| | - Domenico Montanaro
- Fondazione CNR Regione Toscana "G. Monasterio", Neuroradiology Unit, Via Moruzzi, 1, 56124, Pisa, Italy
| | - Daniele De Marchi
- Fondazione CNR Regione Toscana "G. Monasterio", Neuroradiology Unit, Via Moruzzi, 1, 56124, Pisa, Italy
| | - Francesca Frijia
- Fondazione CNR Regione Toscana "G. Monasterio", Neuroradiology Unit, Via Moruzzi, 1, 56124, Pisa, Italy
| | - Susanna Fortunato
- ENT Audiology Phoniatry Unit, Department of Neuroscience, University of Pisa, Pisa, Italy
| | - Francesca Forli
- ENT Audiology Phoniatry Unit, Department of Neuroscience, University of Pisa, Pisa, Italy
| | - Dante Chiappino
- Fondazione CNR Regione Toscana "G. Monasterio", Department of Radiology, Massa, Italy
| | - Stefano Berrettini
- ENT Audiology Phoniatry Unit, Department of Neuroscience, University of Pisa, Pisa, Italy
| | - Raffaello Canapicchi
- Fondazione CNR Regione Toscana "G. Monasterio", Neuroradiology Unit, Via Moruzzi, 1, 56124, Pisa, Italy
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Comparative analysis of preoperative diagnostic values of HRCT and CBCT in patients with histologically diagnosed otosclerotic stapes footplates. Eur Arch Otorhinolaryngol 2015; 273:63-72. [DOI: 10.1007/s00405-015-3490-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/30/2014] [Indexed: 01/20/2023]
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In response to letter to the editor: "Correlation of computed tomography with histopathology in otoslcerosis", Quesnel et al. Otol Neurotol 2013; 34(1):22-8. Otol Neurotol 2014; 34:22-8. [PMID: 24026031 DOI: 10.1097/mao.0b013e318277a1f7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Yamashita K, Yoshiura T, Hiwatashi A, Togao O, Kikuchi K, Inoguchi T, Kumazawa S, Honda H. The radiological diagnosis of fenestral otosclerosis: the utility of histogram analysis using multidetector row CT. Eur Arch Otorhinolaryngol 2014; 271:3277-82. [PMID: 24534895 DOI: 10.1007/s00405-014-2933-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 02/04/2014] [Indexed: 12/15/2022]
Abstract
Bone density measurements using high-resolution CT have been reported to be useful to diagnose fenestral otosclerosis. However, small region of interest (ROI) chosen by less-experienced radiologists may result in false-negative findings. Semi-automatic analysis such as CT histogram analysis may offer improved assessment. The aim of this study was to evaluate the utility of CT histogram analysis in diagnosing fenestral otosclerosis. Temporal bone CT of consecutive patients with otosclerosis and normal controls was retrospectively analyzed. The control group consisted of the normal-hearing contralateral ears of patients with otitis media, cholesteatoma, trauma, facial nerve palsy, or tinnitus. All CT images were obtained using a 64-detector-row CT scanner with 0.5-mm collimation. AROI encompassing 10 × 10 pixels was placed in the bony labyrinth located anterior to the oval window. The mean CT value, variance and entropy were compared between otosclerosis patients and normal controls using Student's t test. The number of pixels below mean minus SD in the control (%Lowcont) and total subjects (%Lowtotal) were also compared. In addition, the area under the receiver operating characteristic curves (AUC) value for the discrimination between otosclerosis patients and normal controls was calculated. 51 temporal bones of 38 patients with otosclerosis and 30 temporal bones of 30 control subjects were included. The mean CT value was significantly lower in otosclerosis cases than in normal controls (p < 0.01). In addition, variance, entropy, %Lowcont and %Lowtotal were significantly higher in otosclerosis cases than in normal controls (p < 0.01, respectively). The AUC values for the mean CT value, %Lowcont and %Lowtotal were 0.751, 0.760 and 0.765, respectively. In conclusion, our results demonstrated that histogram analysis of CT image may be of clinical value in diagnosing otosclerosis.
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Affiliation(s)
- Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan,
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Diagnostic value of cone-beam CT in histologically confirmed otosclerosis. Eur Arch Otorhinolaryngol 2013; 271:2131-8. [DOI: 10.1007/s00405-013-2702-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 09/10/2013] [Indexed: 10/26/2022]
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Response to letter to the editor by Dr. Tamas Karosi Re: "Correlation of computed tomography with histopathology in otosclerosis", Quesnel et al. Otol Neurotol 2013; 34(1):22-28. Otol Neurotol 2013; 34:1363-4. [PMID: 23921922 DOI: 10.1097/mao.0b013e31829ab6fb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Re: "Correlation of computed tomography with histopathology in otosclerosis" Quesnel et al. Otol Neurotol 2013; 34(1):22-28. Otol Neurotol 2013; 34:1362-3. [PMID: 23792413 DOI: 10.1097/mao.0b013e31828d6388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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No evidence for the expression of renin-angiotensin-aldosterone system in otosclerotic stapes footplates. Otol Neurotol 2013; 34:808-15. [PMID: 23370555 DOI: 10.1097/mao.0b013e31827d8a80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Recent studies have reported genetic associations between with single nucleotide polymorphism (SNP) of the several genes of the renin-angiotensin-aldosterone (RAA) system in otosclerosis without the confirmation of RAA system expression in human stapes footplates. There are conflicting results. These results are conflicting because RAA system expression has been attributed exclusively to neural, vascular, and renal tissues, exclusively. MATERIALS AND METHODS Ankylotic stapes footplates (n = 20), cortical bone fragments (n = 10), and human kidney tissue specimens (n = 10) were processed to hematoxylin-eosin (HE) staining and RAA system-specific immunofluorescent assay (IFA), respectively. RESULTS Histologic diagnosis of otosclerosis was established in all ankylotic stapes footplates. Histologically active- (n = 13) and inactive (n = 7) foci of otosclerosis were consequently characterized by negative immunoreactions for renin, angiotensin converting enzyme (ACE), angiotensin-II (AT-II), and angiotensin-II receptor (AT-IIR), consequently. In cortical bones, a considerable RAA system expression was observed confirmed in the perivascular bone marrow progenitor cells. Kidney specimens, applied as positive controls, showed intense RAA system-specific immunoreactions. CONCLUSION Concerning current observations, the 4 studied members of RAA system that did not display active expression were not expressed at protein level in otosclerotic stapes footplates. This phenomenon was independent from the histologic activity of otosclerosis. Between these conditions, the etiologic role of RAA system is questionable in the pathogenesis of otosclerosis.
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The Value of HRCT in Stapes Fixations Corresponding to Hearing Thresholds and Histologic Findings. Otol Neurotol 2012; 33:1300-7. [DOI: 10.1097/mao.0b013e31826352ad] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE OF REVIEW The aim of this study is to summarize current advances in research and clinical aspects of cochlear otosclerosis. RECENT FINDINGS Recent studies have revealed that otosclerosis is a process of bone remodeling that is unique to the otic capsule only. Even though no obvious bone remodeling is seen in the otic capsule under normal conditions, remodeling starts when some molecular factors trigger the capsule in certain patients who have genetic and/or environmental tendencies. SUMMARY Cochlear otosclerosis is defined as otosclerosis located in the otic capsule involving the cochlear endosteum and causing sensorineural hearing loss or mixed-type hearing loss. It has been clearly shown that, when otosclerosis is sufficiently severe to involve the cochlear endosteum, it usually fixes the stapes as well.
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Abstract
The rationale for medical therapy for otospongiosis is to slow down and eventually stop the phase of bone resorption. There is some increase in the incidence of stapedial otospongiosis in a low-fluoride area compared with a high-fluoride area. Sodium fluoride treatment has a role to play in preventing the onset and progression of hearing loss in patients suffering from otosclerosis. Sodium fluoride therapy has been shown to have some beneficial effect on dizziness associated with otosclerosis. In view of the possibility of systemic side effects of sodium fluoride therapy, a regular follow up of patients is warranted. Biphosphonates can be used as an alternative treatment to sodium fluoride in cases where the patient is intolerant to sodium fluoride therapy. Hearing aid is also a treatment option, but it does not halt the disease process.
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Affiliation(s)
- S Uppal
- Department of ENT, York Hospital, York, UK.
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Félix-Trujillo MM, Valdez-Martínez E, Ramírez JE, Lozano-Morales R. Surgical and Medical Treatment of Hearing Loss in Mixed Otosclerosis. Ann Otol Rhinol Laryngol 2009; 118:859-65. [DOI: 10.1177/000348940911801206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: We assessed the effect of using preoperative sodium fluoride (NaF) on the difficulty of working with the footplate during stapedectomy and its effect on the postsurgical hearing gain in patients with mixed otosclerosis (ie, otosclerosis and/or otospongiosis). Methods: There were 2 groups of patients with mixed otosclerosis. The experimental group was made up of patients with an active focus of the disease; they received NaF for 6 months and then underwent stapedectomy. The control group was made up of patients with an inactive focus of the disease; they underwent stapedectomy without administration of NaF. Results: The difference between the study groups in the degree of difficulty in extracting the footplate was not found to be statistically significant. Both groups had hearing gains in bone and air conduction. The level of posttreatment hearing gain in the group exposed to NaF was greater than that in the nonexposed group. Conclusions: Sodium fluoride administered to patients with mixed otosclerosis and an active focus of disease does not increase the difficulty of working with the footplate during stapedectomy, and it increases the hearing gain after the procedure.
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Abstract
Otosclerosis is a bone dystrophy localised to the inner ear and the stapes footplate. Otosclerosis is a frequent cause of deafness in adults. The patient with otosclerosis typically presents with a history of slowly progressive conductive or mixed hearing loss that is usually bilateral and often asymmetric, usually between the ages of 15 and 45 years. The disease is characterised by alternating phases of bone resorption and formation. The majority of studies on families with otosclerosis suggest an autosomal dominant mode of inheritance with incomplete penetrance.
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Affiliation(s)
- S Uppal
- Department of ENT, York Hospital, York, UK
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Computed Tomography Investigation of the Cochlear Capsule in Otosclerosis. Acta Otolaryngol 2009. [DOI: 10.3109/00016488709121927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Moscillo L, Imperiali M, Carra P, Catapano F, Motta G. Bone conduction variation poststapedotomy. Am J Otolaryngol 2006; 27:330-3. [PMID: 16935178 DOI: 10.1016/j.amjoto.2006.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2005] [Indexed: 10/24/2022]
Abstract
We evaluated the variation in bone conduction auditory thresholds in patients undergoing surgical intervention for otosclerosis as part of our report on the use of surgery in patients with a small air-bone gap. Of the 110 patients who underwent stapedotomy, 45 were treated by traditional surgery and 65 with carbon dioxide laser, with a follow-up of 3 years at 500-, 1000-, 2000-, and 3000-Hz frequencies. Both surgical techniques resulted in improvements in air conduction in more than 95% of cases; bone conduction improved more in patients treated with carbon dioxide laser (7.1 dB) compared to those treated with traditional surgery (4 dB) (P < .01). Furthermore, improvement in bone conduction was greater and more frequent in younger subjects (below 45 years) (P < .05). In conclusion, this study allows us to express a positive prognosis when considering otosclerotic patients with sensorineural hearing loss and small air-bone gap.
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Affiliation(s)
- Luca Moscillo
- ENT Department S. Maria delle Grazie Hospital-Pozzuoli, Naples, Italy.
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Cureoglu S, Schachern PA, Ferlito A, Rinaldo A, Tsuprun V, Paparella MM. Otosclerosis: etiopathogenesis and histopathology. Am J Otolaryngol 2006; 27:334-40. [PMID: 16935179 DOI: 10.1016/j.amjoto.2005.11.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Otosclerosis is a disease of the bony labyrinth manifesting clinically as a progressive conductive hearing loss, a mixed-type hearing loss, or a sensorineural hearing loss. The age of onset of the hearing loss caused by otosclerosis is principally between 15 and 40 years. Although histopathological inner ear changes due to otosclerosis have been very well documented, the true etiopathogenesis of the disease has yet to be described despite intensive research. Both genetic and environmental factors have been implicated, however.
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Zehnder AF, Kristiansen AG, Adams JC, Kujawa SG, Merchant SN, McKenna MJ. Osteoprotegrin knockout mice demonstrate abnormal remodeling of the otic capsule and progressive hearing loss. Laryngoscope 2006; 116:201-6. [PMID: 16467704 PMCID: PMC2563156 DOI: 10.1097/01.mlg.0000191466.09210.9a] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The otic capsule, when compared with other bones in the body, is unique in that it undergoes no significant remodeling of bone after development. We previously demonstrated that osteoprotegerin (OPG), which inhibits formation and function of osteoclasts, is produced at high levels in the inner ear of normal mice and secreted into the perilymph from where it diffuses into the surrounding otic capsule bone through a lacunocanalicular system. To test our hypothesis that the high level of OPG may be important in the inhibition of otic capsule remodeling, we studied the light microscopic histology of the otic capsule in OPG knockout mice for evidence of abnormal remodeling of bone. We also tested the hearing in OPG knockout mice to determine whether OPG and its influence on surrounding bone is important for auditory function. METHODS Temporal bone histopathology and pathophysiology were compared in homozygous OPG knockout mice and C57BL/6 (B6) mice, the background strain for the knockouts. Auditory function in age-matched animals from each group was evaluated at approximately 4-week intervals from 8 to 21 weeks using frequency-specific auditory brainstem responses (ABR) and distortion product otoacoustic emissions (DPOAE). After each of the last three evaluations, the cochleae from one mouse of each group were harvested, processed, and examined by light microscopy. RESULTS Osteoprotegerin knockout mice demonstrated abnormal remodeling of bone within the otic capsule with multiple foci showing osteoclastic bone resorption and formation of new bone. Such changes were not seen in the age-matched B6 controls. The active bone remodeling process in the knockout animals showed many similarities to otosclerosis seen in human temporal bones. Over the time period that we monitored, auditory function was significantly and progressively compromised in the knockout animals relative to B6 controls. At the earliest age of test (8 wk), the loss was apparent as a mild, high-frequency reduction in sensitivity by ABR. In contrast, DPOAE losses in the knockouts were substantial even at 8 weeks, and by 21 weeks, these losses exceeded our equipment limits. Results of ABR testing showed hearing sensitivity changes in the animals of the background strain were confined largely to the high frequencies, whereas OPG knockouts demonstrated substantial low-frequency shifts in addition to those at high frequencies. CONCLUSIONS The histopathological and pathophysiological findings in OPG knockout mice support the hypothesis that OPG is important in the inhibition of bone remodeling within the otic capsule and the maintenance of normal auditory function. This mouse may provide a valuable animal model of human otosclerosis.
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MESH Headings
- Acoustic Stimulation
- Animals
- Bone Remodeling/genetics
- Bone Remodeling/physiology
- Disease Models, Animal
- Disease Progression
- Ear, Inner/physiopathology
- Evoked Potentials, Auditory, Brain Stem
- Glycoproteins/deficiency
- Glycoproteins/genetics
- Glycoproteins/physiology
- Hearing Loss/diagnosis
- Hearing Loss/physiopathology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Osteoprotegerin
- Receptors, Cytoplasmic and Nuclear/deficiency
- Receptors, Cytoplasmic and Nuclear/genetics
- Receptors, Cytoplasmic and Nuclear/physiology
- Receptors, Tumor Necrosis Factor/deficiency
- Receptors, Tumor Necrosis Factor/genetics
- Receptors, Tumor Necrosis Factor/physiology
- Temporal Bone/physiopathology
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Affiliation(s)
- Andreas F Zehnder
- Department of Otology and Laryngology, Harvard Medical School, and the Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114-3096, USA
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Brookler K. Questioning the Relationship between Cochlear Otosclerosis and Sensorineural Hearing Loss: A Quantitative Evaluation of Cochlear Structures in Cases of Otosclerosis and Review of the Literature. Laryngoscope 2004; 115:757; author reply 757-8. [PMID: 15805898 DOI: 10.1097/00005537-200407000-00016] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The literature provides conflicting information regarding the prevalence and cause of sensorineural hearing loss (HL) in individuals with otosclerosis. OBJECTIVE The purpose of this study was to further evaluate the association between involvement of the cochlear endosteal layer with otosclerosis and sensorineural HL. STUDY DESIGN Retrospective case review. METHODS Temporal bones and audiograms from five individuals with otosclerosis were evaluated. The cochlear elements were quantified. The location and extent of the cochlear element loss was correlated with the location and extent of endosteal involvement with otosclerosis. RESULTS A reduction in the population of cochlear elements was observed in most individuals; however, the reduction was not proportional to the extent of endosteal involvement with otosclerosis. The cochlear elements remained normal adjacent to some areas of endosteal involvement with otosclerosis. One individual with extensive cochlear otosclerosis had normal hearing and predominantly normal cochlear elements. CONCLUSION This study demonstrates a variable amount of degeneration of the cochlear elements in individuals with otosclerotic involvement of the endosteum. The reduction in the population of cochlear elements was not related to the extent and location of endosteal involvement with otosclerosis. These findings suggest that factors that limit the effect of otosclerotic endosteal involvement on the cochlear elements or processes that effect the cochlear elements directly and are independent of bone involvement may be present.
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Kiyomizu K, Tono T, Yang D, Haruta A, Kodama T, Komune S. Correlation of CT analysis and audiometry in Japanese otosclerosis. Auris Nasus Larynx 2004; 31:125-9. [PMID: 15121220 DOI: 10.1016/j.anl.2004.01.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2003] [Accepted: 01/16/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine the extent of audiometric correlation with CT findings. METHODS Forty-four patients (82 ears) with surgically confirmed otosclerosis underwent preoperative CT examination. Based on the computed tomography (CT) findings, the ears were classified into five groups as follows: Group A, the group with no pathological CT findings; Group B1, the group with demineralization localized in the region of the fissula antefenestram; Group B2, the group with demineralization extending towards the cochleariform process from the anterior region of the oval window; Group B3, the group with extensive demineralization surrounding the cochlea; and Group C, the group with thick anterior and posterior calcified plaques. RESULTS There were 32 ears (39.0%) in Group A, 21 ears (25.6%) in Group B1, 16 ears (19.5%) in Group B2, 7 ears (8.5%) in Group B3, and 6 ears (7.3%) in Group C. The mean bone conduction levels were greater in the order of the extent of demineralization: Groups A, B1-B3 suggesting positive relationship between the cochlear function and the degree of labyrhinthine otosclerosis. CONCLUSION A good correlation between the preoperative CT findings and audiometry findings suggests that CT with a slice intervals between 0.5 and 1mm could provide useful informations in assuming the extent of otosclerosis in the inner ear.
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Affiliation(s)
- Kensuke Kiyomizu
- Department of Otorhinolaryngology, Miyazaki Medical College, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki 889-1692, Japan.
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28
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Gros A, Vatovec J, Sereg-Bahar M. Histologic changes on stapedial footplate in otosclerosis. Correlations between histologic activity and clinical findings. Otol Neurotol 2003; 24:43-7. [PMID: 12544027 DOI: 10.1097/00129492-200301000-00010] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To quantify the relationship between the stage of histologic changes of the stapedial footplate in otosclerosis and the magnitude of preoperative hearing loss, tinnitus, vestibular disorder, and postoperative improvement of hearing. STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. PATIENTS The study included 97 patients (ears) (69 female and 28 male patients), with conductive or mixed hearing loss who were operated on for otosclerosis. The criterion for including a patient in the study was otosclerosis established by tympanoscopy and confirmed by histologic examination of a piece of the stapedial footplate. MAIN OUTCOME MEASURES By the histologic features of the stapedial footplate fragments, the stage of the otosclerotic lesion was classified as spongiotic, fibrotic, or sclerotic. The patients were carefully matched for sex, age, duration of hearing impairment, presence of tinnitus, and vestibular symptoms. Preoperative and postoperative air-conduction and bone-conduction thresholds were calculated as an average of four frequencies (0.5, 1, 2, and 4 kHz). Analysis was subsequently carried out on the preoperative and postoperative air-bone gap and bone-conduction threshold improvement. RESULTS With regard to the histologic stage of otosclerotic lesions, tinnitus and vestibular disorders were present more frequently in patients with the sclerotic type of lesion. The type of otosclerotic lesion had no significant influence on the mean preoperative air-conduction threshold, bone-conduction threshold, and air-bone gap or on postoperative air-conduction threshold and bone-conduction threshold, but the postoperative air-bone gap was higher in patients with the fibrotic type of otosclerotic lesion and was highest in patients with the spongiotic type of otosclerotic lesion (p < 0.01). CONCLUSIONS Tinnitus, vestibular disorders, and better postoperative closure of the air-bone gap are present more frequently in patients with a sclerotic type of otosclerotic lesion on the stapedial footplate.
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Affiliation(s)
- Anton Gros
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, Slovenia.
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29
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Montaño Velázquez BB, Bello Mora A, Zepeda López EG, Ramírez Martínez J, Hernández Goribar M, Jáuregui-Renaud K. [Evidence of otospongiosis obtained by computerized tomography. Does it compromise the post-stapedectomy auditory gain?]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2002; 53:387-90. [PMID: 12402487 DOI: 10.1016/s0001-6519(02)78326-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To study the influence of tomographic otospongiosis/otosclerosis on the audiometric gain after stapedectomy, we evaluated 34 patients (mean age 39.9 years, S.D. 9.8) with otosclerosis and mixed hearing loss. We performed Computed Tomography (CT) with densitometry before stapedectomy and audiometry before and 4 weeks after the surgery. CT results were classified as compatible or not for otospongiosis (< 1000 UH) or for otosclerosis (> 2000 UH). According to the affected turns of the cochlea, the studies were classified in 3 groups. In 43% of the patients the CT showed otospongiosis. After stapedectomy, air conduction thresholds of the low (125-500 Hz), middle (500-2000 Hz) and high frequency bands (2000-8000 Hz) and for the air/bone gap were similar for the ears with or without otospongiosis (p > 0.05, ANOVA). However, patients with otospongiosis in all the cochlea showed the lowest audiometric gain for the high frequency band (p < 0.05 ANOVA). Evidence of otospongiosis evaluated just by CT has a low impact on the audiometric outcome after stapedectomy.
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Affiliation(s)
- B B Montaño Velázquez
- Servicio de Otorrinolaringología, Hospital General GGG del Centro Médico Nacional La Raza, Av. Vallejo y Jacarandas, Colonia La Raza, 02990 México D.F
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30
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Shin YJ, Fraysse B, Deguine O, Cognard C, Charlet JP, Sévely A. Sensorineural hearing loss and otosclerosis: a clinical and radiologic survey of 437 cases. Acta Otolaryngol 2001; 121:200-4. [PMID: 11349779 DOI: 10.1080/000164801300043505] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of this study was to determine if a relationship exists between bone level thresholds and the extension of otosclerotic foci within the otic capsule. The study consisted of a retrospective case review in a university hospital. We included patients who underwent surgery for otosclerosis in our department and who had a CT scan prior to surgery. We analyzed the data charts and CT scans of 437 cases (386 patients). On CT scan, we distinguished patients with fenestral otosclerosis and/or with a pericochlear focus. A pericochlear focus could be extended (Group 2) or not (Group 1) to the cochlear endosteum. Data for Groups 1 and 2 were compared with those for the control group of all patients for whom CT scan showed no cochlear focus (Group 3). Of the 437 CT scans, 399 were positive (91.3%). An anterior focus was reported in 305 cases (69.8%), a footplate thickening in 21 cases (4.8%) and both anomalies were encountered in 60 cases (13.7%). A pericochlear focus was reported in 53 examinations. This focus was extended to the endosteum in 14 cases (26.4% of the pericochlear foci). In Group 1, preoperative air conduction (AC) thresholds were significantly lower than in the control group (p < 0.05). The air--bone gap was also significantly larger in Group 1 (p < 0.05). Bone conduction (BC) thresholds were lower in Group 1 than in the control group but the difference was not significant. In Group 2, preoperative AC thresholds were significantly lower than in the control group (p < 0.05). BC thresholds were also lower in Group 2 than in the control group and the difference was significant (p < 0.05). As a result of this study, we assume that there may be a relationship between bone level thresholds and the radiological extension of otosclerosis within the otic capsule.
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Affiliation(s)
- Y J Shin
- Department of Otolaryngology, Purpan Hospital, Toulouse, France.
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31
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Brookler KH, Tanyeri H. Etidronate for the Neurotologic Symptoms of Otosclerosis: Preliminary Study. EAR, NOSE & THROAT JOURNAL 1997. [DOI: 10.1177/014556139707600605] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The efficacy of etidronate, a Bisphosphonate, was assessed as a treatment for the inner ear symptoms of otosclerosis in a retrospective case review of 896 patients diagnosed with otosclerosis, with primary complaints of dizziness, hearing loss, tinnitus or Meniere's syndrome. The diagnosis of otosclerosis was based on small-pixel computed tomography of the temporal bones. Of the 896 patients placed on an etidronate protocol, 545 were followed for more than six months and were analyzed. The symptomatic response to etidronate, as well as audiologic and computerized rotary chair results were used in the assessment. Patients who were previously on sodium fluoride were separately analyzed. In this preliminary study etidronate appeared to be an effective treatment for the neurotologic symptoms of otosclerosis. Prospective blinded efficacy studies of the bisphosphonates in the treatment of otosclerosis should be undertaken.
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Affiliation(s)
| | - Hasan Tanyeri
- Department of Otolaryngology, Lenox Hill Hospital, New York, New York
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32
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Trune DR, DeGagne JM, Morton JI. Ultrastructure of otic capsule sclerosis in Palmerston North autoimmune mice. Am J Otolaryngol 1994; 15:114-23. [PMID: 8179102 DOI: 10.1016/0196-0709(94)90060-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE Numerous temporal bone studies have reported a correlation between systemic autoimmune disease and osteogenic lesions within the inner ear. However, little is known of the cellular mechanisms that relate these two disease processes. The Palmerston North (PN) autoimmune strain mouse exhibits both spontaneous systemic autoimmune disease and otic capsule sclerotic lesions that are similar in many ways to those reported in humans. This suggests the PN mouse is a potential model in which to study the cellular events responsible for immune-related otic capsule lesions. Therefore, an evaluation of the fine structure of the PN modiolus was conducted to better understand these matrix changes of the inner ear. MATERIALS AND METHODS Inner ears were collected from 15 PN mice at ages from 17 to 24 months and prepared for electron microscopy. The ears were ultrastructurally evaluated to characterize the lesions and their associated cytoarchitecture. RESULTS The sclerotic lesions consisted of an electron-dense mass that appeared lobulated or layered, usually adjacent to the modiolar bone and blood vessels. Immediately surrounding the lesions were activated fibroblasts and fine fibrillar material in the extracellular space between them. The sclerotic foci often were apposed to normal modiolar bone that never appeared degraded. CONCLUSIONS The similarities between these bony lesions and known human otic capsule diseases suggests parallel processes are involved. Thus, further study of the PN inner ear may provide insight into the cellular events that underlie otic capsule and other temporal bone alterations in systemic autoimmune diseases.
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Affiliation(s)
- D R Trune
- Oregon Hearing Research Center, Department of Otolaryngology-Head and Neck Surgery, Portland
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Huang CC, Yabe Y, Yan SD. Effects of indomethacin and calcitonin on bone absorption in type II collagen-induced otosclerosis-like lesions in rats. Otolaryngol Head Neck Surg 1990; 103:1002-8. [PMID: 2177535 DOI: 10.1177/019459989010300619] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In this study, we determined the effects of indomethacin and calcitonin on bone resorption in otosclerosis-like lesions in rats. Morphometric analysis showed that both indomethacin and calcitonin inhibited active otosclerosis-like lesions (bone resorption) and rats immunologically induced with type II collagen, and indomethacin had a much higher inhibitory effect than calcitonin. In in vitro studies we found that conditioned medium from splenic lymphocytes of rats immunized with type II collagen stimulated collagenase production by macrophages and fibroblasts. Collagenase is the major enzyme for degradation of the organic components of bone. Treatment of the immunized rats with indomethacin and calcitonin significantly reduced the stimulatory effect of the lymphocyte-conditioned medium on collagenase production. Indomethacin caused a greater reduction of the stimulatory effect of the lymphocytes on collagenase production than calcitonin. These findings are in agreement with results of the morphometric study. Results of the present study also suggest that cell-to-cell interaction plays an important role in collagenase production for degradation of organic components of bone resorption in otosclerotic lesions.
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Affiliation(s)
- C C Huang
- Department of Otolaryngology, Columbia University College of Physicians and Surgeons, New York, NY 10032
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34
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Abd el-Rahman AG. Cochlear otosclerosis: statistical analysis of relationship of spiral ligament hyalinization to hearing loss. J Laryngol Otol 1990; 104:952-5. [PMID: 1704040 DOI: 10.1017/s002221510011446x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This paper presents an analysis of the relationship of the amount of hyalinization of the spiral ligament, secondary to cochlear otosclerosis (spongiosis), to the amount of hearing loss. This relationship was previously studied by Parahy and Linthicum. It was found that the larger the amount of hyalinization, the greater the hearing loss. This hyalinization is a measure of the amount of toxic enzymes being excreted into the inner ear fluid. These enzymes are suspected to affect the metabolic function of the hair cells.
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Brodie HA, Chole RA. The possible role of immunologic injury in the dysplastic bony lesion in LP/J mice. Am J Otolaryngol 1987; 8:342-50. [PMID: 3434670 DOI: 10.1016/s0196-0709(87)80053-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
An immunohistologic study was performed on temporal bones from 30 LP/J mice and 17 CBA/J mice to assess the role of immunologic injury in the pathogenesis of dysplastic bony lesions in LP/J mice. Temporal bones were harvested from animals aged 2 to 31 months to evaluate the progression of the disease. As early as 2 months of age, before the onset of bony lesions, the tympanic cavities frequently contained small effusions coating the ossicles and otic capsules that were demonstrated to contain immunoglobulins and pockets of macrophages. Later in the course of the disease, bony lesions grossly and histologically similar to human otosclerosis developed, which stained for immunoglobulins. No similar bony lesions, effusions, cellular infiltrates, or staining for immunoglobulins was detected in the control animals, even in the presence of acute otitis media. This study suggests a role of immunologic injury in the pathogenesis of dysplastic bony lesions in LP/J mice.
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Affiliation(s)
- H A Brodie
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis 95616
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Abstract
Otosclerosis is a bone disorder of unknown etiology confined to the otic capsule. Failure of remodeling of newly formed vascular, woven bone (otospongiosis) results in sclerotic bone (otosclerosis) with abnormal osteons. Involvement of the oval window causes conductive hearing loss. Electron microscopic, histochemical, and biochemical studies identify normal cellular and matrix components of otosclerotic bone without providing clues to the abnormal bone formation and resorption. Plastic-embedded, nondecalcified histologic sections with in vivo tetracycline labels permit the study of mineralization rates to separate this disorder from other bone dyscrasias that have similar histopathologic appearances. Characterization of the cells, matrix, and their mediators can yield an understanding of abnormalities that disorder bone.
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Affiliation(s)
- G L Davis
- Department of Pathology, Bridgeport Hospital, CT 06610
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37
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Sziklai I, Ribári O. The effect of flavone treatment on human otosclerotic ossicle organ cultures. ARCHIVES OF OTO-RHINO-LARYNGOLOGY 1985; 242:67-70. [PMID: 4038152 DOI: 10.1007/bf00464409] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We studied the effect of 7-isopropoxy-isoflavone (Ipriflavone) on the collagen synthesizing activity in human otosclerotic auditory ossicle samples from whole organ cultures during incubation for 96 h, and compared this effect with that found in normal meatal cortical bone. Ipriflavone led to a dose-dependent increase in the collagen synthesizing activity in both the healthy and the otosclerotic bone samples. At the highest Ipriflavone concentration used (50 microM), collagen synthesis increased 6-fold in the cortical bone and 9-fold in the otosclerotic bone, as compared with untreated controls. These findings indicate that the otosclerotic bone cavities are filled in vitro with organic matrix.
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Ribári O, Sziklai I, Kiss JG. Cyclic nucleotide and prostaglandin F2 alpha contents of otosclerotic auditory ossicles. ARCHIVES OF OTO-RHINO-LARYNGOLOGY 1985; 242:63-6. [PMID: 2994610 DOI: 10.1007/bf00464408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We found that the cyclic-adenosine-3',5'-monophosphate (cAMP) contents of otosclerotic human ossicles were 40-50 times greater than basal levels. Cyclic-guanosine-3',5'-monophosphate (cGMP) levels were also found to be greater than in physiological conditions, but lower than in cortical bone. These findings suggest the extensive participation of these nucleotide coenzymes in effector cells during the process of bone resorption. This emphasizes the role of bone-resorbing cells in this process as well as the probable osteoclast progenitor role of vascular endothelial cells and their enhanced activity for differentiation. At the same time, the absence of prostaglandin F2 alpha content in the otosclerotic bone analyzed appears to exclude cartilage remnants as a source for inducing the changes in remodelling that occur.
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