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به نام خداوند جان و خرد

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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به نام خداوند جان و خرد

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  1. به نام خداوند جان و خرد

  2. Otosclerosis • Back ground: • METABOLIC BONE DISEASE IN OTIC CAPSULE

  3. 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

  4. PATHOPHYSIOLOGY 1- EARLY OTOSPONGIOTIC PHASE 2- LATER OTOSCLEROTIC PHASE

  5. EPIDEMIOLOGY FREQUECY: HISTOLOGICALLY OTOSCLEROSIS: 10% CLINICALLY OTOSCLEROSIS: 1% MORTALITY & MORBIDITY: 1- CHL 2- SNHL 3- MHL 4-TINNITUS 5- VERTIGO

  6. 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

  7. SYMPTOMS 1- HEARING LOSS: CHL – SNHL – MHL 2- TINNITUS 3- DIZZINESS 4- ROTATORY VERTIGO

  8. PHYSICAL EXAMS 1- PUR TONE AUDIOMETRY 2- TYMPANOMETRY 3- TUNING FORKS TESTS: RINNE TEST WEBER TEST 4- SCHWARTZE SIGN

  9. DIFERENTIAL DIAGNOSIS 1- OTITIS MEDIA 2- CONGENTIAL STAPES FIXATIONS 3- GONGENITAL MALLEAL HEAD FIXATION 4- TYMPANOSCLEROSIS 5- PAGET DISEASE 6- OSTEOGENESIS IMPERFECTA

  10. 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

  11. 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

  12. 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

  13. PROGNOSIS CHL 50 – 60 dB SNHL TOTAL DEAFNESS

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