Otosclerosis 耳鼻咽喉科学课件
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none have be proven. Hormonal factors have been suggested to play a role in otosclerosis based on the observation that pregnancy sometimes accelerates the progression of the disease.
Pathophysiology
otosclerosis has two main forms
a late or sclerotic phase
dense sclerotic bone forms in the areas of previous resorption. Both the sclerotic and spongiotic as well as intermediate phases may be present at the same time. Otosclerotic foci always begin in endochondral bone but may progress to involve endosteal and periosteal layers and even enter into the membranous labyrinth.
Otosclerosis
Chunfu Dai Otolaryngology Department
Fudan University
Background
Definition
primary metabolic bone disease of the otic capsule and ossicles
Pathophysiology
The most common site of involvement is the anterior oval window near the fistula ante fenestrum.
When both the anterior and posterior ends of the footplate are involved it is termed “bipolar” involvement or fixation (if the footplate is immobile).
Epidemiology
Race
incidence of microscopic otosclerosis
Caucasian
10%ห้องสมุดไป่ตู้
Asian
5%
African American
1%
Native American
0%
Etiology
Many theories have been proposed such as
hereditary, 54% of patients present with family history endocrine, women with pregnancy worse her hearing metabolic, enzyme abnormal was pathogen infectious, virus was identified in the lesion vascular, autoimmune,
The early phase is characterized by multiple active cell groups including osteocytes, osteoblasts, and histiocytes. It develops a spongy appearance because of vascular dilation secondary to osteocyte resorption of bone surrounding blood vessels. This can be seen grossly as red hue behind the tympanic membrane termed “Schwartze's sign”
Pathophysiology
Otosclerosis (otospongiosis) is an osseous dyscrasia, limited to the temporal bone, and characterized by resorption and formation of new bone in the area of the ossicles and otic capsule.
It causes fixation of the ossicles (stapes) It results in conductive or mixed hearing loss. It is genetically-mediated via autosomal
dominant transmission
The round window is involved in approximately 30% to 50% of cases
Pathophysiology
otosclerosis has two main forms:
an early of spongiotic phase (otospongiosis)
If only the footplate is involved, it is sometimes referred to as a “stapedial otosclerosis”.
When the entire footplate and annular ligament are involved it is known as an obliterated footplate or obliterative otosclerosis.
Pathophysiology
Microscopically, a focus of active otosclerosis reveals finger projections of disorganized bone, rich in osteocytes particularly at the leading edge. In the center of the focus, multinucleated osteocytes are often present. In the sclerotic phase,
Pathophysiology
otosclerosis has two main forms
a late or sclerotic phase
dense sclerotic bone forms in the areas of previous resorption. Both the sclerotic and spongiotic as well as intermediate phases may be present at the same time. Otosclerotic foci always begin in endochondral bone but may progress to involve endosteal and periosteal layers and even enter into the membranous labyrinth.
Otosclerosis
Chunfu Dai Otolaryngology Department
Fudan University
Background
Definition
primary metabolic bone disease of the otic capsule and ossicles
Pathophysiology
The most common site of involvement is the anterior oval window near the fistula ante fenestrum.
When both the anterior and posterior ends of the footplate are involved it is termed “bipolar” involvement or fixation (if the footplate is immobile).
Epidemiology
Race
incidence of microscopic otosclerosis
Caucasian
10%ห้องสมุดไป่ตู้
Asian
5%
African American
1%
Native American
0%
Etiology
Many theories have been proposed such as
hereditary, 54% of patients present with family history endocrine, women with pregnancy worse her hearing metabolic, enzyme abnormal was pathogen infectious, virus was identified in the lesion vascular, autoimmune,
The early phase is characterized by multiple active cell groups including osteocytes, osteoblasts, and histiocytes. It develops a spongy appearance because of vascular dilation secondary to osteocyte resorption of bone surrounding blood vessels. This can be seen grossly as red hue behind the tympanic membrane termed “Schwartze's sign”
Pathophysiology
Otosclerosis (otospongiosis) is an osseous dyscrasia, limited to the temporal bone, and characterized by resorption and formation of new bone in the area of the ossicles and otic capsule.
It causes fixation of the ossicles (stapes) It results in conductive or mixed hearing loss. It is genetically-mediated via autosomal
dominant transmission
The round window is involved in approximately 30% to 50% of cases
Pathophysiology
otosclerosis has two main forms:
an early of spongiotic phase (otospongiosis)
If only the footplate is involved, it is sometimes referred to as a “stapedial otosclerosis”.
When the entire footplate and annular ligament are involved it is known as an obliterated footplate or obliterative otosclerosis.
Pathophysiology
Microscopically, a focus of active otosclerosis reveals finger projections of disorganized bone, rich in osteocytes particularly at the leading edge. In the center of the focus, multinucleated osteocytes are often present. In the sclerotic phase,