耳鼻咽喉科学英文版ppt课件 otosclerosis.ppt

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1、Otosclerosis,Otosclerosis,Symptoms,Slowly progressive hearing lossipsilateral or bilateralTinnitus in 75%Vestibular complaints 25%,Histopathology,lytic phaseIncreased osteoclastic activity results in perivascular bony resorption forming fibrotic spaces bone production phaseosteoblasts within the fib

2、rotic spaces producing immature bone remodeling phasecycling of resorption and bone formation results in otosclerotic bone,Histopathology,Epidemiology,Hereditary in 70%of casesAutosomal dominantIncomplete penetrance7-10%Caucasian temporal bones1%Caucasians with symptomsOther races lesser incidence,H

3、istory,1704 Valsalva autopsy1894 Politzer“otosclerosis”1930s Lempert horizontal canal fenestration1953 Rosen stapes mobilization1955 Shea stapedectomystapedotomy,Diagnosis,HistoryPhysical examinationAudiogramImagingSurgical exploration,Physical examination,OtomicroscopynormalSchwartzes signTuning fo

4、rks,Differential diagnosis,TympanosclerosisOMEincus/malleus fixationossicular discontinuitycongenital footplate fixation,Systemic diseases,Osteogenesis imperfectastapes fixationblue sclerafractures,Pagets diseasecrowding in epitympanumelevated alk phosskeletal bone involvement,Differential diagnosis

5、,Imaging,Multidirectional tomographyCTMRI,Audiology,TympanometryAcoustic ReflexesPure tone audiogramSpeech discrimination,Tympanogram,Normal type AShallow type As,Acoustic Reflexes,Very sensitiveprecedes hearing loss“On-Off”phenomenon,Pure tone audio,Management,AmplificationRefuse surgeryPoor surgical candidateMedical therapySodium fluorideVitamin DCalcium carbonateStapes surgery,Stapes surgery,Total StapedectomyPartial StapedectomyAnterior crurotomyStapedotomy,Thanks！,