Otosclerosis, (Thickened Ear Bones) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

by Kenneth Kee

Overview

This book describes Otosclerosis, Diagnosis and Treatment and Related Diseases
Otosclerosis is an abnormal bone growth in the middle ear that produces hearing loss.
There is abnormal bone metabolism affecting the stapes, oval window and the otic capsule.
It leads to the progressive fusion of the stapes footplate and ultimately sclerosis of the cochlea in advanced cases.
Otosclerosis (OTSC) is the single most frequent cause of hearing impairment.
It is a genetically controlled metabolic dysplasia, involving the bony tissue of the otic capsule (the skeletal elements enclosing the inner ear mechanism) and the auditory ossicles.
The otic capsular bone is unusual in that, after early development, it does not undergo extensive re-modeling.
In OTSC there is a pathological higher bony change leading to sclerosis and malfunction of sound conduction mechanism from ankylosis of the stapes footplate in the fenestra ovalis (oval window)of the cochlea.
This produces a slowly progressive conductive hearing impairment.
In some cases, the disease process may also extend from bony tissue to the cochlea itself, causing a mixed conductive and sensorineural hearing loss.
Incidence
Otosclerosis is the most frequent source of middle ear hearing loss in young adults.
It normally starts in early to mid-adulthood.
It is more frequent in women than in men.
Certain races such as Caucasians and Indians are more prone to have otosclerosis.
Causes

The exact cause of otosclerosis is not known.
It may be inherited through families.
OTSC is inherited in an autosomal dominant fashion with inconsistent penetrance
The interplay of genes with environmental factors is believed to be vital in the phenotypic activation of genetic susceptibility
Environmental factors implicated in the cause of otosclerosis are:
1. Estrogens,
2. Fluoride and
3. Viral infections such as measles.
People who have otosclerosis have an atypical sponge-like bone growing in the middle ear.
This growth stops the ear bones from vibrating in reaction to sound waves.
These vibrations are needed in order for the patient to hear.
The disorder may involve one or both ears.
The abnormal deposition and the hardening of the bone in the region results in the fixation of the stapes footplate, with concomitant conductive hearing loss.
The active bone remodeling may involve and injure the cochlea through the release of proteolytic enzymes or direct damage to the cochlea and spinal ligament.
Symptoms
1. Hearing loss 70%
2. Ringing in the ears (tinnitus)
3. Vertigo or dizziness
These symptoms are also found in Meniere’s Disease.
The start of hearing loss normally begins between the age of 15 and 45 years and then slowly progresses.
Signs:
Schwartz sign which is a faint reddish hue seen over the cochlear promontory through the ear drum
Rinne’s tuning fork test would be negative
Weber’s test will move to the affected side
Diagnosis
A hearing test (audiometry) determine the seriousness of hearing loss.
Temporal-bone CT scanning may be done to determine other causes of hearing loss.
Treatment
No treatment is needed until the patient has serious hearing problems.
Hearing loss can be improved with correct use of bilateral hearing aids.
Surgery can cure or improve conductive hearing loss.
Either all or part of one of the small middle ear bones behind the eardrum is excised (stapedectomy) and replaced with prosthesis.
This surgery has now been mostly replaced by stapedotomy
The stapes are removed except for the footplate
A small hole using a laser is made in the footplate
The stapes piston is then inserted into the vestibule
Surgical therapy has improved significantly with new stapes pistons
The success rate is close to 90%

TABLE OF CONTENT
Introduction
Chapter 1 Otosclerosis
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Deafness
Chapter 8 Meniere’s Disease
Epilogue

Product Details

BN ID:	2940155767183
Publisher:	Kenneth Kee
Publication date:	08/06/2018
Sold by:	Smashwords
Format:	eBook
File size:	166 KB

About the Author

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 65. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical conditions seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog afamilydoctorstale.blogspot.com. This autobiolographical account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Conditions” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 550 amazon kindle books and some into Smashwords.com eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical conditions. The first chapter of all my ebooks is always taken from my blog A Simple Guide to Medical Conditions which was started in 2007 as a simple educational help to my patients on my first blog http://kennethkee.blogspot.com. The medical condition was described simply and direct to the point. Because the simple guide as taken from the blog was described as too simple, I have increased the other chapters to include more detailed description of the illness, symptoms, diagnosis and treatment. As a result there are the complaints by some readers of constant repetitions of the same contents but in detail and fairly up to date. He has published 550 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health conditions and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Bouna Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. All the PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"