Otosclerotic Stapes Research Articles

Veränderungen im Bereich der Mittelohrschleimhaut bei der Otosklerose

In 98 samples of middle-ear mucosa, taken from patients during otosclerotic stapes surgery, considerable pathological changes in the organization of the capillaries were found (endothelial hydrops, proliferation of the intima and adventitia, total obliteration of small vessels). They caused pathological reactions of the mesenchymal elements of the submucosa: fibrocytes undergo lysis, collagen fibres show fibolysis and hyalinosis. Free and cellular bound calcium deposits are located in these lytic areas. Even the epithelial stratum reveals uncommon inclusions such as glycogen and acid mucopolysaccharides. The basement membranes of the capillaries as well as of the epithelium show enlargements and solution of their ultrastructure. The changes of the connective tissue and of the epithelium are secondary to the capillary obstructions.

Active otosclerotic foci in the stapes. An electron microscopic study.

A total of 12 undecalcified and decalcified otosclerotic stapes containing active spongiotic lesions were examined using an electron microscope. Evidence of osteolytic osteolysis was seen in all specimens, but osteoclasts were observed in only four. The advancing front in the spongiotic lesion was 'moth-eaten' due to the demineralization of canaliculi and lacunae. The demineralizing process appeared to be initiated by degranulation of lysosomes by the degenerating osteocytes. As bone resorption continued, poorly mineralized new bone was laid down by osteoblasts which showed mitochondrial swelling. The possible implication of this mitochondrial swelling is discussed in relation to the pathology of the otosclerosis.

Microhardness Testing as a Means of Analysing the Mineralization of the Otosclerotic Stapes

The microhardness of 18 otosclerotic and 9 normal stapedes was tested in order to analyse the degree of mineralization. The analysis was carried out with the Leitz-Durimet on specimens fixed in alcohol and embedded in methacrylates. It was found that the otosclerotic bone is less mineralized than the normal bone. The mineral content of the active foci is 10–15% less than that of the normal bone and the quiescent foci are only 1.2–4% less mineralized. The values of microhardness were compared with the data obtained by microradiography.

The Connective Tissue in Normal and Otosclerotic Bone

Normal and otosclerotic human stapes was studied by light and electron microscopy with a view to disclosing generalized histologic changes in the stapes outside the otosclerotic focus that might lend support to the theory that otosclerosis is a generalized connective-tissue disorder. By means of various connective-tissue stains 43 stapedes, of which 31 presented an otosclerotic focus, were studied by light microscope; eight stapedes, thereof four with otosclerosis, were examined by electron microscope. The structure of periosteum and bony tissue was found to be normal, and there were no significant differences in normal and otosclerotic stapes. Preotosclerotic changes were not disclosed in any preparation. The study provided no evidence of otosclerosis being a generalized connective-tissue disorder.

Glomus tympanicum tumor in an otosclerotic ear.

REVIEW of the English literature since 1945, the year Rosenwasser reported the first surgical removal of a glomus jugulare tumor, failed to reveal any reference to the simultaneous occurrence of clinical otosclerosis and a tumor of the glomus jugulare. In this report, such a case is presented. Report of a Case A 55-year-old white woman had been well except for slowly progressive bilateral hearing loss until the fall of 1965, when she noted a pulsating tinnitus in the left ear following a cold. The hearing loss seemed to increase after the onset of tinnitus. An otological evaluation in May 1966 revealed normal tympanic membranes on both sides. The audiometric test showed bilateral mixed hearing loss. The diagnosis of clinical otosclerosis was made and the patient underwent a left stapedectomy on Aug 26. The fixed otosclerotic stapes was replaced with a fat-wire prosthesis. The surgeon noted a persistent stapedial artery, which

Osteogenesis imperfecta. Light and electron microscopic studies of the stapes.

The light and electron microscopic findings in the stapes from a patient with osteogenesis imperfecta are correlated with the findings in the normal and otosclerotic stapes. In osteogenesis imperfe...

Bilateral malleal fixation and conductive presbycusis.

"THE Fixed Malleus Syndrome" as a term applied to fixation of the malleus head (caput mallei) has been described in previous publications.^1,2Undoubtedly, a number of factors may be etiologically significant in this syndrome. Most of the cases reported have been unilateral, although bilateral cases have been noted by Guilford and Anson,³Davies,⁴and Sleeckx et al.⁵It is especially in the bilateral case that one is faced with a difficult differential diagnosis. The syndrome has been encountered both with and without otosclerotic stapes fixation. Much speculation exists with reference to the etiology of malleus fixation when it occurs concomitantly with stapedial otosclerosis. It would probably be helpful to consider such concomitant malleal fixation as "secondary" and due to long continued lateral ossicular deformation as the result of stapedial otosclerosis. Similarly, malleus fixation due to obvious epitympanic tympanosclerosis plaques should be considered secondary. Thus, it would