Otosclerosis MCQs

Gelle's test Compares intensity of bone-conducted tuning fork sound, without and with, raising pressure on the tympanic membrane with Siegel's speculum. Normally, Gelle's test is positive because intensity of hearing decreases when air pressure is raised in external auditory canal. In ossicular fixation or ossicular discontinuity, increased air pressure makes no changes in the sound intensity(Gelle's negative). Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 27.

SODIUM FLUORIDE Mechanism of action: Inhibitor of osteoclast activity and so a stabilizer of bone turnover. It also leads to increased calcium deposition in otospongiotic foci and decreased bone remodelling. It inhibits the proteolytic enzymes in the cochlea. Uses: Sodium fluoride is the treatment of choice in Schwartz sign positive patients which represents the active stage of the disease. It is also used in cochlear otosclerosis. Contraindications: Chronic nephritis, Flourosis, in pregnant and lactating women and in children. Reference: Scott Brown's Otolaryngology, Head and Neck Surgery, 8 th edition, Volume 2, Page - 1074.

Rising sun sign is seen in Glomus Jugulare. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page -

Schwartz sign in otosclerosis is contraindication for surgery . Other treatment for Otosclerosis Hearing aid- is given for patients unwilling for surgery. Sodium fluoride (NaF) oral therapy. It is treatment of choice for Schwartz sign (+) patient. (Early stage of disease) Cochlear otosclerosis. NaF leads to stabilization of disease. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 105. Reference: Scott Brown's Otolaryngology, Head and Neck Surgery, 8 th edition, Volume 2, Page - 1079.

VAN DER HOEVE SYNDROME OSTEOGENESIS IMPERFECTA. OTOSCLEROSIS. BLUE SCLERA. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 103.

Diplacusis : Patient can hear the same sound in 2 frequencies. This is seen in MENIERES DISEASE not in OTOSCLEROSIS. Paracusis willisi : Patient can hear better in noisy areas . It is seen in OTOSCLEROSIS. Remaining all other options are true about Otosclerosis. Reference : Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, Chapter name: Otosclerosis, Page number: 104

The case scenario given in the question is suggestive of Otosclerosis . Surgical management: Stapedectomy/stapedotomy with a placement of prosthesis is the treatment of choice. Here the fixed otosclerotic stapes is removed and a prosthesis inserted between the incus and oval window. Prosthesis employed may be a teflon piston, stainless steel piston, platinum-teflon or titanium-teflon piston. Other options: The case given in the question is of Otosclerosis in which we occasionally manage conservatively (option B) and not by Tympanoplasty (option A) and tympanoplasty with stapedectomy.

Acoustic neuroma is a retrocochlear lesion. Tone decay Test is a measure of auditory nerve fatigue. Tone decay is faster in retrocochlear lesion. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 31.