Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
-
To assess the reliability of high-resolution computed tomographic scan (HRCT scan) for the diagnosis of otosclerosis and to determine its usefulness to predict hearing deterioration and surgical difficulties. ⋯ In our series, the sensitivity of HRCT scan to otosclerosis was 95.1%. Hypodense otosclerotic foci were mostly localized at the anterior part of footplate. Negative or doubtful cases were associated with the highest incidence of stapes footplate complications. Foci involving otic capsule, internal auditory canal, or round window led to a significantly higher risk of sensorineural hearing loss.
-
The increased likelihood of facial nerve stimulation (FNS) with cochlear implantation in advanced cochlear otosclerosis is due to a lowering of the facial nerve excitation threshold with increasing bone demineralization. ⋯ The clinical observation of increased FNS in cases of cochlear otosclerosis has been demonstrated in a computational model. Rather than decreased FN threshold, it is the increased levels for cochlear stimulation that is the main factor. Particularly, perimodiolar designs with more shielding against lateral spread of current could reduce the likelihood of FNS.