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Otol Neurotol. 2013 Sep;34(7):e55-60. doi: 10.1097/MAO.0b013e318298ac96.

The role of imaging in the diagnosis and management of otosclerosis.

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  • 1ENT Department, Northwick Park Hospital, North West London NHS Trust, Harrow, UK.

Abstract

OBJECTIVE:

To examine the evidence for the role of radiologic imaging in the diagnosis and management of otosclerosis.

DATA SOURCES:

A review of contemporary (1990 to present) English medical literature via MedLine using the terms imaging, otosclerosis, otospongiosis, stapes surgery, computed tomography, magnetic resonance, CT, and MRI was performed.

STUDY SELECTION:

Abstracts were reviewed independently by 2 authors and relevant articles were then evaluated. Exclusion criteria included editorials, non-English language, comments, and letters.

DATA EXTRACTION:

Level of evidence was assigned in accordance with the Oxford Centre for Evidence-based Medicine guidance (Levels I-V).

RESULTS:

Thirty-seven articles met the inclusion criteria, of which, 11 were of Level III, 22 of Level IV, and 4 of level V evidence. High-resolution computed tomography (CT) of the temporal bones is the imaging technique of choice in the diagnosis of otosclerosis with newer multidetector scanners demonstrating a sensitivity and specificity in excess of 90%. There is Level III evidence that CT densitometry and extent of disease on CT correlates with hearing thresholds. Extensive and multifocal disease on CT has a poorer prognosis (Level III/IV). The potential use of CT in staging classifications, surgical planning, predicting surgical outcomes and risk of complications has also been described and evaluated.

CONCLUSION:

This systematic review indicates that imaging has a useful role in both the diagnosis and management of otosclerosis, supported principally by Level III/IV evidence.

PMID:
23921926
[PubMed - indexed for MEDLINE]
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