Otosclerosis

otosclerosis

1. OTOSCLEROSIS

2. Otosclerosis Otosclerosis or “hardening of the ear” result from the formation of an abnormal spongy bone , like bone growth along the stapes in the middle ear. With the new bone growth , the stapes become immobile prevents transmission as sound vibration into the ear, leading to conductive hearing loss. Otosclerosis usually affect the both ears.

3. Classification There are mainly two types of classification 1. Histological otosclerosis 2. Clinical otosclerosis

4. 1.Histological otosclerosis This type of otosclerosis does not produce any symptoms during life but is revealed only at postmortem

5. 2.Clinical otosclerosis There are three sub types Stapedial otosclerosis Cochlear otosclerosis Mixed otosclerosis

6. 1.stapedial otosclerosis The otosclerosis focus may produce ankylosis of the membraneous labyrinth 2.Cochlear otosclerosis The otosclerotic process encroaches upon the membraneous labyrinth producing sensoryneural deafness.

7. 3.Mixed otosclerosis Otosclerosis causes both fixation of the stapes as well as in involvement of the labyrinth so that there are mixed hearing loss.

8. causes Geneic factors Viral infection Measles Other ear conditions

9. Clinical Manifestations Hearing loss Dizziness Tinnitus Roaring Buzzng the ear Vertigo headache & earache

10. Diagnostic evaluation History Physial examination Tuning fork test Audiometry test Tympanocentesis – fluid for middle ear send for culture CT scan – collection of fluidin ear & mastoid region , abscess formation MRI – evaluation of tumor & soft tissue AUDIOGRAPHY – to assess hearing loss

11. Management Otosclerosis may slowly get worse. The condition may not require treatment until you having severe hearing problems. Medications such as fluoride, calcium, or vitamin D may help to slow the hearing loss, but the benefits have not yet been proved. No known medical treatment exists for this form of deafness, but amplification with a hearing aid may be helpful.

12. Administer analgesics such as – IBUPROFEN OXYCODONE ACETAMENOPHEN (PCM) Hearing aid may be used to treat the hearing loss General measures : Avoidance of noise full environment Side lying position Continuous applications of medications High protein diet

13. Surgerical management stapedectomy . The removal of portion of the sclerotic stepes footplate of stapes or complete removal of the stapes and the implant with prosthesis to maintain suitable conduction.

14. Stapedotomy Modern surgery called stapedotomy is performed by drilling a small hole in the stapes footplate with micro drill or laser, and the insertion of a piston like prosthesis.

15. Nursing assessment History of onset & progression of symptoms Extend of hearing loss via audiotory Rinne test – to evaluate loss of air conduction Webers test-

16. Complications Complete deafness Nerve damage Infection, dizziness, pain, or blood clot in the ear after surgery