Laryngorhinootologie 2018; 97(08): 563-578
DOI: 10.1055/a-0589-3613
Facharztwissen HNO
© Georg Thieme Verlag KG Stuttgart · New York

Diagnostik und operative Therapie der Otosklerose

Teil 1: Grundlagen, Diagnostik und DifferenzialdiagnostikDiagnosis and operative therapy of otosclerosisPart 1: Basics, Diagnostics and Differential Diagnosis
Marie-Luise Metasch
,
Stefan K. Plontke
,
Jonas Zirkler
,
Thomas Zahnert
Further Information

Publication History

Publication Date:
06 August 2018 (online)

Zusammenfassung

Die Otosklerose ist eine für den HNO-Arzt/Ärztin wichtige, oft in (Differenzial-)Diagnostik und Therapie anspruchsvolle Erkrankung. Wenngleich bis heute eine kausale Therapieoption nicht besteht, kann bei richtiger Diagnosestellung eine operative oder apparative Hörrehabilitation mit sehr hohen Erfolgschancen in Aussicht gestellt werden.

Abstract

Otosclerosis is an important condition for the otorhinolaryngologist, and often in (differential) diagnosis and therapy challenging disease. Although a causal therapy option does not exist until today, if the diagnosis is correct, an operative or apparative hearing rehabilitation with very high chances of success can be promised. In addition to hearing aids surgical treatment with passive implants as a standard therapy, and in special cases also the implantation of active middle ear implants or cochlear implants, in advanced otosclerosis with significant involvement of the inner ear, are of importance. Knowledge of the definition, pathogenesis, diagnostics and in particular of the differential diagnosis as well as the current conservative and operative therapeutic limits are indispensable for the indication and selection of the optimal treatment path.

In a two-part presentation, the current specialist medical knowledge of the disease in diagnosis and therapy is summarized. In addition to modern diagnostic procedures, aspects of therapy and prognosis are considered in a second article. This article therefore primarily refers to continuing education for residents in training and for young specialists.

 
  • Literatur

  • 1 Arnold W. Some Remarks on the Histopathology of Otosclerosis 2007; 65: 25-30
  • 2 Albers AE, Wagner W, Stölzel K. et al. [Laser stapedotomy]. HNO 2011; 59: 1093-1102
  • 3 Tange RA. The history of otosclerosis treatment: a survey of more than a centuryís search for the best treatment of the disease. Amsterdam, The Netherlands: Kugler Publications; 2014
  • 4 Weir N, Mudry A. Otorhinolaryngology An Illustrated History. 2. Auflage.. Ashford, UK:: Headley Brothers Digital Ltd; 2013
  • 5 Schrader M. Geschichte der Otosklerose. Oto-Rhino-Laryngol Nova 1998; 8: 1-6
  • 6 Schwartze H. Zur Pathologie der Synostose des Steigbügels 1870; 257-271
  • 7 Politzer A. Ueber primäre Erkrankung der knöchernen Labyrinthkapsel. Ztschr Ohrenheilk 1893; 25: 309-327
  • 8 Panse R. Die Schwerhörigkeit durch Starrheit der Paukenfenster. Jena: Gustav Fischer; 1897
  • 9 Zenner H. Beethovens Taubheit – Wie ein Verbannter muß ich leben!. Dtsch Ärztebl 2002; 99: A 2762-2766
  • 10 Diagnosedaten der Krankenhäuser in Deutschland (Tabelle). Im Internet: http://www.gbe-bund.de/gbe10/I?I=550:30286774D
  • 11 DRG Statistik. Im Internet: http://www.gbe-bund.de/gbe10/I?I=662:30286860D
  • 12 Guild S. Histologic otosclerosis. Ann Otol Rhinol Laryngol 1944; 53: 246-266
  • 13 Vincent R, Wegner I, Vonck BMD. et al. Primary stapedotomy in children with otosclerosis: A prospective study of 41 consecutive cases. The Laryngoscope 2016; 126: 442-446
  • 14 Arnold W, Ganzer U. Checkliste Hals-Nasen-Ohren-Heilkunde: 48 Tabellen. 5. Aufl.. Stuttgart: Thieme; 2011
  • 15 Strutz J, Mann W, Arndt O. (Hrsg) Praxis der HNO-Heilkunde, Kopf- und Halschirurgie. 2. Aufl.. Stuttgart: Thieme; 2010
  • 16 Rudic M, Keogh I, Wagner R. et al. The pathophysiology of otosclerosis: Review of current research. Hear Res 2015; 330: 51-56
  • 17 Ealy M, Smith RJH. The genetics of otosclerosis. Hear Res 2010; 266: 70-74
  • 18 Yoo TJ. Etiopathogenesis of Otosclerosis: A Hypothesis. Ann Otol Rhinol Laryngol 1984; 93: 28-33
  • 19 Sörensen MS, Nielsen LP, Bretlau P. et al. The Role of Type II Collagen Autoimmunity in Otosclerosis Revisited. Acta Otolaryngol (Stockh) 1988; 105: 242-247
  • 20 Karosi T, Szekanecz Z, Sziklai I. Otosclerosis: An autoimmune disease?. Autoimmun Rev 2009; 9: 95-101
  • 21 Stankovic KM, McKenna MJ. Current research in otosclerosis. Curr Opin Otolaryngol Head Neck Surg 2006; 14: 347
  • 22 McKenna MJ, Mills BG, Galey FR. et al. Filamentous structures morphologically similar to viral nucleocapsids in otosclerotic lesions in two patients. Am J Otol 1986; 7: 25-28
  • 23 Arnold W, Friedmann I. Nachweis von masern- und rötelnspezifischen Antigenen in der enchondralen Verknöcherungszone bei der Otosklerose*. Laryngol Rhinol Otol Ihre Grenzgeb 1987; 66: 167-171
  • 24 Niedermeyer H, Arnold W, Neubert WJ. et al. Evidence of Measles Virus RNA in Otosclerotic Tissue. ORL 1994; 56: 130-132
  • 25 Grayeli AB, Palmer P, Huy PTB. et al. No Evidence of Measles Virus in Stapes Samples from Patients with Otosclerosis. J Clin Microbiol 2000; 38: 2655-2660
  • 26 Karosi T, Jókay I, Kónya J. et al. Detection of Osteoprotegerin and TNF-alpha mRNA in Ankylotic Stapes Footplates in Connection With Measles Virus Positivity. The Laryngoscope 2006; 116: 1427-1433
  • 27 Imauchi Y, Lainé P, Sterkers O. et al. Effect of 17β-estradiol on diastrophic dysplasia sulfate transporter activity in otosclerotic bone cell cultures and SaOS-2 cells. Acta Otolaryngol (Stockh) 2004; 124: 890-895
  • 28 Fanó G, Venti-Donti G, Belia S. et al. PTH induces modification of transductive events in otosclerotic bone cell cultures. Cell Biochem Funct 1993; 11: 257-261
  • 29 Grayeli AB, Sterkers O, Roulleau P. et al. Parathyroid hormone-parathyroid hormone-related peptide receptor expression and function in otosclerosis. Am J Physiol-Endocrinol Metab 1999; 277 (06) Pt 1 E1005-12
  • 30 Lippy WH, Berenholz LP, Schuring AG. et al. Does pregnancy affect otosclerosis?. The Laryngoscope 2005; 115: 1833-1836
  • 31 Scholes M, Ramakrishnan V. ENT Secrets. 4th ed. Philadelphia: Elsevier; 2016
  • 32 Reifl M. Facharztwissen HNO-Heilkunde – Differenzierte Diagnostik und Therapie. 1. Aufl.. Berlin, Heidelberg: Springer; 2009
  • 33 Gundersen T. Paracusis Willisii. Acta Otolaryngol (Stockh) 1958; 49: 499-508
  • 34 Huber AM, Sequeira D, Breuninger C. et al. The effects of complex stapes motion on the response of the cochlea. Otol Neurotol 2008; 29: 1187-1192
  • 35 Kim J, Koo M. Mass and Stiffness Impact on the Middle Ear and the Cochlear Partition. J Audiol Otol 2015; 19: 1-6
  • 36 Carhart R. The clinical application of bone conduction audiometry. Arch Oto-Laryng 1950; 51: 798
  • 37 Khanna SM, Tonndorf J. The vibration pattern of the round window in cats. J Acoust Soc Am 1971; 50: 1475-1483
  • 38 Emanuel D, Letowski T. Hearing Science. Baltimore: Lippincott Williams and Wilkins; 2009
  • 39 Kelemen G, Linthicum JF. Labyrinthine otosclerosis. Acta Oto-Laryngol Suppl 1969; 253: 1-68
  • 40 Merchant SN, Nadol JB. Schuknechtís Pathology of the Ear. PMPH-USA; 2010
  • 41 Baysal E, Gulsen S, Aytac I. et al. Oxidative stress in otosclerosis. Redox Rep Commun Free Radic Res 2017; 22: 235-239
  • 42 Kashio A, Ito K, Kakigi A. et al. Carhart Notch 2-kHz Bone Conduction Threshold Dip: A Nondefinitive Predictor of Stapes Fixation in Conductive Hearing Loss With Normal Tympanic Membrane. Arch Otolaryngol Neck Surg 2011; 137: 236-240
  • 43 Yasan H. Predictive role of Carhart‘s notch in pre-operative assessment for middle-ear surgery. J Laryngol Amp Otol 2007; 121: 219-221
  • 44 Wada H, Kobayashi T, Suetake M. et al. Dynamic Behavior of the Middle Ear Based on Sweep Frequency Tympanometry. Audiology 1988; 127-134
  • 45 Wegner I, Bittermann AJN, Hentschel MA. et al. Pure-tone Audiometry in Otosclerosis: Insufficient Evidence for the Diagnostic Value of the Carhart Notch. Otolaryngol-Head Neck Surg 2013; 149: 528-532
  • 46 Ernst A, Todt I, Wagner J. Dehiszenzsyndrome. HNO 2016; 64: 790-796
  • 47 Baljić I, Winkler A, Schmidt T. et al. Untersuchungen zur perzeptiven Äquivalenz der Testlisten im Freiburger Einsilbertest. HNO 2016; 64: 572-583
  • 48 Exter M, Winkler A, Holube I. Phonemische Ausgewogenheit des Freiburger Einsilbertests. HNO 2016; 64: 557-563
  • 49 Hoppe U. Hörgeräteerfolgskontrolle mit dem Freiburger Einsilbertest. HNO 2016; 64: 589-594
  • 50 Hoth S. Der Freiburger Sprachtest. HNO 2016; 64: 540-548
  • 51 Schmidt T, Baljić I. Untersuchung zum Trainingseffekt des Freiburger Einsilbertests. HNO 2016; 64: 584-588
  • 52 Steffens T. Verwendungshäufigkeit der Freiburger Einsilber in der Gegenwartssprache. HNO 2016; 8: 549-556
  • 53 Winkler A, Holube I. Test-Retest-Reliabilität des Freiburger Einsilbertests. HNO 2016; 64: 564-571
  • 54 Müller J, Plontke SK, Rahne T. Sprachaudiometrische Zielparameter in klinischen Studien zur Hörverbesserung. HNO 2017; 65: 211-218
  • 55 Zirkler J, Rahne T, Plontke SK. Stapeschirurgie bei Otosklerose mit einer neuen Titanprothese mit superelastischem Nitinol-Clip. HNO 2016; 64: 111-116
  • 56 Kösling S. Moderne Schläfenbeinbildgebung. HNO 2017; 65: 462-471
  • 57 Pein MK, Brandt S, Plontke SK. et al. Darstellung subtiler Schläfenbeinstrukturen. Radiol 2014; 54: 271-278
  • 58 Dudau C, Salim F, Jiang D. et al. Diagnostic efficacy and therapeutic impact of computed tomography in the evaluation of clinically suspected otosclerosis. Eur Radiol 2017; 27: 1195-1201
  • 59 Yamashita K, Hiwatashi A, Togao O. et al. Additive value of –otosclerosis-weightedì images for the CT diagnosis of fenestral otosclerosis. Acta Radiol Stockh Swed 1987 2017; 58: 1215-1221
  • 60 Gürkov R, Jerin C, Flatz W. et al. Dehiszenzsyndrom des oberen Bogengangs: Diagnostik mit vestibulär evozierten myogenen Potenzialen und Fremitusnystagmus. HNO 2018; 66: 390-395
  • 61 Pein MK, Rahne T, Noll A. et al. Seltene Differenzialdiagnose einerSchallleitungsschwerhörigkeit im Kindesalter. HNO. 2018 https://doi.org/10.1007/s00106–018–0486–5
  • 62 Plontke SK, Rahne T, Pfister M. et al. Intralabyrinthäre Schwannome. HNO 2017; 65: 419-433
  • 63 Plontke SK, Zirkler J. Hörverbesserung durch Tympanoplastik. Laryngo-Rhino-Otol 2017; 96: 718-740
  • 64 Foster MF, Backous DD. Clinical Evaluation of the Patient with Otosclerosis. Otolaryngol Clin North Am 2018; 51: 319-326
  • 65 Zahnert T. Schwerhörigkeit – Ätiologie, Diagnostik und auditive Rehabilitation. Laryngo-Rhino-Otol 2010; 89: 669-693
  • 66 Quesnel AM, Seton M, Merchant SN. et al. Third generation bisphosphonates for treatment of sensorineural hearing loss in otosclerosis. Otol Neurotol 2012; 33: 1308-1314
  • 67 Hentschel MA, Huizinga P, van der Velden DL. et al. Limited Evidence for the Effect of Sodium Fluoride on Deterioration of Hearing Loss in Patients With Otosclerosis: A Systematic Review of the Literature. Otol Neurotol 2014; 35: 1052
  • 68 Penido N de O, Vicente A de O. Medical Management of Otosclerosis. Otolaryngol Clin North Am 2018; 51: 441-452
  • 69 Rettinger G, Hosemann W, Hüttenbrink KB. et al., (Hrsg). HNO-Operationslehre: mit allen wichtigen Eingriffen. 5. Aufl.. Stuttgart: Thieme; 2018
  • 70 Bittermann AJN, Rovers MM, Tange RA. et al. Primary Stapes Surgery in Patients With Otosclerosis: Prediction of Postoperative Outcome. Arch Otolaryngol Neck Surg 2011; 137: 780-784
  • 71 Vincent R, Sperling NM, Oates J. et al. Surgical findings and long-term hearing results in 3,050 stapedotomies for primary otosclerosis: a prospective study with the otology-neurotology database. Otol Neurotol 2006; 27: 25-47
  • 72 Ayache D, Earally F, Elbaz P. Characteristics and Postoperative Course of Tinnitus in Otosclerosis. Otol Neurotol 2003; 24: 48
  • 73 Koopmann M, Weiss D, Savvas E. et al. Outcome measures in stapes surgery: postoperative results are independent from preoperative parameters. Eur Arch Otorhinolaryngol 2015; 272: 2175-2181
  • 74 Gersdorff M, Nouwen J, Gilain C. et al. Tinnitus and otosclerosis. Eur Arch Otorhinolaryngol 2000; 257: 314-316
  • 75 Kishimoto M, Ueda H, Uchida Y. et al. Factors affecting postoperative outcome in otosclerosis patients: Predictive role of audiological and clinical features. Auris Nasus Larynx 2015; 42: 369-373
  • 76 Marchese MR, Conti G, Cianfrone F. et al. Predictive Role of Audiological and Clinical Features for Functional Results after Stapedotomy. Audiol Neurotol 2009; 14: 279-285
  • 77 Dhooge I, Desmedt S, Maly T. et al. Long-term hearing results of stapedotomy: analysis of factors affecting outcome. Eur Arch Otorhinolaryngol 2018; 275 (05) 1111-1119
  • 78 Rahne T, Seiwerth I, Götze G. et al. Functional results after Bonebridge implantation in adults and children with conductive and mixed hearing loss. Eur Arch Otorhinolaryngol 2015; 272: 3263-3269
  • 79 Rahne T, Plontke SK. Apparative Therapie bei kombiniertem Hörverlust. HNO 2016; 64: 91-100
  • 80 Eshraghi AA, Ila K, Ocak E. et al. Advanced Otosclerosis: Stapes Surgery or Cochlear Implantation?. Otolaryngol Clin North Am 2018; 51: 429-440