A 45 year old female presented with progressive loss of hearing.

1. What is the diagnosis?

2. What is the typical history?

3. The most common location of the lesion is?

Correct answer:

1. What is the diagnosis?

Otosclerosis (Otospongiosis)

2. What is the typical history?

Hearing loss in adulthood (40s)

3. The most common location of the lesion is?

The margin of the oval window (fissula ante fenestram)

Otospongiosis (Fenestral)

Idiopathic disorder of the bony labyrinth in which the dense, ivory like endochondral bone is replaced with a spongy irregular haversian bone (deafness follows).

KEY FEATURES

- It’s usually seen in white women in their 40s.

- If you catch it early you can prevent their deafness. If you miss it. I’m sure the jury will understand. “Let him off judge... he’s doing his best. "

- It might get worse with pregnancy

- There are two types:

        - Fenestral (most common) - targets the anterior margin of the oval window (fissula ante fenestram), more conductive hearing loss

        - Retrofenestral (less common) - targets the otic capsule around the cochlea, causes a more sensorineural hearing loss.

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