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Obliquity of the Stapes in Otosclerosis: A New Radiological Sign.

Anand V, Udayabhanu HN, Subramaniam BS - Int Arch Otorhinolaryngol (2016)

Bottom Line: Results An increased mean distance between the horizontal segment of facial nerve and stapes head in otosclerotic patients (i.e., 2.49mm +/- 0.24mm SD), when compared with the non-otosclerotic patients (i.e., 1.46mm +/- 0.16mm SD) is noted.There is a change in angle (i.e., 64.550 +/- 7.190 SD) subtended by the stapes toward the promontory in otosclerotic ears when compared with that of controls (i.e., 99.700 +/- 40 SD).We applied the Mann-Whitney U non-parametric test and considered p value of < 0.0001 highly significant.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, MCV Memorial ENT Trust Hospital, Pollachi, Tamil Nadu, India.

ABSTRACT
Introduction Observing the obliquity of stapes by closely scrutinizing the HRCT temporal bone in otosclerosis revealed a reliable and consistent finding. This finding can add to the existing radiological criteria in diagnosis of otosclerosis. Objective The objective of this study is to establish the obliquity of stapes in otosclerosis by radiological measurements using HRCT temporal bone by comparing: (a) the distance between the horizontal (tympanic) segment of facial nerve and stapes head in otosclerotic ears (study group) with non-otosclerotic ears (control group); and (b) the angle subtended by stapes with promontory in the study and control groups. Methods This is a prospective study performed after the institutional Ethics Committee clearance (IEC 3/2013). Results An increased mean distance between the horizontal segment of facial nerve and stapes head in otosclerotic patients (i.e., 2.49mm +/- 0.24mm SD), when compared with the non-otosclerotic patients (i.e., 1.46mm +/- 0.16mm SD) is noted. There is a change in angle (i.e., 64.550 +/- 7.190 SD) subtended by the stapes toward the promontory in otosclerotic ears when compared with that of controls (i.e., 99.700 +/- 40 SD). We applied the Mann-Whitney U non-parametric test and considered p value of < 0.0001 highly significant. Conclusions Obliquity of stapes in otosclerosis referred to as a "Pisa" sign by the senior author has diagnostic value as a new radiological sign in imaging of otosclerosis. This obliquity explains the torsional effect of otosclerosis on the ossicular chain. The findings correlate with late complications and failures in stapes surgery.

No MeSH data available.


Related in: MedlinePlus

HRCT Temporal bone length measured in non-otosclerotic patient.
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FI0346or-5: HRCT Temporal bone length measured in non-otosclerotic patient.

Mentions: We compared the radiological measurements obtained in the otosclerotic and non-otosclerotic patients (i.e., SSNHL) and ran a statistical analysis with SPSS 17.0 software using the Mann-Whitney U non-parametric test. The mean distance between the facial nerve and the stapes head in High resolution CT scans, 1 mm contiguous coronal sections, taken at the level of the lateral semicircular canal was 2.49 mm +/− 0.24 mm SD in otosclerotic ears and 1.46 mm +/− 0.16 mm SD in non-otosclerotic ears. In the otosclerosis subjects, the mean angle measured was 64.55° +/− 7.19° SD, whereas in the non-otosclerotic ears it was 99.70° +/− 4° SD. The Man-Whitney U non-parametric test showed that the test statistic value was greater than the table value for length and angle measurements in both the groups and the p value was highly significant at level < 0.0001. This indicates a torsional effect and downshift of the stapes toward the promontory (Tables 1, 2, 3 and Figs. 345678).


Obliquity of the Stapes in Otosclerosis: A New Radiological Sign.

Anand V, Udayabhanu HN, Subramaniam BS - Int Arch Otorhinolaryngol (2016)

HRCT Temporal bone length measured in non-otosclerotic patient.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4835337&req=5

FI0346or-5: HRCT Temporal bone length measured in non-otosclerotic patient.
Mentions: We compared the radiological measurements obtained in the otosclerotic and non-otosclerotic patients (i.e., SSNHL) and ran a statistical analysis with SPSS 17.0 software using the Mann-Whitney U non-parametric test. The mean distance between the facial nerve and the stapes head in High resolution CT scans, 1 mm contiguous coronal sections, taken at the level of the lateral semicircular canal was 2.49 mm +/− 0.24 mm SD in otosclerotic ears and 1.46 mm +/− 0.16 mm SD in non-otosclerotic ears. In the otosclerosis subjects, the mean angle measured was 64.55° +/− 7.19° SD, whereas in the non-otosclerotic ears it was 99.70° +/− 4° SD. The Man-Whitney U non-parametric test showed that the test statistic value was greater than the table value for length and angle measurements in both the groups and the p value was highly significant at level < 0.0001. This indicates a torsional effect and downshift of the stapes toward the promontory (Tables 1, 2, 3 and Figs. 345678).

Bottom Line: Results An increased mean distance between the horizontal segment of facial nerve and stapes head in otosclerotic patients (i.e., 2.49mm +/- 0.24mm SD), when compared with the non-otosclerotic patients (i.e., 1.46mm +/- 0.16mm SD) is noted.There is a change in angle (i.e., 64.550 +/- 7.190 SD) subtended by the stapes toward the promontory in otosclerotic ears when compared with that of controls (i.e., 99.700 +/- 40 SD).We applied the Mann-Whitney U non-parametric test and considered p value of < 0.0001 highly significant.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, MCV Memorial ENT Trust Hospital, Pollachi, Tamil Nadu, India.

ABSTRACT
Introduction Observing the obliquity of stapes by closely scrutinizing the HRCT temporal bone in otosclerosis revealed a reliable and consistent finding. This finding can add to the existing radiological criteria in diagnosis of otosclerosis. Objective The objective of this study is to establish the obliquity of stapes in otosclerosis by radiological measurements using HRCT temporal bone by comparing: (a) the distance between the horizontal (tympanic) segment of facial nerve and stapes head in otosclerotic ears (study group) with non-otosclerotic ears (control group); and (b) the angle subtended by stapes with promontory in the study and control groups. Methods This is a prospective study performed after the institutional Ethics Committee clearance (IEC 3/2013). Results An increased mean distance between the horizontal segment of facial nerve and stapes head in otosclerotic patients (i.e., 2.49mm +/- 0.24mm SD), when compared with the non-otosclerotic patients (i.e., 1.46mm +/- 0.16mm SD) is noted. There is a change in angle (i.e., 64.550 +/- 7.190 SD) subtended by the stapes toward the promontory in otosclerotic ears when compared with that of controls (i.e., 99.700 +/- 40 SD). We applied the Mann-Whitney U non-parametric test and considered p value of < 0.0001 highly significant. Conclusions Obliquity of stapes in otosclerosis referred to as a "Pisa" sign by the senior author has diagnostic value as a new radiological sign in imaging of otosclerosis. This obliquity explains the torsional effect of otosclerosis on the ossicular chain. The findings correlate with late complications and failures in stapes surgery.

No MeSH data available.


Related in: MedlinePlus