[Deafness and Paget's disease].

Cases of deafness due to Paget's disease can be separated into two types : (1) deafness of a mainly mixed type in which progressive aggravation occurs particularly in the inner ear, and (2) perceptional deafness which progresses without involvement of the transmission apparatus. Among 35 hospitalized patients with Paget's disease, 21 of whom suffered cranial involvement, 18 cases of deafness related to the bone disease were discovered by means of systematic examinations. The deafness was of the mixed type in 11 cases and of the perceptional type in the other 7. Of the 11 patients with the mixed type of deafness with an ankylosis syndrome of the ossicles, 3 were operated upon : one of them underwent an operation to mobilize the stapes, and the two others underwent total stapedectomy followed by venous interposition and the positioning of a Teflon piston. The long-term results were frankly disappointing and did not suggest that these attempts at surgical treatment should be followed up. Calcitonin was employed in 9 patients (6 with mixed deafness and 3 with perception type deafness), with comparative audiograms in 5 cases, and was also not very effective : this lack of effect was a result of the long duration of the Paget's disease and of the deafness in the patients treated. The value of hormonal treatment in cases of deafness associated with Paget's disease will probably be in the prevention of this complication.