Blood flow to the promontory in cochlear otosclerosis.

OBJECTIVE

To investigate Schwartze sign with measurements of blood flow to the promontory in patients with cochlear otosclerosis.

DESIGN

Prospective clinical study.

SETTING

Tertiary referral centre.

PARTICIPANTS

Five patients with cochlear otosclerosis and five control subjects. Significant decalcification around the cochlea was observed by computed tomography (CT) in patients with cochlear otosclerosis. However, no recognizable lesion was observed at the oval window in two patients. One patient had mixed hearing loss and four patients had sensorineural hearing loss without an air-bone gap.

MAIN OUTCOME MEASURES

The relationship between CT findings and the presence or absence of Schwartze sign was investigated. Blood flow to the promontory was measured through the tympanic membrane using laser speckle flowgraphy and laser Doppler flowmetry.

RESULTS

The Schwartze sign correlated significantly with otosclerotic lesions invading the promontory. Patients with otosclerosis exhibited elevated and pulsating blood flow to the promontory with the Schwartze sign.

CONCLUSIONS

Computed tomography demonstrated that cochlear otosclerosis can exist without the oval window lesion. Schwartze sign can be used as a sign of the otosclerotic invasion to the promontory. The reddening of the Schwartze sign is likely due to increased blood flow.