Declau F, Spaendonck M van, Timmermans J P, Michaels L, Liang J, Qiu J P, Van de Heyning P
Department of Otorhinolaryngology, Head and Neck Surgery and Communication Disorders, University of Antwerp, Antwerp, Belgium.
Adv Otorhinolaryngol. 2007;65:6-16. doi: 10.1159/000098663.
'Histologic otosclerosis' refers to a disease process without clinical symptoms or manifestations that can only be discovered by sectioning of the temporal bone at autopsy. 'Clinical otosclerosis' concerns the presence of otosclerosis at a site where it causes conductive hearing loss by interfering with the motion of the stapes or of the round window membrane. Various authors have studied the prevalence of histologic otosclerosis on laboratory collections of temporal bones. Some 12-15% of the temporal bones with histologic otosclerosis have demonstrated stapedial fixation. Using these figures for calculating the prevalence of clinical otosclerosis gives an extrapolated clinical prevalence of 0.99-1.2%. This does not correlate well with the clinical data on otosclerotic families from which a clinical prevalence of 0.3% has been estimated.
To study the prevalence of histologic otosclerosis in an unselected series of temporal bones.
During a 1-year period, 118 consecutive pairs of temporal bones of deceased patients at a tertiary center were collected to determine the prevalence of otosclerosis. Although histology remains the gold standard for evaluation of otosclerosis, the gross observation of temporal bone slices combined with microradiography was used to screen for otosclerotic lesions more rapidly and with a lower cost-benefit ratio. The temporal bones with suspected otosclerosis shown with these techniques were further analyzed by conventional histology.
2.5% of the 236 temporal bones (or 3.4% of patients) studied demonstrated histologic otosclerosis.
Although the prevalence of 2.5% is much lower than previously published figures on histologic otosclerosis, the extrapolated data (extrapolated clinical prevalence = 0.30-0.38%) correlate well with clinical studies of otosclerotic families. The previous studies based on laboratory collections were likely biased by the presence of hearing loss or other otological diseases.
“组织学耳硬化症”指的是一种没有临床症状或表现的疾病过程，只有在尸检时对颞骨进行切片才能发现。“临床耳硬化症”是指耳硬化症出现在某个部位，通过干扰镫骨或圆窗膜的运动而导致传导性听力损失。许多作者研究了颞骨实验室标本中组织学耳硬化症的患病率。约12% - 15%有组织学耳硬化症的颞骨显示有镫骨固定。用这些数字来计算临床耳硬化症的患病率，得出的临床患病率推断值为0.99% - 1.2%。这与耳硬化症家族的临床数据不太相符，据估计临床患病率为0.3%。
研究未经选择的一系列颞骨中组织学耳硬化症的患病率。
在一年时间里，收集了某三级医疗中心118对连续的已故患者的颞骨，以确定耳硬化症的患病率。虽然组织学仍然是评估耳硬化症的金标准，但对颞骨切片进行大体观察并结合微射线照相术，可更快速且成本效益比更低地筛查耳硬化性病变。用这些技术显示出疑似耳硬化症的颞骨，再通过传统组织学进行进一步分析。
在研究的236块颞骨中，2.5%（或患者的3.4%）显示有组织学耳硬化症。
虽然2.5%的患病率远低于先前发表的关于组织学耳硬化症的数据，但推断数据（推断临床患病率 = 0.30% - 0.38%）与耳硬化症家族的临床研究结果相符。先前基于实验室标本的研究可能因听力损失或其他耳科疾病的存在而存在偏差。
