Department of Otolaryngology Head and Neck Surgery, University Medical School of Debrecen, Debrecen, Hungary.
Otol Neurotol. 2009 Dec;30(8):1058-66. doi: 10.1097/MAO.0b013e31819fe802.
Different diseases without exact histopathologic classification can cause stapes ankylosis.
Otosclerosis is a complex bone remodeling disorder of the otic capsule due to persisting measles virus infection and consecutive inflammatory reaction. In fact, clinical and demographic features of otosclerosis have reference to stapes ankylosis. In the clinical practice, otosclerosis and stapes ankylosis are incorrect synonyms.
Nonotosclerotic stapes footplates (n = 284) removed during stapedectomy were analyzed histologically. Otosclerosis was excluded during the histologic preselection (n = 437). Total RNA was extracted, and measles virus-specific reverse-transcriptase-polymerase chain reaction was performed.
Nonotosclerotic stapes ankylosis was associated with total absence of measles virus RNA. Six main types of nonotosclerotic stapes fixations could be distinguished histologically: annular calcification (n = 152; 53.5%), globular fibrosis (n = 49; 17.25%), lymphocytic infiltration (n = 31; 10.9%), hemosiderosis (n = 22; 7.75%), granulomas (n = 17; 6%) and amyloidosis (n = 13; 4.6%). Fragmentation of nonotosclerotic stapes footplates was infrequent (7%) during stapes surgery. Only 1 floating footplate (0.35%) was reported.
Two thirds of nonotosclerotic stapes footplates represented complete pathologic bone remodeling. Unlike otosclerosis, nonotosclerotic stapes fixations were characterized by basic histopathologic findings without organ specificity that can also be identified in case of different diseases. Prevalence of nonotosclerotic stapes ankylosis is approximately 30 to 40% among stapes fixation cases. The long-term prognosis and surgical considerations theoretically differ from those of otosclerosis.
没有明确组织病理学分类的不同疾病可导致镫骨固定。
耳硬化症是一种由于持续性麻疹病毒感染和连续炎症反应导致的耳壳复杂骨重塑障碍。实际上，耳硬化症的临床和人口统计学特征与镫骨固定有关。在临床实践中，耳硬化症和镫骨固定是不正确的同义词。
分析了在镫骨切除术期间切除的非耳硬化性镫骨底板（n = 284）。在组织学预选过程中排除了耳硬化症（n = 437）。提取总 RNA，并进行麻疹病毒特异性逆转录-聚合酶链反应。
非耳硬化性镫骨固定与麻疹病毒 RNA 完全缺失有关。从组织学上可区分六种主要类型的非耳硬化性镫骨固定：环状钙化（n = 152；53.5%）、球状纤维化（n = 49；17.25%）、淋巴细胞浸润（n = 31；10.9%）、含铁血黄素沉着症（n = 22；7.75%）、肉芽肿（n = 17；6%）和淀粉样变性（n = 13；4.6%）。在镫骨手术期间，非耳硬化性镫骨底板的碎裂并不常见（7%）。仅报告了 1 个游离底板（0.35%）。
三分之二的非耳硬化性镫骨底板代表完全的病理性骨重塑。与耳硬化症不同，非耳硬化性镫骨固定的特征是基本组织病理学发现，没有器官特异性，在不同疾病中也可以识别。在镫骨固定病例中，非耳硬化性镫骨固定的患病率约为 30%至 40%。理论上，其长期预后和手术考虑与耳硬化症不同。
