Early detection of otosclerosis by impedance-audiometry screening.

The basis of the early detection of otosclerosis is dual: first, a better knowledge of the mechanism of the disease itself, which is of enzymatic origin, and the starting point of which is an antigen-antibody conflict between the otic capsule and the embryonic cartilaginous remnants; - second, the fact that the otospongiotic disease appears to be a genetic deafness with an autosomal inheritance and about 40% of genes penetrance. Consequently an early detection is absolutely essential to combat the disease at its beginning and to assure its prevention. The early diagnosis of the otospongiotic/otosclerotic disease is twofold: first, the early detection of stapedial fixation is given by systematic impedance-audiometry screening on school-children by means of stapedius reflex elicitation in order to detect a possible diphasic impedance change (on-off effect); - second, the early diagnosis of progressive cochlear deterioration is yielded through systematic bone-conducted audiometry testing in young children in families with an otospongiotic/otosclerotic history.