Description of otosclerosis
Otosclerosis is a degenerative disease affecting the bony labyrinth of the inner ear. There is a reconstruction of the bony portion of the inner ear and consequently to damage and loss of hearing.
To understand the nature of the disease, we must first explain the anatomy of the ear. The human ear as a body has three parts. Part of the exterior, which we all know is the outer ear. It consists of the auricle, the external auditory canal and the ear drum which is at the end of the ear canal and transmits sound to the middle ear, which is located behind it. The second part is for middle earcavity which is formed inside which there is a transfer system with three tiny middle ear ossicles, whose task is to transmit sound by vibrate. The third part of the human ear, the inner ear, which is the body that holds two major functions. The first function of the inner ear is hearing (in the section called snail) and the second is the perception of motion and balance (it happens in the vesicles and the semicircular canals). The entire inner ear is made up of parts of bone (bony labyrinth) and membranous (membranous labyrinth) with membranous located inside the bone. From the middle ear is the inner ear a separate opening in the bone portion called “oval window”. On the oval window climbs the last of the three middle ear ossicles stirrup (stapes). The sound that reaches the outer ear is captured the ears and guided through the external auditory canal to the eardrum. It quivers and vibrates as well as middle ear ossicles system that transmits vibrations to the oval window. The oval window is vibrated and the fluid inside the inner ear (endolymph) and these vibrations have been detected actual hearing organ inside the cochlea (ie. “The organ of Corti”). It therefore follows that there is a perception of sound in our auditory organ and we now let’s see what happens in otosclerosis.
When otosclerosis is to rebuild or restructure certain precincts bony part of the inner ear, the ongoing new bone formation may impair the proper functioning of the internal and by extension of the middle ear. If the disease process affects the hearing or not, it depends largely on what part of the bony labyrinth bony changes begin to take place. The most commonly affected is the oval window, which leads to its ossification, stapes is gradually more and more fixed and how to accrue to the oval window and gradually restricts his mobility and he can not properly transmit sound vibrations. Comes to his complete osseous coalescence with zkostnatěným oval window and a sound transmission system conversion is impossible. It must be said that the hearing organ (organ of Corti) is able to perceive sound in two ways. First, can the so-called. “Transfer line”, which was described above and which is the way the hearing, but another possibility is the so-called. “Bone conduction” where the sound vibrate the skull bones, and thus vibration bones transferred into the inner ear and there also thrill endolymph even if the transfer system of the middle ear (ossicles) does not work. So when will completely immobilize the stirrup, we call this state in bilateral affections so. “Translation deafness” when the patient is nearly deaf, but certain sounds is obviously able to faintly hear precisely because of bone conduction.
Over time, however, patients may lead to disability and other parts of the bony labyrinth and damage to the auditory (organ of Corti) and the patient may become deaf to the affected ear completely (ie. “Sensorineural deafness”).
Hearing loss is often reversible, although asymmetric (unequal expressed on both sides). It develops slowly and gradually, sometimes the situation may occur that affected a better understanding in noise (ie. Paracusis Willis).
Another symptom is tinnitus, technically called “tinnitus”, which have the most character humming, sometimes the so-called pulse murmur when the intensity varies rhythmically. The patient hears the sound constantly, even in silence, mostly when the intensity increases even more, because it is not drowned out by ambient sounds. It is very unpleasant and often affected greatly handicaps. Tinnitus suffers about two thirds of patients with otosclerosis.
Sometimes they may appear dizziness due to impaired balance system of the inner ear.
Otosclerosis affects twice more women than men, usually occurs around 20 years of age, rarely at puberty. In children, the disease does not occur. It is shown that the sooner the illness develops, the quicker the process and the larger the perceptual component (damage to the hearing organ).
In women, the disease manifests itself mostly at the time of major hormonal changes, i.e. during pregnancy, lactation and during menopause (the transition to menopause).
It is interesting that otosclerosis is purely a disease of the white race, for example, blacks does not suffer from this disease. If that happened, it is very likely that the patient has a dark complexion in his pedigree ancestor of the white race. This fact leaves no doubt that the disease has a genetic basis, which causes it to rise.
Risk factors for otosclerosis
A risk factor is belonging to the white race.
The causes otosclerosis
Otosclerosis causes are unknown. What is certain is that the role played by genetic predisposition(congenital conditions) that we inherit from our parents. This is evidenced by the fact that otosclerosis occurs only in individuals Caucasians or in individuals who have at least ancestors belonging to the white race.
Also play a role hormonal influences, the first symptoms of the disease in women often occurs during pregnancy, lactation (breastfeeding) and menopause (the transition).
It is also likely impact of measles infections, the measles virus probably activates genes responsible and will start illness. It should be noted that the frequency of the disease is today lower in relation to the introduction of measles vaccination.
prevention of otosclerosis
There is no known effective prevention of otosclerosis.
treatment of otosclerosis
Treatment is performed by the operating surgeon gets into the cavity of the middle ear space and dysfunctional stirrup is used to replace it. It is called various tools which are most often made of gold, titanium or teflon. Piston miniature prosthesis that substitutes the function of the stirrup and transmits the sound vibrations to the inner ear. The affected person may reclaim their lost hearing.Surgery is usually in a large percentage of cases successful.
Conservative treatment for hearing loss, the use of hearing aids or other aids for the hearing impaired.
Balance disorders and dizziness can affect the anti-vertigo (antivertigo).
complications of otosclerosis
Complicated course of the disease can result in deafness, balance disorder, they are very problematic tinnitus (tinnitus).
