Antimeasles immunoglobulin g for serologic diagnosis of otosclerotic hearing loss.
OBJECTIVE
Persistent measles virus infection of the otic capsule is suggested to be an etiologic factor in otosclerosis. Otosclerosis is a disease of complex unknown etiology causing progressive conductive and/or sensorineural hearing loss (HL).


BACKGROUND
Diagnostic methods of otosclerosis are sensitive to ossicular chain fixation with low specificity for otosclerotic stapes ankylosis.


METHODS
Nucleic acid was extracted from stapes foot plates of clinically stapes fixation patients (N = 213). Measles virus nucleoprotein RNA was amplified by reverse-transcriptase polymerase chain reaction. Amplification results were correlated to histologic findings in 49 cases. Antimeasles IgG levels of all clinically stapes fixation as well as control sera specimens were measured by enzyme-linked immunosorbent assay.


RESULTS
Among clinically stapes fixation patients, 141 stapes foot plates contained measles virus RNA. Among 49 histologic specimens, viral RNA was detectable only in histologically otosclerotic stapes foot plates (n = 35). Histology for virus-negative foot plates (n = 14) excluded otosclerosis. Antimeasles IgG levels were significantly lower in the sera of patients with virus-positive stapes than in control sera.


CONCLUSIONS
Combination of decreased antimeasles IgG serum level and conductive HL has a great specificity and sensitivity as a diagnostic method in the preoperative evaluation of ossicular chain fixations otosclerosis. Low antimeasles IgG level indicates otosclerosis, whereas high level suggests non-otosclerotic ossicular chain fixations. Preoperative elucidation of the cause of a conductive HL may suggest optional medical treatment in preference to surgical methods.
Department of Otolaryngology Head and Neck Surgery, University Medical School of Debrecen, Debrecen, Hungary.
Tamás
T
Karosi
József
J
Kónya
Mihály
M
Petkó
László Z
LZ
Szabó
József
J
Pytel
József
J
Jóri
István
I
Sziklai
D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis*; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008297:Male; D008457:Measles / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D008459:Measles virus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D008875:Middle Aged; D010040:Otosclerosis / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D012367:RNA, Viral / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013199:Stapes / Q000821:virology
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D012367:RNA, Viral