title: Blood flow to the promontory in cochlear otosclerosis.
abstract: OBJECTIVE
  To investigate Schwartze sign with measurements of blood flow to the promontory in patients with cochlear otosclerosis.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  Five patients with cochlear otosclerosis and five control subjects. Significant decalcification around the cochlea was observed by computed tomography (CT) in patients with cochlear otosclerosis. However, no recognizable lesion was observed at the oval window in two patients. One patient had mixed hearing loss and four patients had sensorineural hearing loss without an air-bone gap.
  
  
  METHODS
  The relationship between CT findings and the presence or absence of Schwartze sign was investigated. Blood flow to the promontory was measured through the tympanic membrane using laser speckle flowgraphy and laser Doppler flowmetry.
  
  
  RESULTS
  The Schwartze sign correlated significantly with otosclerotic lesions invading the promontory. Patients with otosclerosis exhibited elevated and pulsating blood flow to the promontory with the Schwartze sign.
  
  
  CONCLUSIONS
  Computed tomography demonstrated that cochlear otosclerosis can exist without the oval window lesion. Schwartze sign can be used as a sign of the otosclerotic invasion to the promontory. The reddening of the Schwartze sign is likely due to increased blood flow.
authors.affiliation: Department of Otorhinolaryngology, Nagoya University School of Medicine, Showa-ku, Japan. tsutomun@med.nagoya-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Nakashima
authors.forename: M
authors.initials: M
authors.lastname: Sone
authors.forename: H
authors.initials: H
authors.lastname: Fujii
authors.forename: M
authors.initials: M
authors.lastname: Teranishi
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: H
authors.initials: H
authors.lastname: Otake
authors.forename: M
authors.initials: M
authors.lastname: Sugiura
authors.forename: S
authors.initials: S
authors.lastname: Naganawa
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003051:Cochlea / Q000098:blood supply* / Q000473:pathology; D004432:Ear, Middle / Q000098:blood supply* / Q000473:pathology; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000175:diagnosis / Q000503:physiopathology*; D011446:Prospective Studies; D012039:Regional Blood Flow; D014057:Tomography, X-Ray Computed