Histopathology of nonotosclerotic stapes fixations.
OBJECTIVE
Different diseases without exact histopathologic classification can cause stapes ankylosis.


BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Otolaryngology Head and Neck Surgery, University Medical School of Debrecen, Debrecen, Hungary. karosi@freemail.hu
Tamás
T
Karosi
Péter
P
Csomor
Mihály
M
Petkó
Bálint
B
Liktor
László Z
LZ
Szabó
József
J
Pytel
József
J
Jóri
István
I
Sziklai
D000328:Adult; D000367:Age Factors; D000368:Aged; D000686:Amyloidosis / Q000473:pathology; D000844:Ankylosis / Q000145:classification / Q000453:epidemiology / Q000473:pathology*; D002114:Calcinosis / Q000473:pathology; D005260:Female; D005355:Fibrosis; D006099:Granuloma / Q000473:pathology; D006486:Hemosiderosis / Q000473:pathology; D006801:Humans; D006818:Hyalin / Q000502:physiology; D007249:Inflammation / Q000473:pathology; D008297:Male; D008459:Measles virus / Q000235:genetics; D008875:Middle Aged; D020556:Neutrophil Infiltration / Q000502:physiology; D010014:Osteolysis / Q000473:pathology; D013506:Otologic Surgical Procedures; D012367:RNA, Viral / Q000096:biosynthesis / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012737:Sex Factors; D013199:Stapes / Q000473:pathology*; D013201:Stapes Surgery; D055815:Young Adult
D012367:RNA, Viral