title: The spatial distribution of otosclerosis: a quantitative study using design-based stereology.
abstract: CONCLUSIONS
  This study documents that otosclerotic bone remodeling is distributed centripetally around the inner ear space whereas normal bone remodeling is distributed centrifugally. We suggest that this inverse relation reflects the unique osteo-dynamic setting of the otic capsule: since perilabyrinthine bone remodeling is extremely low, osteocyte deficiency and microcracks accumulate in excess toward the inner ear space with age. This may disrupt the osseus functional network, impede propagation of anti-resorptive signals, and precipitate otosclerotic bone remodeling with a spatial preference for older bone.
  
  
  OBJECTIVE
  To quantify the spatial distribution of otosclerotic bone around the inner ear space in order to explore a possible spatial relation with normal capsular bone remodeling.
  
  
  METHODS
  Otosclerotic lesions in 53 undecalcified human temporal bones were identified and volume data were measured with the CAST-grid system and processed by dedicated software for advanced design-based stereology.
  
  
  RESULTS
  The maximum volume fraction of otosclerotic bone was observed in the innermost perilabyrinthine zones of the otic capsule. The volume fraction of otosclerotic bone declined gradually but significantly from the inner ear space towards the capsular periphery with a general perilabyrinthine centripetal distribution.
authors.affiliation: Otopathological Laboratory, Department of Otorhinolaryngology Head and Neck Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. SuneBloch@hotmail.com
authors.forename: Sune Land
authors.initials: SL
authors.lastname: Bloch
authors.forename: Mads Sølvsten
authors.initials: MS
authors.lastname: Sørensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016723:Bone Remodeling; D007758:Ear, Inner / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000473:pathology*; D013701:Temporal Bone / Q000473:pathology*; D055815:Young Adult