The role of imaging in the diagnosis and management of otosclerosis.
OBJECTIVE
To examine the evidence for the role of radiologic imaging in the diagnosis and management of otosclerosis.


METHODS
A review of contemporary (1990 to present) English medical literature via MedLine using the terms imaging, otosclerosis, otospongiosis, stapes surgery, computed tomography, magnetic resonance, CT, and MRI was performed.


METHODS
Abstracts were reviewed independently by 2 authors and relevant articles were then evaluated. Exclusion criteria included editorials, non-English language, comments, and letters.


METHODS
Level of evidence was assigned in accordance with the Oxford Centre for Evidence-based Medicine guidance (Levels I-V).


RESULTS
Thirty-seven articles met the inclusion criteria, of which, 11 were of Level III, 22 of Level IV, and 4 of level V evidence. High-resolution computed tomography (CT) of the temporal bones is the imaging technique of choice in the diagnosis of otosclerosis with newer multidetector scanners demonstrating a sensitivity and specificity in excess of 90%. There is Level III evidence that CT densitometry and extent of disease on CT correlates with hearing thresholds. Extensive and multifocal disease on CT has a poorer prognosis (Level III/IV). The potential use of CT in staging classifications, surgical planning, predicting surgical outcomes and risk of complications has also been described and evaluated.


CONCLUSIONS
This systematic review indicates that imaging has a useful role in both the diagnosis and management of otosclerosis, supported principally by Level III/IV evidence.
ENT Department, Northwick Park Hospital, North West London NHS Trust, Harrow, UK.
Jagdeep Singh
JS
Virk
Arvind
A
Singh
Ravi Kumar
RK
Lingam
D054893:Cone-Beam Computed Tomography; D018450:Disease Progression; D019317:Evidence-Based Medicine; D034381:Hearing Loss / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D013506:Otologic Surgical Procedures; D010040:Otosclerosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D013201:Stapes Surgery; D015899:Tomography, Emission-Computed, Single-Photon