title: A Systematic Review of the Diagnostic Value of CT Imaging in Diagnosing Otosclerosis.
abstract: OBJECTIVE
  To evaluate the diagnostic value of computed tomography (CT) in detecting otosclerosis in patients with conductive hearing loss and a clinical suspicion of otosclerosis.
  
  
  METHODS
  PubMed, Embase, and the Cochrane Library.
  
  
  METHODS
  A systematic search was conducted. Studies reporting original study data were included.
  
  
  METHODS
  Relevance and risk of bias of the selected articles were assessed. Studies with low relevance, high risk of bias, or both were excluded. Prevalences, sensitivities, specificities, and post-test probabilities were extracted from the included articles.
  
  
  RESULTS
  Seven studies characterized by a moderate to high relevance and moderate to low risk of bias were included for data extraction. The prevalence of otosclerosis was high (up to 100%) in the majority of the included studies. In those studies with a high prevalence of disease, both positive and negative post-test probabilities were (relatively) high: 99% and between 51% and 67% respectively. In one study with a low prevalence of disease (9%), both positive and negative post-test probabilities were low (23% and 3% respectively). Overall, reported sensitivities ranged between 60% and 95%.
  
  
  CONCLUSIONS
  Preoperative CT has little to add in establishing otosclerosis and may not be necessary to confirm the diagnosis. We would recommend reserving CT for those patients with suspected additional abnormalities, for specific preoperative planning, or out of legal necessity.
authors.affiliation: *Department of Otorhinolaryngology-Head and Neck Surgery†Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Wegner
authors.forename: Anne M A
authors.initials: AM
authors.lastname: van Waes
authors.forename: Arnold J
authors.initials: AJ
authors.lastname: Bittermann
authors.forename: Sophie H
authors.initials: SH
authors.lastname: Buitinck
authors.forename: Caroline F
authors.initials: CF
authors.lastname: Dekker
authors.forename: Sophie A
authors.initials: SA
authors.lastname: Kurk
authors.forename: Matea
authors.initials: M
authors.lastname: Rados
authors.forename: Wilko
authors.initials: W
authors.lastname: Grolman
mesh_terms: D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D010040:Otosclerosis / Q000139:chemically induced / Q000175:diagnosis*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*