Cochlear otosclerosis: Fact or fantasy

Abstract

Abstract Histological examination of 910 temporal bones from 582 individuals reveals 92 specimens with clinical otosclerosis (stapes fixation) and 32 with histological otosclerosis (without stapes fixation). The incidence of histological otosclerosis in ears from white individuals over the age of five (734 ears) was 4.4 percent. The otosclerotic focus involved the endosteum of the cochlear wall (cochlear otosclerosis) in three of the latter group for an incidence of 0.3 percent. The atrophic changes in one of the ears with cochlear otosclerosis cannot be attributed to the otosclerosis, for the same changes are present in the other ear which does not have an otosclerotic focus; neither can the mild hearing loss in the other two ears showing cochlear otosclerosis be attributed to the otosclerosis, for the atrophic changes are identical to those observed in aging individuals without otosclerosis. In conclusion, this study shows that sensori‐neural hearing loss occurring in pure form without a conductive loss cannot be attributed to otosclerosis, for when the otosclerotic lesion is sufficiently severe to cause atrophy of the supporting, sensory, and neural structures within the cochlea, it invariably also fixes the stapes.