European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 8, pp 2131–2138 | Cite as

Diagnostic value of cone-beam CT in histologically confirmed otosclerosis

  • Balázs Liktor
  • Péter Révész
  • Péter Csomor
  • Imre Gerlinger
  • István Sziklai
  • Tamás KarosiEmail author


This retrospective case review was performed with the aim to asses the value of cone-beam computed tomography (CBCT) in the preoperative diagnosis of otosclerosis. A total of 32 patients with histologically confirmed stapedial otosclerosis, who underwent unilateral stapedectomies were analyzed. Preoperative temporal bone CBCT scans were performed in all cases. CBCT imaging was characterized by a slice thickness of 0.3 mm and multiplanar image reconstruction. Histopathologic examination of the removed stapes footplates was performed in all cases. Findings of CBCT were categorized according to Marshall’s grading system (from grade 0 to grade 3). Histopathologic results were correlated to multiplanar reconstructed CBCT scans, respectively. Histologically active foci of otosclerosis (n = 21) were identified by CBCT in all cases with a sensitivity of 100 %. However, CBCT was unable to detect histologically inactive otosclerosis (n = 11, sensitivity = 0 %). According to CBCT scans, no retrofenestral lesions were found and all positive cases were recruited into the grade 1 group indicating solely fenestral lesions at the anterior pole of stapes footplates. In conclusion, CBCT is a reliable imaging method with considerably lower radiation dose than high-resolution CT (HRCT) in the preoperative diagnosis of otosclerosis. These results indicate that CBCT has high sensitivity and specificity in the detection of hypodense lesions due to histologically active otosclerosis.


Cone-beam computed tomography Hearing loss Histopathology Otosclerosis 



Thanks are due to János Angyal MD (University of Debrecen, Medical and Health Science Center, Department of Stomatology and Dentistry) for the precious help in the collection of archived CBCT images. This work was supported by the grant of Hungarian Scientific Research Fund (OTKA K81480).

Conflict of interest



  1. 1.
    Chole RA, McKenna M (2001) Pathophysiology of otosclerosis. Otol Neurotol 22:249–257CrossRefPubMedGoogle Scholar
  2. 2.
    Parahy C, Linthicum FH Jr (1984) Otosclerosis and otospongiosis: clinical and histological comparisons. Laryngoscope 94:508–512CrossRefPubMedGoogle Scholar
  3. 3.
    Swartz JD, Faerber EN, Wolfson RJ, Marlowe FI (1984) Fenestral otosclerosis: significance of preoperative CT evaluation. Radiology 151:703–707CrossRefPubMedGoogle Scholar
  4. 4.
    Sziklai I, Batta TJ, Karosi T (2009) Otosclerosis: an organ-specific inflammatory disease with sensorineural hearing loss. Eur Arch Otorhinolaryngol 266:1711–1718CrossRefPubMedGoogle Scholar
  5. 5.
    Declau F, van Spaendonck M, Timmermans JP, Michaels L, Liang J, Qiu JP, van de Heyning P (2007) Prevalence of histologic otosclerosis: an unbiased temporal bone study in Caucasians. Adv Otorhinolaryngol 65:6–16PubMedGoogle Scholar
  6. 6.
    Karosi T, Csomor P, Petkó M, Liktor B, Szabó LZ, Pytel J, Jóri J, Sziklai I (2009) Histopathology of nonotosclerotic stapes fixations. Otol Neurotol 30:1058–1066CrossRefPubMedGoogle Scholar
  7. 7.
    Iyer PV, Gristwood RE (1984) Histopathology of the stapes in otosclerosis. Pathology 16:30–38CrossRefPubMedGoogle Scholar
  8. 8.
    Mafee MF, Henrikson GC, Deitch RL, Norouzi P, Kumar A, Kriz R, Valvassori GE (1985) Use of CT in stapedial otosclerosis. Radiology 156:709–714CrossRefPubMedGoogle Scholar
  9. 9.
    Shaffer KA, Haughton VM, Wilson CR (1980) High resolution computed tomography of the temporal bone. Radiology 134:409–414CrossRefPubMedGoogle Scholar
  10. 10.
    Grayeli AB, Yrieix CS, Imauchi Y, Cyna-Gorse F, Ferrary E, Sterkers O (2004) Temporal bone density measurements using CT in otosclerosis. Acta Otolaryngol 124:1136–1140CrossRefPubMedGoogle Scholar
  11. 11.
    Lagleyre S, Sorrentino T, Calmels MN, Shin YJ, Escudé B, Deguine O, Fraysse B (2009) Reliability of high-resolution CT scan in diagnosis of otosclerosis. Otol Neurotol 30:1152–1159CrossRefPubMedGoogle Scholar
  12. 12.
    Naumann IC, Porcellini B, Fisch U (2005) Otosclerosis: incidence of positive findings on high-resolution computed tomography and their correlation to audiological test data. Ann Otol Rhinol Laryngol 114:709–716CrossRefPubMedGoogle Scholar
  13. 13.
    Shin YJ, Fraysse B, Deguine O, Cognard C, Charlet JP, Sévely A (2001) Sensorineural hearing loss and otosclerosis: a clinical and radiologic survey of 437 cases. Acta Otolaryngol 121:200–204CrossRefPubMedGoogle Scholar
  14. 14.
    Marx M, Lagleyre S, Escudé B, Demeslay J, Elhadi T, Deguine O, Fraysse B (2011) Correlations between CT scan findings and hearing thresholds in otosclerosis. Acta Otolaryngol 131:351–357CrossRefPubMedGoogle Scholar
  15. 15.
    Valvassori GE (1993) Imaging of otosclerosis. Otolaryngol Clin N Am 26:359–371Google Scholar
  16. 16.
    Wycherly BJ, Berkowitz F, Noone AM, Kim HJ (2010) Computed tomography and otosclerosis: a practical method to correlate the sites affected to hearing loss. Ann Otol Rhinol Laryngol 119:789–794CrossRefPubMedGoogle Scholar
  17. 17.
    Kiyomizu K, Tono T, Yang D, Haruta A, Kodama T, Komune S (2004) Correlation of CT analysis and audiometry in Japanese otosclerosis. Auris Nasus Larynx 31:125–129CrossRefPubMedGoogle Scholar
  18. 18.
    Karosi T, Csomor P, Sziklai I (2012) The value of HRCT in stapes fixations corresponding to hearing thresholds and histologic findings. Otol Neurotol 33:1300–1307CrossRefPubMedGoogle Scholar
  19. 19.
    Merchant SN, Rosowski JJ, McKenna MJ (2007) Superior semicircular canal dehiscence mimicking otosclerotic hearing loss. Adv Otorhinolaryngol 65:137–145PubMedPubMedCentralGoogle Scholar
  20. 20.
    Patel S, Dawood A, Ford TP, Whaites E (2007) The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endod J 40:818–830CrossRefPubMedGoogle Scholar
  21. 21.
    Small BW (2007) Cone beam computed tomography. Gen Dent 55:179–181PubMedGoogle Scholar
  22. 22.
    Redfors YD, Gröndahl HG, Hellgren J, Lindfors N, Nilsson I, Möller C (2012) Otosclerosis: anatomy and pathology in the temporal bone assessed by multi-slice and cone-beam CT. Otol Neurotol 33:922–927PubMedGoogle Scholar
  23. 23.
    Rotteveel LJ, Proops DW, Ramsden RT, Saeed SR, van Olphen AF, Mylanus EA (2004) Cochlear implantation in 53 patients with otosclerosis: demographics, computed tomographic scanning, surgery, and complications. Otol Neurotol 25:943–952CrossRefPubMedGoogle Scholar
  24. 24.
    Marshall AH, Fanning N, Symons S, Shipp D, Chen JM, Nedzelski JM (2005) Cochlear implantation in cochlear otosclerosis. Laryngoscope 115:1728–1733CrossRefPubMedGoogle Scholar
  25. 25.
    Lee TC, Aviv RI, Chen JM, Nedzelski JM, Fox AJ, Symons SP (2009) CT grading of otosclerosis. Am J Neuroradiol 30:1435–1439CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Balázs Liktor
    • 1
  • Péter Révész
    • 2
  • Péter Csomor
    • 3
  • Imre Gerlinger
    • 2
  • István Sziklai
    • 4
  • Tamás Karosi
    • 1
    Email author
  1. 1.Department of Otolaryngology and Head and Neck SurgeryB-A-Z County Hospital and University HospitalMiskolcHungary
  2. 2.Department of Otolaryngology and Head and Neck Surgery, Medical SchoolUniversity of PécsPecsHungary
  3. 3.Department of Rheumatology, Medical and Health Science CenterUniversity of DebrecenDebrecenHungary
  4. 4.Department of Otolaryngology and Head and Neck Surgery, Medical and Health Science CenterUniversity of DebrecenDebrecenHungary

Personalised recommendations