Otosclerosis is a condition where abnormal bone growth replaces the normal bone in the inner ear, often affecting the stapes and causing conductive hearing loss. It has no known cause but has genetic and demographic risk factors. The most common type affects the stapes and causes conductive hearing loss. Diagnosis is made based on symptoms of hearing loss and normal ear exam findings. Treatment is usually surgical to replace the stapes bone. Meniere's disease is a disorder of the inner ear where a compartment of fluid is distended, causing episodes of vertigo, hearing loss, and tinnitus. Diagnosis involves ruling out other causes through hearing and balance tests.

1. OTOSCLEROSIS

2.  Otosclerosis, more aptly called otospongiosis
 In this, one or more foci of irregularly laid spongy bone replace
part of normally dense enchondral layer of bony otic capsule.
 otosclerotic focus involves the stapes region leading to stapes
fixation and conductive deafness

3.  The exact cause of otosclerosis is not known
 Heredity. About 50% of otosclerotics have positive family history; rest are
sporadic
 Race.White races are affected more than black Americans
 Sex. Females are affected twice as often as males.
 Age of onset. Hearing loss usually starts between 20 and 30 years of age
 Effect of other factors. Hearing loss due to otosclerosis may be initiated or made
worse by pregnancy

4.  TYPES OF OTOSCLEROSIS : STAPEDIAL OTOSCLEROSIS

5.  Cochlear otosclerosis
 Histologic otosclerosis

6.  PATHOLOGY
 Grossly, otosclerotic lesion appears chalky white, greyish or yellow. Sometimes, it
is red in colour due to increased vascularity
 Microscopically, spongy bone appears in the normally dense enchondral layer of
otic capsule

7.  SYMPTOMS
 Hearing loss.
 paracusis willisii.
 Tinnitus.
 Vertigo.
 Speech.

8.  SIGNS
 Tympanic membrane is quite normal and mobile
 Eustachian tube function is normal.
 Tuning fork tests show negative Rinne
 Weber test will be lateralized to the ear with greater conductive loss.
 Absolute bone conduction may be normal.

10.  TREATMENT
 Medical.There is no medical treatment that cures otoclerosis
 Surgical. Stapedectomy/stapedotomy with a placement of prosthesis is the
treatment of choice.

13. MENIERS DISEASE
 Meniers disease, also called endolymphatic hydrops, is a
disorder of the inner ear where the endolymphatic system is
distended with endolymph

15.  EXAMINATION
 Otoscopy. No abnormality is seen in the tympanic membrane.
 Nystagmus. It is seen only during acute attack.The quick component of
nystagmus is towards the unaffected ear.
 Tuning ForkTests.They indicate sensorineural hearing loss

16.  INVESTIGATIONS

17.  Speech Audiometry. Discrimination score is usually 55–85% between the attacks
but discrimination ability is much impaired during and immediately following an
at- tack.
 Special AudiometryTests.
 (a) Recruitment test is positive.
 (b) SISI (short increment sensitivity index) test. SISI score is better than 70% in
two-thirds of the patients (normal 15%).
 (c) Tone decay test. Normally, there is decay of less than 20 dB.

18.  Electrocochleography

19.  CaloricTest. It shows reduced response on the affected side in 75% of cases.
 GlycerolTest. Glycerol is a dehydrating agent.When given orally, it reduces
endolymph pressure and thus causes an improvement in hearing.