Peixoto MC*, Caiado R, Moura JE, Bastos J
Department of Otorhinolaryngology, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal.
Dr. Peixoto MC
Department of Otorhinolaryngology
Centro Hospitalar e Universitário de Coimbra
Objective: To evaluate the role of preoperative imaging in otosclerosis concerning its effective need for diagnosis and management or its role as a medical legal defender.
Data Sources: A review of English medical literature via Medline using the terms imaging, preoperative imaging, CT scan/computed tomography, MRI/magnetic resonance plus otosclerosis was performed.
Review Methods: Abstracts were reviewed independently by two authors and relevant articles were then evaluated. Exclusion criteria included non-English language, articles published prior to 1990, and editorials, comments, and letters. A list of questions related to otosclerosis/stapes surgery (concerning diagnosis and surgical difficulties) were asked for each article considered relevant.
Results: 42 studies were included in the study, the majority of them related to computed tomography (CT). Sensitivity of CT scan in diagnosing otosclerosis varies widely between the studies, ranging from 46% to 100%. CT densitometry seems to correlate with audiological findings and work as a risk factor for complications. Few references address ossicles’ integrity, congenital anomalies, and facial nerve abnormalities.
Conclusion: This systematic review indicates that imaging has a useful role in both the diagnosis and management of otosclerosis. This is supported predominantly by Level III/IV evidence and, as such, requires further investigation.