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Two Subgroups of Stapes Fixation: Otosclerosis and Pseudo‐Otosclerosis
Author(s) -
Karosi Tamás,
Kónya József,
Petkó Mihály,
Szabó László Z.,
Pytel József,
Jóri József,
Sziklai István
Publication year - 2005
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000178325.48942.f1
Subject(s) - otosclerosis , stapes , measles virus , morbillivirus , histopathology , medicine , paramyxoviridae , pathology , biology , virology , virus , measles , anatomy , viral disease , middle ear , surgery , vaccination
Hypothesis: Stapes ankylosis is a disease with variable histopathology and can be caused by otosclerosis or pseudo‐otosclerosis. Viral pathogenesis of otosclerosis could be established only by correlative analysis: histologic examination of the stapes footplate and reverse‐transcriptase polymerase chain reaction (RT‐PCR) amplification of the viral RNA. Background: Presence of the RNA genome of measles virus was demonstrated in the footplates of clinically otosclerotic patients by RT‐PCR, and also viral proteins were detected by immunohistochemistry. Methods: Nucleic acids were extracted from ankylotic stapes footplates of clinically stapes fixation patients (n = 104). Measles virus genomic nucleoprotein (NP) RNA was amplified by seminested RT‐PCR. Amplification results were correlated to postoperative histologic and audiologic findings. Results: Measles virus RNA was detectable only in histologically otosclerotic stapes footplates (n = 67). Histology for virus negative footplates (n = 37) excluded otosclerosis. Virus negative stapes footplates showed nonotosclerotic, degenerative disorders. Conclusions: Stapes ankylosis is a heterogeneous disease causing conductive hearing loss with different etiologies. Nonotosclerotic stapes fixations could be established as pseudo‐otosclerosis and may belong to nonspecific, degenerative disorders with variable and noncharacteristic histopathology. Otosclerosis is an inflammatory disease caused by persisting measles virus infection of the otic cap‐sule.