Otosclerosis is a condition where one or more foci of irregularly laid spongy bone replace part of normally dense enchondral layer of bony otic capsule in the bony labyrinth. This condition affects one of the ossicles (the stapes) resulting in hearing loss, tinnitus, vertigo or a combination of symptoms. The term otosclerosis is something of a misnomer. Much of the clinical course is characterized by lucent rather than sclerotic bony changes, so the disease is also known as otospongiosis.
Introduction
Otosclerosis
Otosclerosis | Introduction
A condition where one or more foci of irregularly laid spongy bone replace part of normally dense enchondral layer of bony otic capsule in the bony labyrinth. It is a condition where one or more foci of irregularly laid spongy bone replace part of normally dense enchondral layer of bony otic capsule in the bony labyrinth. It  is a condition where one or more foci of irregularly laid spongy bone replace part of normally dense enchondral layer of bony otic capsule in the bony labyrinth It is a condition where one or more foci of irregularly laid spongy bone replace part of normally dense enchondral layer of bony otic capsule in the bony labyrinth.
what are the 3 smallest bones in the human body
user
Strapes is one of them
assistant
what is the size of this above bone?
user
Roughly 3 x 2.5mm
assistant
which part of the body is this located?
user
Middle ear of humans
assistant
besides the human, is this bony structure present in other living species in the animal kingdom?
user
It is one of three ossicles in mammals, in non-mammalian four-legged animals its homologous form is called the columella
assistant
what are the functions this bony structure serves?
user
It transmits sound vibrations from the incus to the oval window, a membrane-covered opening to the inner ear.
assistant
are there any variations of this bony structure?
user
It appears to be relatively constant in size in different ethnic groups
assistant
can this bony structure get affected or impaired?
user
Yes, its impairment causes conductive hearing loss
assistant
is there any remedy to solve this?
user
Two common treatments are stapedectomy and stapedotomy
assistant
how is the first treatment that you mentioned - carried out?
user
It is the surgical removal of the stapes and replacement with an artificial prosthesis
assistant
what are some of the complications involved?
user
Causes fibrosis-related damage to the base of the bone, or obliterative otosclerosis, resulting in obliteration of the base.
assistant
what does the term otosclerosis mean?
user
Otosclerosis is a condition where one or more foci of irregularly laid spongy bone replace part of normally dense enchondral layer of bony otic capsule in the bony labyrinth. This condition affects one of the ossicles (the stapes) resulting in hearing loss, tinnitus, vertigo or a combination of symptoms. The term otosclerosis is something of a misnomer. Much of the clinical course is characterized by lucent rather than sclerotic bony changes, so the disease is also known as otospongiosis.
Otosclerosis | Introduction
The most common location of involvement of otosclerosis is the bone just anterior to the oval window at a small cleft known as the fissula ante fenestram. The fissula is a thin fold of connective tissue extending through the endochondral layer, approximately between the oval window and the cochleariform process, where the tensor tympani tendon turns laterally toward the malleus.
Otosclerosis | Pathophysiology
Surgery may be complicated by a persistent stapedial artery, fibrosis-related damage to the base of the bone, or obliterative otosclerosis, resulting in obliteration of the base.
Stapes | Clinical relevance
Otosclerosis is a disorder of the middle ear, characterized by abnormal bone growth at the foot plate of the stapes which affect its mobility, resulting in progressive hearing loss. OPG gene polymorphisms c.9C>G and c.30+15C> have shown genetic association with OTSC in Indian and Tunisian populations. Some of the reports have shown significantly reduced or missing OPG expression in otosclerotic tissues which might be a causal factor for abnormal bone remodeling during disease manifestation.
Osteoprotegerin | Otosclerosis
The pathophysiology of otosclerosis is complex. The key lesions of otosclerosis are multifocal areas of sclerosis within the endochondral temporal bone. These lesions share some characteristics with Paget's Disease, but they are not thought to be otherwise related. Histopathological studies have all been done on cadaveric temporal bones, so only inferences can be made about progression of the disease histologically. It seems that the lesions go through an active "spongiotic" or hypervascular phase before developing into "sclerotic" phase lesions. There have been many genes and proteins identified that, when mutated, may lead to these lesions. Also there is mounting evidence that measles virus is present within the otosclerotic foci, implicating an infectious etiology (this has also been noted in Paget's Disease).
Otosclerosis | Pathophysiology
Otosclerosis is traditionally diagnosed by characteristic clinical findings, which include progressive conductive hearing loss, a normal tympanic membrane, and no evidence of middle ear inflammation. The cochlear promontory may have a faint pink tinge reflecting the vascularity of the lesion, referred to as the Schwartz sign. Approximately 0.5% of the population will eventually be diagnosed with otosclerosis. Post-mortem studies show that as many as 10% of people may have otosclerotic lesions of their temporal bone, but apparently never had symptoms warranting a diagnosis. Caucasians are the most affected race, with the prevalence in the Black and Asian populations being much lower.
Otosclerosis | Diagnosis
Occasionally the joints between the ossicles become rigid. One condition, otosclerosis, results in the fusing of the stapes to the oval window. This reduces hearing and may be treated surgically.
Ossicles | Clinical relevance
There are various methods to treat otosclerosis. However the method of choice is a procedure known as stapedectomy. Early attempts at hearing restoration via the simple freeing of the stapes from its sclerotic attachments to the oval window were met with temporary improvement in hearing, but the conductive hearing loss would almost always recur. A stapedectomy consists of removing a portion of the sclerotic stapes footplate and replacing it with an implant that is secured to the incus. This procedure restores continuity of ossicular movement and allows transmission of sound waves from the eardrum to the inner ear. A modern variant of this surgery called a stapedotomy, is performed by drilling a small hole in the stapes footplate with a micro-drill or a laser, and the insertion of a piston-like prothesis.
Otosclerosis | Surgery
Most patients with otosclerosis notice tinnitus (head noise) to some degree. The amount of tinnitus is not necessarily related to the degree or type of hearing impairment. Tinnitus develops due to irritation of the delicate nerve endings in the inner ear. Since the nerve carries sound, this irritation is manifested as ringing, roaring or buzzing. It is usually worse when the patient is fatigued, nervous or in a quiet environment.
Otosclerosis | Presentation
Otosclerosis is a congenital or spontaneous-onset disease characterized by abnormal bone remodeling in the inner ear. Often this causes the stapes to adhere to the oval window, which impedes its ability to conduct sound, and is a cause of conductive hearing loss. Clinical otosclerosis is found in about 1% of people, although it is more common in forms that do not cause noticeable hearing loss. Otosclerosis is more likely in young age groups, and females. Two common treatments are stapedectomy, the surgical removal of the stapes and replacement with an artificial prosthesis, and stapedotomy, the creation of a small hole in the base of the stapes followed by the insertion of an artificial prosthesis into that hole.
Stapes | Clinical relevance
Otosclerosis can be caused by both genetic and environmental factors, such as a viral infection (like measles). Ribonucleic acid of the measles virus has been found in stapes footplate in most patients with otosclerosis. Populations that have been vaccinated against measles had a significant reduction in otosclerosis. While the disease is considered to be hereditary, its penetrance and the degree of expression is so highly variable that it may be difficult to detect an inheritance pattern. Most of the implicated genes are transmitted in an autosomal dominant fashion. One genome-wide analysis associates otosclerosis with variation in RELN gene. Loci include:
Otosclerosis | Causes
Fixation of the stapes within the oval window causes a conductive hearing loss. In pure-tone audiometry, this manifests as air-bone gaps on the audiogram (i.e. a difference of more than 10 dB between the air-conduction and bone-conduction thresholds at a given test frequency). However, medial fixation of the ossicular chain impairs both the inertial and osseotympanic modes of bone conduction, increasing the bone-conduction thresholds between 500 Hz and 4 kHz, and reducing the size of air-bone gaps. As 2 kHz is the resonant frequency of the ossicular chain, the largest increase in bone-conduction threshold (around 15 dB) occurs at this frequency – the resultant notch is called "Carhart's notch" and is a useful clinical marker for medial ossicular-chain fixation.
Otosclerosis | Audiometry
CHL in otosclerosis is caused by two main sites of involvement of the sclerotic (or scar-like) lesions. The best understood mechanism is fixation of the stapes footplate to the oval window of the cochlea. This greatly impairs movement of the stapes and therefore transmission of sound into the inner ear ("ossicular coupling"). Additionally the cochlea's round window can also become sclerotic, and in a similar way impair movement of sound pressure waves through the inner ear ("acoustic coupling"). Conductive hearing loss is usually concomitant with impingement of abnormal bone on the stapes footplate. This involvement of the oval window forms the basis of the name fenestral otosclerosis.
Otosclerosis | Pathophysiology
Osteosclerosis can be detected with a simple radiography. There are white portions of the bone which appear due to the increased number of bone trabeculae.
Osteosclerosis | Diagnosis
Well defined, rounded or triangular radiodensity, that is uniformly opaque. There is no lucent component. Found near the root apex or in the inter-radicular area. Root resorption and tooth movement are rare.
Idiopathic osteosclerosis | Radiology
Tympanometry measures the peak pressure (TPP) and peak-compensated static admittance ("Y") of the middle ear at the eardrum. As the stapes is ankylosed in otosclerosis, the lateral end of the ossicular chain may still be quite mobile. Therefore, otosclerosis may only slightly reduce the admittance, resulting in either a shallow tympanogram (type A), or a normal tympanogram (type A). Otosclerosis increases in the stiffness of the middle-ear system, raising its resonant frequency. This can be quantified using multi-frequency tympanometry. Thus, a high resonant-frequency pathology such as otosclerosis can be differentiated from low resonant-frequency pathologies such as ossicular discontinuity. In the absence of a pathology, a loud sound (generally greater than 70 dB above threshold) causes the stapedius muscle to contract, reducing the admittance of the middle ear and softening the perceived loudness of the sound.
Otosclerosis | Audiometry
The success rate of either surgery depends greatly on the skill and the familiarity with the procedure of the surgeon. However, comparisons have shown stapedotomy to yield results at least as good as stapedectomy, with fewer complications, and thus stapedotomy is preferred in normal circumstances.
Otosclerosis | Surgery
Although hearing aids cannot prevent, cure or inhibit the progression of otosclerosis, they can help treat the largest symptom, hearing loss. Hearing aids can be tuned to specific frequency losses. However, due to the progressive nature of this condition, use of a hearing aid is palliative at best. Without eventual surgery, deafness is likely to result.
Otosclerosis | Amplification
A reaction to past trauma or infection but it's difficult to rule out in some cases.
Idiopathic osteosclerosis | Cause
Imaging is usually not pursued in those with uncomplicated conductive hearing loss and characteristic clinical findings. Those with only conductive hearing loss are often treated medically or with surgery without imaging. The diagnosis may be unclear clinically in cases of sensorineural or mixed hearing loss and may become apparent only on imaging. Therefore, imaging is often performed when the hearing loss is sensorineural or mixed. A high-resolution CT shows very subtle bone findings. However, CT is usually not needed prior to surgery. Otosclerosis on CT can be graded using the grading system suggested by Symons and Fanning.
Otosclerosis | CT imaging
Osteosclerosis is a disorder that is characterized by abnormal hardening of bone and an elevation in bone density. It may predominantly affect the medullary portion and/or cortex of bone. Plain radiographs are a valuable tool for detecting and classifying osteosclerotic disorders. It can manifest in localized or generalized osteosclerosis. Localized osteosclerosis can be caused by Legg–Calvé–Perthes disease, sickle-cell disease and osteoarthritis among others. Osteosclerosis can be classified in accordance with the causative factor into acquired and hereditary. Skeletal fluorosis
Osteosclerosis | Introduction
In clinical practice otosclerosis is encountered about twice as frequently in females as in males, but this does not reflect the true sex ratio. When families are investigated it is found that the condition is only slightly more common in women. Usually noticeable hearing loss begins at middle-age, but can start much sooner. The hearing loss was long believed to grow worse during pregnancy, but recent research does not support this belief.
Otosclerosis | Diagnosis
If the mobility of the stapes is reduced due to otosclerosis, then stapedius muscle contraction does not significantly decrease the admittance. When acoustic reflex testing is conducted, the acoustic reflex thresholds (ART) cannot be determined when attempting to measure on the affected side. Also, a conductive pathology will attenuate the test stimuli, resulting in either elevated reflex thresholds or absent reflexes when the stimulus is presented in the affected ear and measured in the other ear.
Otosclerosis | Audiometry
The primary form of hearing loss in otosclerosis is conductive hearing loss (CHL) whereby sounds reach the ear drum but are incompletely transferred via the ossicular chain in the middle ear, and thus partly fail to reach the inner ear (cochlea). This can affect one ear or both ears. On audiometry, the hearing loss is characteristically low-frequency, with higher frequencies being affected later. Sensorineural hearing loss (SNHL) has also been noted in patients with otosclerosis; this is usually a high-frequency loss, and usually manifests late in the disease. The causal link between otosclerosis and SNHL remains controversial. Over the past century, leading otologists and neurotologic researchers have argued whether the finding of SNHL late in the course of otosclerosis is due to otosclerosis or simply to typical presbycusis.
Otosclerosis | Presentation
The word "osteoporosis" is from the Greek terms for "porous bones".
Osteoporosis | Introduction
The journal covers all aspects of atherosclerosis and related diseases.
Atherosclerosis (journal) | Scope
In addition, osteoblasts within the bone are damaged and destroyed, leading to decreased production of normal bone tissue. In the constitutive organized phase, fibroblasts persist and are converted to myofibroblasts by these same cytokines, that begin to fibrous extracellular matrix (ECM) within the affected bone. Consequently, the increased production of ECM by myofibroblasts coupled with decreased production of osteoid by osteoblasts results in weakened bony tissue. Finally, during the late fibroatrophic phase, the affected bone becomes hypocellular as myofibroblasts begin to die and leave behind weak, fibrotic tissue. Ultimately, these tissues are fragile and susceptible to damage by trauma or infection with little ability to repair or defend themselves due to the lack of vasculature caused during the pre-fibrotic phase.
Osteoradionecrosis | Pathophysiology
Subjects are exposed to a substantial amount of radiation with this procedure, so their use is limited.
Cerebral atherosclerosis | Diagnosis
It is also associated with a benign inner ear dysplasia known as osteosclerosis.
Melorheostosis | Diagnosis
The diagnosis is often made as an incidental finding intraoperatively. Cartilage exposed to the air turns dark gray or black within minutes.
Ochronosis | Diagnosis
Under the microscope, the lesion now appears as a fatty streak. Foam cells eventually die and further propagate the inflammatory process.
Atherosclerosis | Cellular
"Myringosclerosis" refers to a calcification only within the tympanic membrane and is usually less extensive than "intratympanic tympanosclerosis", which refers to any other location within the middle ear such as the ossicular chain, middle ear mucosa or, less frequently, the mastoid cavity.
Tympanosclerosis | Classification
Earlier workers suggested the use of calcium fluoride; now sodium fluoride is the preferred compound. Fluoride ions inhibit the rapid progression of disease. In the otosclerotic ear, there occurs formation of hydroxylapatite crystals which lead to stapes (or other) fixation. The administration of fluoride replaces the hydroxyl radical with fluoride leading to the formation of fluorapatite crystals. Hence, the progression of disease is considerably slowed down and active disease process is arrested. This treatment cannot reverse conductive hearing loss, but may slow the progression of both the conductive and sensorineural components of the disease process. Otofluor, containing sodium fluoride, is one treatment.
Otosclerosis | Medical
Myringosclerosis seems to be more common than tympanosclerosis. Most research has not been conducted upon the general, healthy population, but rather those with otitis media or patients who have had tympanostomy tubes in prior procedures. Of the children studied who had 'glue ear', and who were treated with tympanostomy tubing, 23-40% of cases had tympanosclerosis. One study suggested that people with atherosclerosis were more likely to have tympanosclerosis than otherwise healthy individuals.
Tympanosclerosis | Epidemiology
New Latin "Otodectes" is from Greek prefix "ωτο- ("ōto-")" meaning "ear" and the Greek word "δήκτης ("dēktēs")" meaning "biter."
Otodectes | Etymology
The recovered long bones lack inner cavities, like in "Paleoparadoxia" and "Desmostylus", and the trabecular pattern is different from that in "Behemotops".
Ashoroa | Introduction
Osteoporosis means "porous bones", from Greek: οστούν/"ostoun" meaning "bone" and πόρος/"poros" meaning "pore".
Osteoporosis | History
http://kneearthrofibrosis.com http://www.kneeguru.co.uk/KNEEnotes/primers/complications-rehabilitation/key-arthrofibrosis-resources-kneeguru-site
Arthrofibrosis | External links
The following terms are similar, yet distinct, in both spelling and meaning, and can be easily confused: arteriosclerosis, arteriolosclerosis, and atherosclerosis. "Arteriosclerosis" is a general term describing any hardening (and loss of elasticity) of medium or large arteries (); "arteriolosclerosis" is any hardening (and loss of elasticity) of arterioles (small arteries); "atherosclerosis" is a hardening of an artery specifically due to an atheromatous plaque (). The term "atherogenic" is used for substances or processes that cause formation of atheroma.
Atherosclerosis | Definitions
The "Otocinclus" name is derived from the Greek "oto", meaning ear and the Latin "cinclus", meaning a latticework, an allusion to the holes in the head in the region of the ear.
Otocinclus | Etymology
Usual diagnosis is via radiograph, patient history, biopsy is rarely needed. Periodic follow ups should included additional radiographs that show minimal growth or regression.
Idiopathic osteosclerosis | Diagnosis
The term "otitis media" is composed of "otitis", Ancient Greek for "inflammation of the ear", and "media", Latin for "middle".
Otitis media | Etymology
The term "adenomyosis" is derived from the Greek terms "adeno-" (meaning "gland"), "myo-" (meaning "muscle"), and "-osis" (meaning "condition").
Adenomyosis | Etymology
As the skull base is progressively involved, the adjacent exiting cranial nerves and their branches, especially the facial nerve and the vagus nerve, may be affected, resulting in facial paralysis and hoarseness, respectively. If both of the recurrent laryngeal nerves are paralyzed, shortness of breath may develop and necessitate tracheotomy. Profound deafness can occur, usually later in the disease course due to relative resistance of the inner ear structures. Gallium scans are sometimes used to document the extent of the infection but are not essential to disease management. Skull base osteomyelitis is a chronic disease that can require months of IV antibiotic treatment, tends to recur, and has a significant mortality rate.
Otitis externa | Complications
The bulk of these lesions is made of excess fat, collagen, and elastin. At first, as the plaques grow, only wall thickening occurs without any narrowing. Stenosis is a late event, which may never occur and is often the result of repeated plaque rupture and healing responses, not just the atherosclerotic process by itself.
Atherosclerosis | Pathophysiology
Arthrofibrosis may arise without an obvious cause or it may follow a known cause.
Arthrofibrosis | Introduction
O'Brien's test - Ober's test - Oligodactyly - Ollier disease - Orthopaedic pathology - Orthopaedic procedure - Orthopedic cast - Orthopedic plaster casts - Orthopedic plates - Orthopedic surgery - Orthotics - Ortolani test - Ortolani test - Osgood–Schlatter disease - Osseointegration - Osseous tissue - Ossification center - Ossification - Ostectomy - Osteitis fibrosa cystica - Osteitis - Osteoarthritis - Osteoblast - Osteoblastoma - Osteochondritis dissecans - Osteochondritis - Osteochondrodysplasia - Osteochondroma - Osteochondromatosis - Osteochondrosis - Osteoclast - Osteocyte - Osteofibrous dysplasia - Osteogenesis imperfecta - Osteoid osteoma - Osteoid - Osteolysis - Osteoma - Osteomalacia - Osteomyelitis - Osteon - Osteopetrosis - Osteophyte - Osteoporosis - Osteosarcoma - Osteosclerosis - Osteostimulation - Osteotomy
Index of trauma and orthopaedics articles | O
"You're a SAD BET with these risk factors": Sex: male Age: middle-aged, elderly
List of pathology mnemonics | Atherosclerosis risk factors
Arteriolosclerosis is a form of cardiovascular disease involving hardening and loss of elasticity of arterioles or small arteries and is most often associated with hypertension and diabetes mellitus. Types include hyaline arteriolosclerosis and hyperplastic arteriolosclerosis, both involved with vessel wall thickening and luminal narrowing that may cause downstream ischemic injury. The following two terms whilst similar, are distinct in both spelling and meaning and may easily be confused with arteriolosclerosis.
Arteriolosclerosis | Introduction
On radiographic images, the otic capsule is the most dense portion of the temporal bone. In otospongiosis, a leading cause of adult-onset hearing loss, the otic capsule is exclusively affected. This area normally undergoes no remodeling in adult life and is extremely dense. With otospongiosis, the normally dense enchondral bone is replaced by haversian bone, a spongy and vascular matrix that results in sensorineural hearing loss due to compromise of the conductive capacity of the inner ear ossicles. This results in hypodensity on CT, with the portion first affected usually being the "fissula ante fenestram".
Bony labyrinth | Introduction
In humans, these conditions may be classified into three groups:
Osteochondrosis | Classification
A sequestrum (plural: sequestra) is a piece of dead bone that has become separated during the process of necrosis from normal or sound bone. It is a complication (sequela) of osteomyelitis. The pathological process is as follows: The sequestra are surrounded by sclerotic bone which is relatively avascular (without a blood supply). Within the bone itself, the haversian canals become blocked with scar tissue, and the bone becomes surrounded by thickened periosteum.
Sequestrum | Introduction
The suffix '-otomy' is derived from the Greek suffix τόμος, "-tómos", "meaning cutting, sharp, or separate".
List of -otomies | Introduction
Osteoarthritis is derived from the prefix "osteo-" (from ) combined with "arthritis" (from , , ), which is itself derived from "arthr-" (from , , ) and "-itis" (from , , ), the latter suffix having come to be associated with inflammation. The "-itis" of osteoarthritis could be considered misleading as inflammation is not a conspicuous feature. Some clinicians refer to this condition as "osteoarthrosis" to signify the lack of inflammatory response, the suffix "-osis" (from , , ) simply referring to the pathosis itself.
Osteoarthritis | Etymology
Recently, some success has been claimed with a second such treatment, bisphosphonate medications that inhibit bone destruction. However, these early reports are based on non-randomized case studies that do not meet standards of clinical trials. There are numerous side-effects to both pharmaceutical treatments, including occasional stomach upset, allergic itching, and increased joint pains which can lead to arthritis. In the worst case, bisphosphonates may lead to osteonecrosis of the auditory canal itself. Finally, neither approach has been proven to be beneficial after the commonly preferred method of surgery has been undertaken.
Otosclerosis | Medical
An examination of the external ear canal and tympanic membrane performed by a medical doctor, otolaryngologist, or audiologist using an otoscope, a visual instrument inserted into the ear. This also allows some inspection of the middle ear through the translucent tympanic membrane.
Presbycusis | Otoscopy
In general, an axial and coronal bone computed tomography study without contrast will yield the most information for this tumor. The tumor appears as a soft tissue mass usually within a well-aerated mastoid bone. The features of chronic otitis media are not usually seen. Bone invasion and destruction are usually not seen in this tumor which expands within the mesotympanum (middle ear cavity). Encasement of the ossicles is usually present. There may be an irregular margin at the periphery, especially if the tumor has been present for a long time, with associated bone remodeling.
Neuroendocrine adenoma middle ear | Imaging findings
Complications of otitis media include hearing loss, facial nerve paralysis, or extension of infection to surrounding anatomic structures, including:
Ear pain | Acute otitis media
From Greek παρωτῖτις (νόσος), parōtĩtis (nósos) : (disease of the) parotid gland < παρωτίς (stem παρωτιδ-) : (gland) behind the ear < παρά - pará : behind, and οὖς - ous (stem ὠτ-, ōt-) : ear.
Parotitis | Etymology
The Editor-in-Chief is Arnold von Eckardstein. According to the "Journal Citation Reports", the journal has a 2016 impact factor of 4.239.
Atherosclerosis (journal) | Introduction
Tissue damage leads to necrosis in the end.
Postvaccinal encephalitis | Histology
Otitis is a general term for inflammation or infection of the ear, in both humans and other animals. It is subdivided into the following:
Otitis | Introduction
Given this understanding of the pathophysiology of ORN, current treatments are targeted at decreasing inflammatory cytokines and reducing free radical damage to DNA.
Osteoradionecrosis | Pathophysiology
Trauma, such as a basilar skull fracture, can also lead to cerebrospinal fluid otorrhea (discharge of CSF from the ear) due to cerebral spinal drainage from the brain and its covering (meninges).
Otitis media | Signs and symptoms
The plaque is divided into three distinct components: Apart from thromboembolism, chronically expanding atherosclerotic lesions can cause complete closure of the lumen. Chronically expanding lesions are often asymptomatic until lumen stenosis is so severe (usually over 80%) that blood supply to downstream tissue(s) is insufficient, resulting in ischemia. These complications of advanced atherosclerosis are chronic, slowly progressive and cumulative. Most commonly, soft plaque suddenly ruptures (see vulnerable plaque), causing the formation of a thrombus that will rapidly slow or stop blood flow, leading to death of the tissues fed by the artery in approximately five minutes. This event is called an infarction.
Atherosclerosis | Components
An enostosis is a small area of compact bone within the cancellous bone. They are commonly seen as an incidental finding on radiographs or CT scans. They are typically very small and do not cause any symptoms. Their radiodensity is generally similar to cortical bone. No treatment is necessary. Multiple enostoses are present in osteopoikilosis.
Enostosis | Introduction
It can also cause skull base osteomyelitis (SBO), manifested by multiple cranial nerve palsies, described below under the "Treatment" heading.
Otitis externa | external otitis
A specific form of conjunctivoplasty may help somewhat.
Nevus of Ota | Treatment
Nucleoli are small with inconspicuous mitoses. There may be secretions in the gland tumor. It is possible to see a concurrent cholesteatoma.
Neuroendocrine adenoma middle ear | Pathology findings
The term is a combination of New Latin combining forms ("oto-" + "rhino-" + "laryngo-" + "-logy") derived from four Ancient Greek words: οὖς "ous" (gen.: ὠτός "otos"), "ear", ῥίς "rhis", "nose", λάρυγξ "larynx", "larynx" and -λογία "logia", "study" (cf. Greek ωτορινολαρυγγολόγος, "otorhinolaryngologist").
Otorhinolaryngology | Etymology
This is an uncommon lesion, usually affecting young patients (mean age, 30 years), with a male to female ratio of 2:1. The middle ear is involved, although it may extend to the external auditory canal if there is tympanic membrane perforation.
Otic polyp | Epidemiology
Octet - Ode - Onomatopoeia - Oral tradition - Oxymoron
Index of literature articles | O
Although the disease process tends to be slowly progressive over decades, it usually remains asymptomatic until an atheroma ulcerates, which leads to immediate blood clotting at the site of atheroma ulcer. This triggers a cascade of events that leads to clot enlargement, which may quickly obstruct the flow of blood. A complete blockage leads to ischemia of the myocardial (heart) muscle and damage. This process is the myocardial infarction or "heart attack". If the heart attack is not fatal, fibrous organization of the clot within the lumen ensues, covering the rupture but also producing stenosis or closure of the lumen, or over time and after repeated ruptures, resulting in a persistent, usually localized stenosis or blockage of the artery lumen.
Atherosclerosis | Rupture and stenosis
Research to treat ORN at a molecular level has increased with progress in the field of medicine. The pharmacological methods to treat ORN listed below were developed to treat the etiologic factors.
Osteoradionecrosis | Therapeutic approach
Otic means pertaining to the ear. It can refer to:
Otic | Introduction
Treacher Collins syndrome and hemifacial microsomia).
Otoplasty | Introduction
"Osteosclerosis", an elevation in bone density, is normally detected on an X-ray as an area of whiteness, and is where the bone density has significantly increased. Localized osteosclerosis can be caused by injuries that compress the bone, by osteoarthritis, and osteoma.
Osteochondrodysplasia | Osteosclerosis
The epidemiology of osteoradionecrosis has proven difficult to estimate, with previous studies reporting incidence of disease between 4.74-37.5%. More recent reports have estimated the incidence to 2%, which is likely attributable to improvements in radiation therapy.
Osteoradionecrosis | Epidemiology
Direct examination of the external canal and tympanic membrane (ear drum) with an otoscope, a medical device inserted into the ear canal that uses light to examine the condition of the external ear and tympanic membrane, and middle ear through the semi-translucent membrane.
Sensorineural hearing loss | Otoscopy
Atherosclerosis, formerly considered a bland lipid storage disease, actually involves an ongoing inflammatory response. Recent advances in basic science have established a fundamental role for inflammation in mediating all stages of this disease from initiation through progression and, ultimately, the thrombotic complications of atherosclerosis. These new findings provide important links between risk factors and the mechanisms of atherogenesis. Clinical studies have shown that this emerging biology of inflammation in atherosclerosis applies directly to human patients. Elevation in markers of inflammation predicts outcomes of patients with acute coronary syndromes, independently of myocardial damage. In addition, low-grade chronic inflammation, as indicated by levels of the inflammatory marker C-reactive protein, prospectively defines risk of atherosclerotic complications, thus adding to prognostic information provided by traditional risk factors.
Inflammation | Atherosclerosis
Today a growing body of scientific evidence indicates that this disease process, in the cancellous bone and bone marrow, is caused by bone infarcts mediated by a range of local and systemic factors. Bone infarcts as well as damage to the deeper portion of the cancellous bone is an insidious process. It is certainly not visible clinically and routine imaging techniques such as radiographs are not effective for that sort of damage. ""An important and often incompletely understood principle of radiography is the amount of bone destruction that goes undetected by routine x-rays procedures; this has been demonstrated by numerous investigators.
Osteonecrosis of the jaw | History
Up to a quarter of all severe ligament or capsular knee injuries leading to a haemarthrosis are associated with cartilage damage that can lead to progressive degenerative arthritis.
Hemarthrosis | Complications
The "os ulnostyloideum" is an ulnar styloid process that is not fused to the rest of the ulna bone. On X-rays, an "os ulnostyloideum" is sometimes mistaken for an avulsion fracture of the styloid process. However, the distinction between these is extremely difficult. It is alleged that the os ulnostyloideum has a close relationship with or is synonymous with the os triquetrum secundarium.
Accessory bone | Os ulnostyloideum
Atherosclerosis is categorized as an aging disease and is brought about by vascular remodeling, the accumulation of plaque, and the loss of arterial elasticity. Over time, these processes can stiffen the vasculature. For these reasons, older age is listed as a major risk factor for atherosclerosis. Specifically, the risk of atherosclerosis increases for men above 45 years of age and women above 55 years of age.
Aging-associated diseases | Atherosclerosis
Endothelial dysfunction may be involved in the development of atherosclerosis and may predate vascular pathology.
Endothelial dysfunction | Atherosclerosis
Otitis media is an inflammation of the middle ear.
Middle ear | Clinical significance
The staging system can be useful as a baseline reference for management after a definitive diagnosis of ORN has been established.
Osteoradionecrosis | Staging
According to Weerda: cosmetically disfiguring cartilage edges along the anterior surface of the antihelix if the cartilage is scratched or scored too deeply or is injured; post-operative bleeding; haematoma; relapse (ears protrude again); too closely pinned ear; hypertrophic scar; keloid; hypersensitivity; pressure damage (necrosis) if hard bandages are applied too tightly; perichondritis (inflammation of the cartilage); stronger asymmetry of the ears.
Stenström technique | Complications
Atherosclerosis is a monthly peer-reviewed scientific journal established in 1970 and published by Elsevier. It is the official journal of the European Atherosclerosis Society and is affiliated with the International Atherosclerosis Society. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biologyand disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The journal can publish original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.
Atherosclerosis (journal) | Introduction
Atherosclerosis is the progressive thickening of blood vessels and plaque formation that eventually can lead to coronary artery disease (CAD).
Coronary thrombosis | Terminology
The initial damage is attributed to the formation of bubbles, and one episode can be sufficient, however incidence is sporadic and generally associated with relatively long periods of hyperbaric exposure and aetiology is uncertain.
Dysbaric osteonecrosis | Presentation
Nodulosis–arthropathy–osteolysis syndrome is a cutaneous condition that shares features with juvenile hyaline fibromatosis.
Nodulosis–arthropathy–osteolysis syndrome | Introduction
The onset of ORS may be sudden, where it usually follows after a precipitating event, or gradual.
Olfactory reference syndrome | Signs and symptoms
Although imaging is not required to yield a diagnosis, it may be obtained to exclude other disorders, such as a concurrent cholesteatoma.
Otic polyp | Imaging
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Otospondylomegaepiphyseal dysplasia | External links
This procedure is required if there is a damage to the bone chain of the middle ear. Commonly affected bone is the long process of incus, where it gets necrosed. The bone chain can be repaired using autograft of incus or cartilage. Prosthetic implants made of titanium, hydroxyapatite or teflon are also used.
Tympanoplasty | Ossicular reconstruction
Symptoms are also often more severe. Generally, the presence of a palpable neck mass is also indicative of the cancer, occurring in approximately 50% of sufferers, but virtually nonexistent in individuals with OFC with a different origin.
Osteitis fibrosa cystica | Signs and symptoms
Necrosis is a form of cell injury that results in the premature death of cells in living tissue. Necrosis may also refer to:
Necrosis (disambiguation) | Introduction
Etymologically, "myringotomy" ("myringo-", from Latin "myringa" "eardrum", + "-tomy") and "tympanotomy" ("tympano-" + "-tomy") both mean "eardrum cutting", and "tympanostomy" ("tympano-" + "-stomy" means "making an eardrum stoma".
Myringotomy | Nomenclature
If the causative factor persists, tissue will become more fibrous over time.
Epulis fissuratum | Prognosis