Otosclerosis

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Otosclerosis - Quiz

Baileys 143 - Otosclerosis answer appropriately


Questions and Answers
  • 1. 

    Otosclerosis is genetically transmitted by

    • A.

      Autosomal dominance with complete penetrance

    • B.

      Autosomal dominance with incomplete penetrance

    • C.

      Autosomal recessive with complete penetrance

    • D.

      Autosomal recessive with incomplete penetrance

    Correct Answer
    B. Autosomal dominance with incomplete penetrance
    Explanation
    Otosclerosis is a condition that affects the bones in the middle ear, causing hearing loss. The correct answer is autosomal dominance with incomplete penetrance. This means that the condition is inherited in an autosomal dominant manner, where a single copy of the mutated gene is enough to cause the condition. However, the penetrance is incomplete, meaning that not everyone who inherits the mutated gene will develop the condition. This suggests that other factors, such as environmental or additional genetic factors, may influence the expression of the condition.

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  • 2. 

    What is the percentage of patients in which there is increased vascularity of the cochlear promontory in the early phase of OS?

    • A.

      10%

    • B.

      20%

    • C.

      30%

    • D.

      40%

    Correct Answer
    A. 10%
    Explanation
    (The phase is otospongiosis and the sign is Schwartze sign – reddish hue behind an intact TM)

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  • 3. 

    A patient presents for their post-op visit following stapedotomy for otoslclerosis.  They are complaining of severe SNHL.  What diagnosis was most likely missed on initial evaluation prior to surgery?

    • A.

      Prior Hx of skullbase fracture

    • B.

      Acoustic Neuroma

    • C.

      Meniere disease

    • D.

      Semicircular Canal Dehiscence

    Correct Answer
    C. Meniere disease
    Explanation
    (Meniere disease is an absolute contraindication for stapedectomy)

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  • 4. 

    A patient with suspected otosclerosis presents to your office for testing.  What may be a characteristic finding on audiogram?

    • A.

      Normal speech discrims, 5dB loss at 2000Hz and 20dB loss at 500 and 4000Hz

    • B.

      Abnormal speech discrims,20dB loss at 2000Hz and 5dB loss at 500 and 4000Hz

    • C.

      Abnormal speech discrims, 5dB loss at 2000Hz and 20dB loss at 500 and 4000Hz

    • D.

      Normal speech discrims, 20dB loss at 2000Hz and 5dB loss at 500 and 4000Hz

    Correct Answer
    D. Normal speech discrims, 20dB loss at 2000Hz and 5dB loss at 500 and 4000Hz
    Explanation
    (otherwise known as Carhart notch)

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  • 5. 

    Your patient is currently being treated medically with sodium fluoride for otosclerosis and presents with complaints of nausea, what is your next step in management?

    • A.

      Discontinue medication

    • B.

      Lower dose of medication

    • C.

      Recommend taking medication with food

    • D.

      Recommend taking medication at night

    Correct Answer
    B. Lower dose of medication
    Explanation
    If a patient presents with complaints of nausea while being treated with sodium fluoride for otosclerosis, the next step in management would be to lower the dose of the medication. Nausea is a common side effect of sodium fluoride, and reducing the dosage may help alleviate this symptom while still providing the necessary treatment for otosclerosis. Discontinuing the medication completely may not be necessary if the patient is benefiting from it, and recommending taking the medication with food or at night may not address the underlying issue of nausea caused by the medication.

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  • 6. 

    What patient has the least amount of risk in complications from stapedectomy?

    • A.

      75 y/o female with HTN

    • B.

      25 y/o female scuba diver

    • C.

      6 y/o female with congenital footplate fixation

    • D.

      40 y/o female chef

    Correct Answer
    A. 75 y/o female with HTN
    Explanation
    (scuba diver – risk of fistula, pediatric – higher risk of OW reclosure, chef – risk of chorda tympani injury)

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  • 7. 

    What is the minimum amount of time to wait before attempting a stapedectomy on the second ear?

    • A.

      2 months

    • B.

      4 months

    • C.

      6 months

    • D.

      12 months

    Correct Answer
    C. 6 months
    Explanation
    The minimum amount of time to wait before attempting a stapedectomy on the second ear is 6 months. This is because stapedectomy is a surgical procedure to treat hearing loss caused by otosclerosis, a condition where the stapes bone in the middle ear becomes fixed and cannot vibrate properly. Performing the surgery on the second ear too soon after the first surgery may increase the risk of complications and affect the healing process. Waiting for 6 months allows sufficient time for the first ear to heal and ensures a better outcome for the second surgery.

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  • 8. 

    What is the risk of postoperative deafness in stapedectomy?

    • A.

      2%

    • B.

      4%

    • C.

      6%

    • D.

      8%

    Correct Answer
    A. 2%
    Explanation
    The risk of postoperative deafness in stapedectomy is 2%. This means that out of every 100 stapedectomy procedures, 2 patients may experience deafness after the surgery. Stapedectomy is a surgical procedure performed to treat hearing loss caused by otosclerosis, a condition where the stapes bone in the middle ear becomes fixed and cannot vibrate properly. While the procedure is generally safe and effective, there is still a small risk of complications, including postoperative deafness.

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  • 9. 

    The artery that courses in the obturator foramen of the stapes is the embryologic remnant of the _____

    • A.

      First branchial arch

    • B.

      Second branchial arch

    • C.

      Third branchial arch

    • D.

      Fourth branchial arch

    Correct Answer
    B. Second branchial arch
    Explanation
    (the persistant stapedial artery must be divided or the procedure must be aborted)

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  • 10. 

    A profuse perilymph gusher secondary to a patent cochlear aqueduct is seen more frequently which side?

    • A.

      Left

    • B.

      Right

    Correct Answer
    A. Left
    Explanation
    A profuse perilymph gusher secondary to a patent cochlear aqueduct is seen more frequently on the left side.

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  • 11. 

    A patient post-op stapedectomy is in your office a week after surgery.  They complain that their hearing was better and now is worse.  Audiogram confirms MHL severe in the high frequencies. What complication is suspected?

    • A.

      Acute otitis media

    • B.

      OW fistula

    • C.

      TM perforation

    • D.

      Reparative granuloma

    Correct Answer
    D. Reparative granuloma
    Explanation
    Reparative granuloma is suspected as a complication in this case. A stapedectomy is a surgical procedure performed to improve hearing in patients with otosclerosis. However, in some cases, a reparative granuloma can form at the surgical site, leading to complications such as worsening of hearing. The presence of severe mixed hearing loss (MHL) in the high frequencies on the audiogram further supports this suspicion. Acute otitis media, OW fistula, and TM perforation are not likely to cause these specific symptoms.

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 24, 2009
    Quiz Created by
    Pascolini
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