gms | German Medical Science

During the last decade the pathology and etiopathogenesis of otosclerosis has focussed on the fact that the active phase (otospongiosis) is an inflammatory process associated with the intracellular presence of measles virus-RNA. It seems that similar to SSPE (subacute sclerosing panencephalitis) this bone disease has a persistent measles virus infection. In the view of new findings otosclerosis also bears resemblance to the described measles virus association in Paget’s disease of the bone. Histologically as well as clinically otosclerosis is 1,5 – 2 times more often seen in female than in male patients. This is in accordance with the female/male ratio of severe measles virus infections (WHO).

The clinical development of new and very sophisticated stapes prostheses have to regard the fact that as larger the perilymph–contacting surface of a stapes prosthesis is, as better is the sound pressure and basilar membrane movement within the cochlea. The same is valid for the size of the “fenestra”, since – as intraoperativ measurements have shown - already the large fenestra alone allows better inner ear dynamics than the small fenestra.

The impacts of these new results on pathogenesis in clinics of otosclerosis are discussed.