Article
Preoperative serologic diagnosis of otosclerosis
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Published: | April 24, 2006 |
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Otosclerosis is a disease of complex etiology causing progressive conductive and/or sensorineural hearing loss. Diagnostic methods of otosclerosis are sensitive to ossicular chain fixation with low specificity for otosclerotic stapes ankylosis.
Nucleic acid was extracted from stapes footplates of clinically stapes fixation patients (N=279). Measles virus nucleoprotein RNA was amplified by RT-PCR. Amplification results were correlated to histologic findings in 86 cases. Anti-measles IgG levels of all clinically stapes fixation as well as control sera specimens were measured by ELISA.
Among clinically stapes fixation patients, 182 stapes footplates contained measles virus RNA. Among 86 histologic specimens, viral RNA was detectable only in histologically otosclerotic stapes footplates (N=57). Histology for virus negative footplates (N=29) excluded otosclerosis. Anti-measles IgG levels were significantly lower in the sera of patients with virus positive stapes compared with control sera.
Combination of decreased anti-measles IgG serum level and conductive hearing loss has a great specificity and sensitivity as a diagnostic method in preoperative evaluation of otosclerosis. Low anti-measles IgG level indicates otosclerosis, whereas high level suggests non-otosclerotic ossicular chain fixations. Preoperative elucidation of the etiology of a conductive hearing loss may suggest optional medical treatment in preference to surgical methods.