Otosyphilis

Otosyphyilis, otic syphilis or syphilitic labyrinthitis is the syphilitic inner ear disease resultoing from vasculitis and obliterative endarteritis from the agent Treponema pallidum.

Pathology

The pathological features of syphilitic labyrinthitis consist of:

  • severe endolymphatic hydrops
  • degeneration of the membranous labyrinth
  • diffuse osteitis

Electrocochleography of otitis syphilis patients resembles similar results to those of Meniere disease.1

Diagnosis

The FTA-Abs assay reliably indicates a history of exposure to Treponema pallidum or cross-reacting antigen, however does not distinguish between active and treated disease. Whilst FTA-Abs assays have high sensitibity and specificity (100% and 98% respectively) due to the very low levels of disease prevalence the positive predicative value is only 22%.2 Western blot assays are however able to confirm if the infection is active. Clinically, patients report vertigo that lasts minutes to hours, and the Tullio phenomenon may also be present, whereby motion of the tympanic membrane and ossicular chain (loud noise) can induce vertigo and nystagmus (Hennebert sign) in patients with otic syphilis, but may also occur in perilymph fistula and semicircular canal dehiscence.3


Share article

Article Information

rID: 51127
System: Head & Neck
Section: Pathology
Synonyms or Alternate Spellings:
  • otitic syphilis
  • syphilitic labyrinthitis

Support Radiopaedia and see fewer ads

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.