Presentation
The patient presented with a longstanding history of progressive mixed pattern of hearing loss
Patient Data
High-resolution CT at the level of both petrous bones shows bilateral areas of lucencies (due to demineralisation) involving oval windows, stapes footplates, and fissulae ante fenestram.
Note also the circumscribed areas of demineralisation just medial to cochlear basal turns and cochlear apertures bilaterally.
1. First annotated image shows areas of demineralisation centred to the cochlear promontory involving oval window and fissulae ante fenestrae (white arrows)
2. Second and third magnified annotated images in the coronal plane of both right and left petrous bones showing the areas of demineralisation (white arrows)
3. Forth and fifth annotated images show focal demineralisation medial to the basal cochlear turns and cochlear apertures (black arrows)
Case Discussion
The case presented demonstrates the characteristic appearance of fenestral and retrofenestral otospongiosis.
Otospongiosis is the better term to describe early otosclerosis (The active phase of bone dystrophy and demineralisation). Later on, osteoblasts activity predominate and dense bone is formed hence the term otosclerosis is the widely used term to describe the condition.
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