XLIV Therapy of Cochlear Otosclerosis

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Abstract
Pure sensorineural hearing loss can be suspected as being due to cochlear otosclerosis when there is a positive Schwartze sign, a family history of stapedial otosclerosis, unusual audiometric configuration and age of onset usual for stapedial otosclerosis. The positive diagnosis of cochlear otosclerosis can be made if that patient later develops stapes fixation, or by demonstration of a spongy focus of the cochlear capsule by polytomography. The otosclerotic bone lesion has a slight tendency toward spontaneous recalcification and inactivation, with mature histologically inactive lesions being a little more frequent in older individuals. Clinical studies confirm the tendency for some cases of otosclerosis to become nature and inactive with stabilization of the hearing loss. Experimental studies on young rats demonstrate a retarding effect of sodium fluoride on bone resorption and a promoting effect on calcium deposition. The spongy active stage of otosclerosis consists of young growing bone histologically resembling the bone of callus formation. In rats, sodium fluoride promotes calcification of callus after fracture. Preliminary clinical experience with large doses of sodium fluoride shows a significant though inconstant promoting effect on recalcification of a spongy otosclerotic focus.

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