166 / 264
Prevalence of Otosclerosis
In three studies, the prevalence of otosclerosis was
100% and as a result only sensitivities could be calcu-
lated for these studies (2,6,20). Prevalences were high in
the studies performed by Marx et al./Lagleyre et al.
(16,17), Shin et al. (18), and Karosi et al. (3). In two
of these studies patients with a clinical suspicion of
otosclerosis were included (16–18). In one study patients
with surgically confirmed otosclerosis were included.
Since the outcome measure in this study was histopa-
thology instead of middle ear surgery, the prevalence of
(histopathologically confirmed) otosclerosis was not
TABLE 3.
Study characteristics
Study (Year)
Study Population
Type of CT
CT Slice
Thickness
Diagnostic
Criteria CT
Diagnostic Criteria Surgery
and/or Histopathology
Shin (2001a) (18)
Conductive hearing loss
with a normal
tympanic membrane
HRCT
1 mm Otospongiotic foci
surrounding the otic
capsule and/or
footplate thickening
Intraoperatively established
presence of fixation or
macropscopic otosclerotic
foci, and absence of minor
malformations
Kiyomizu (2004) (6)
Otosclerosis surgically
confirmed in at least
one ear
NA
1mm Focus of
demineralization
or thick anterior
and posterior
calcified plaques
Intraoperatively established
in at least one ear
Trojanowska (2007) (19) Indication for middle
ear surgery
Multislice CT 0.6 mm Hypodense foci
around otic capsule
Intraoperatively established,
not further specified
Tringali (2007) (20)
Intraoperatively confirmed
otosclerosis
Helical CT 0.6 mm Focus of
demineralization
Intraoperatively established,
not further specified
Marx (2011) (16),
Lagleyre (2009) (17)
Conductive hearing loss
with a normal tympanic
membrane and absent or
biphasic stapedial reflex
in at least one ear
HRCT
0.6mm to
1 mm
Hypodense foci
around otic capsule
Intraoperatively established
macroscopic otosclerotic
foci
Karosi (2012) (3)
Intraoperatively confirmed
otosclerosis and stapes
completely removed for
histopathology
HRCT
0.6 mm Hypodense foci
around otic capsule
and/or footplate
thickening
Pseudovascular spaces filled
with osteoclasts (active
otosclerosis) or obliterated
vascular spaces and
resorption of lacunae with
decreased numbers of
osteoclasts (inactive
otosclerosis)
histopathologically
Liktor (2014) (2)
Intraoperatively confirmed
otosclerosis and stapes
completely removed for
histopathology
Cone beam CT 0.4 mm Hypodense foci
around otic
capsule
Pseudovascular spaces filled
with osteoclasts (active
otosclerosis) or obliterated
vascular spaces and resorption
of lacunae with decreased
numbers of osteoclasts
(inactive otosclerosis)
histopathologically
HRCT indicates high-resolution computed tomography; NA, not available.
TABLE 4.
Results
Study (Year)
Reference Test
Prevalence
a
Sensitivity
a
Specificity
a
Positive Post-test
Probability
a
Negative Post-test
Probability
a
Shin (2001a) (18)
Middle ear surgery 92 (89–94)
91 (88–94)
100 (89–100)
NA
51 (NA)
Kiyomizu (2004) (6)
Middle ear surgery 100 (95–100)
61 (50–71)
NA
NA
NA
Trojanowska (2007) (19)
Middle ear surgery
9 (6–14)
75 (50–90)
75 (68–81)
23 (13–36)
3 (2–6)
Tringali (2007) (20)
Middle ear surgery 100 (96–100)
82 (74–88)
NA
NA
NA
Marx (2011) (16),
Lagleyre (2009) (17)
Middle ear surgery 97 (94–99)
95 (91–97)
83 (42–98)
99 (96–100)
67 (22–93)
Karosi (2012) (3)
Histopathology
74 (61–83)
60 (45–73)
100 (76–100)
NA
53 (NA)
Liktor (2014) (2)
Histopathology
100 (87–100)
66 (48–80)
NA
NA
NA
NA indicates not available.
a
% (95% confidence interval).
CT IMAGING IN OTOSCLEROSIS
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