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available evidence on this topic. The search strategy was
transparent and thorough. The screening of eligible
articles, as well as the critical appraisal of selected
studies, was performed by at least two independent
authors, thereby limiting erroneous subjective decisions
as much as possible. The critical appraisal ensures the
transparent evaluation of strengths and limitations of the
included studies. The evaluation of both relevance and
validity is based on clear, predetermined criteria and aids
the reader in interpreting the evidence.
There is one limitation that could have potentially
biased the results presented in this review. Two studies
were excluded on the basis of language (Japanese and
Spanish) (14,15). None of the authors are fluent in these
two languages and therefore we decided not to include
these studies. There is a possibility that these articles
were relevant to our review.
CONCLUSION
The prevalence of otosclerosis in patients with a
clinical suspicion of otosclerosis and/or an indication
for surgery is generally high. As a result, preoperative CT
has little to add in establishing otosclerosis and may not
be necessary to confirm the diagnosis. Furthermore, a
normal CT does not fully exclude otosclerosis. We would
recommend reserving CT for those patients with sus-
pected additional abnormalities, for specific preoperative
planning, or out of legal necessity, but not for diagnosing
otosclerosis.
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