Otospongiosis

Case contributed by Bassem Marghany
Diagnosis almost certain

Presentation

Bilateral diminished hearing for few months, more on the left side.

Patient Data

Age: 40 years
Gender: Male
ct

Confluent hypodense plaques of demineralization partially surrounding the basal turns of both cochlea, yet sparing the middle and apical turns [Retrofenestral/Cochlear otospongiosis] (grade 2A - Symons and Fanning CT grading system), more on the left side.

Associated smaller hypodense plaques of demineralization are seen at the left fissula ante fenestrum, representing fenestral otospongiosis.

Case Discussion

Otospongiosis represents the early/active phase of the disease, while otosclerosis represents the late/inactive phase.

In this case, the confluent hypodense plaques of demineralization are partially surrounding the basal turns of both cochlea (pericochlear) [Retrofenestral/Cochlear otospongiosis] (grade 2A - Symons and Fanning CT grading system), more on the left side.

Associated smaller hypodense plaques of demineralization are seen at the left fissula ante fenestrum, representing fenestral otospongiosis.

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