The effect of sodium fluoride treatment in patients with otospongiosis has been evaluated blindly in a morphological and microchemical element analysis of otospongiotic specimens together with a prospective clinical double-blind, placebo-controlled study. The results show that using the calcium/phosphorus ratio as an indication for bone maturity, the sodium fluoride treatment can stabilize otospongiotic lesions in retaining calcium relative to phosphorus. The clinical double-blind, placebo-controlled study of 95 patients showed a statistically significant worse deterioration of the hearing loss in the placebo group than in the active treated (40 mg sodium fluoride daily) group, supporting the view that sodium fluoride can change otospongiotic, active lesions to more dense, inactive otosclerotic lesions. We have postulated in the past that the actual mechanism of the cochlear loss is toxic enzymes produced by histiocytes at the periphery of the microfoci, and it may be that sodium fluoride has some effect on these enzymes.

Adolescent↗

PubMedDate not supplied

Otospongiosis: morphologic and microchemical investigation after NaF-treatment.

Element analysis of microareas of otospongiotic specimens is described. A total of 36 otospongiotic stapes are ultrasectioned without decalcification and examined using a transmission and a scanning electron microscopy (STEM-mode). The latter was equipped with an energy dispersive x-ray analyzer. Twenty of the stapes came from patients who have had sodium fluoride (NaF) treatment (15 to 45 mg/day) for a minimum of 12 months. The otospongiotic stapes are classified as spongiotic and sclerotic according to their pathologic characteristics and state of mineralization. Using the Ca/P ratio as criterion--measured by the characteristic x-ray fluorescence--it was shown in a blind study that the NaF-treated otospongiotic stapes had a statistically higher Ca/P ratio, indicating that the fluoride may stabilize otospongiotic lesions, particularly the spongiotic type with unstable mineralization.

Adolescent↗

PubMedDate not supplied

Hydrolytic activity of the perilymph in otosclerosis. A preliminary report.

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Acid Phosphatase↗

PubMedDate not supplied

Paradoxical compliances in otosclerosis.

Results of impedancemetry have been compared with operative findings in 1 867 cases of otosclerosis, 1 583 of which were pure otosclerosis. This comparison indicated that: (1) with present techniques, the results of impedancemetry are only of a relative value in otosclerosis; it is thus necessary to asses the various connected anatomical elements in the middle ear with extreme rigor; (2) impedancemetry data have an absolute value in all disorders of the middle ear with closed eardrum associated with otosclerosis; (3) relative impedancemetry often gives informative results when it concurs with the other elements of clinical and audiometrical diagnosis; (4) impedancemetry data are a valuable element of early diagnosis of otosclerosis before the first audiometric expression, either by a lowering of compliance or, most of all, by appearance of an on-off effect (diphasic impedance change) or by disappearance of the stapedius reflex; (5) parallel or crossed paradoxical compliances are only apparently paradoxical and are usually the sign of either an early stapedo-vestibular fixation (before its audiometric expression) or an associated factor in the middle ear, both of which may have been unnoticed; (6) the problem of compliance value in otosclerosis will be solved only when the proper stapes frequency is found and when it is possible to test this frequency. This problem is the subject of our current research.

Adolescent↗