Patient undergoing HEENT workup.

Our appreciation is extended to Dr. Bharat Kakarala, Indiana University Department of Radiology, for contributing this case.

Patient undergoing HEENT workup.

Patient undergoing HEENT workup.

Patient undergoing HEENT workup.

• Fenestral otosclerosis
• Bony labyrinth infection
• Tympanosclerosis
• Paget's disease
• Fibrous dysplasia
• Osteoradionecrosis

Patient undergoing HEENT workup.

Key points - Fenestral Otosclerosis: 

• Most common presenting symptom is progressive conductive hearing loss, followed by tinnitus
• Occurs in 1% of the population
• In patients with conductive hearing loss 90% of time fenestral otosclerosis is the cause
• 85% fenestral otosclerosis vs. 15% cochlear otosclerosis is the typical breakdown for types of otosclerosis
• Fenestral otosclerosis begins at fistula ante fenestram and spreads posteriorly along oval window to the round window
• The disease process continues to spread to the otic capsule
• The active process eventually fixes the stapes footplate in the oval window and ultimately results in conductive hearing loss

References: 

1. Statdx.  Author: Ric Harnsberger MD, StatDx - Fenestral Otosclerosis.

Patient undergoing HEENT workup.