To scan or not to scan, otosclerosis
Reviewed by Hassan Mohammed

Otosclerosis can co-exist with other ear pathologies such as superior semicircular canal dehiscence (SSCD). Stapedectomy in this situation can lead to development of SSCD symptoms. Authors conducted an email-based survey involving active members of the American Neurotologic Society (ANS) and American Otologic Society (AOS). Respondents were asked about what investigations they would use, the reasons for not doing a CT scan if they don’t do one, and if they would offer a stapedectomy if an SSCCD is present. There was a 14.4% response rate. One fifth won’t investigate routinely, 35% will arrange for a CT scan and more likely so  in an academic setting. In special circumstances such as a revision stapedectomy, presence of stapedial reflex, autophony and other middle ear surgery, around 80% of those who will not routinely scan will request a scan. Sixty percent of respondents will not recommend stapedectomy if there is evidence of SSCCD on CT. Authors concluded that CT scan is a common diagnostic test. They also found similarities between academic and private practice in terms of the tests used. This is an interesting study. However, the validity is low due to the low response rate. The findings build a strong case for a preoperative CT scanning because it will help with patient counselling, including not offering surgery.

Preoperative Evaluation of Otosclerosis: A National Survey of Otologists.
Doerfer K, Tu N, Sioshansi P, et al.
OTOLOGY & NEUROTOLOGY
2022;43(9):e963-8.