Schwaze sign seen in?
Ans. is 'b' i.e., Otosclerosis Symptoms of otosclerosis Hearing loss :- Bilateral conductive deafness which is painless and progressive with insidious onset. In cochlear otosclerosis sensorineural hearing loss also occur along with conductive deafness. Paracusis willissii :- An otosclerotic patient hears better in noisy than quiet surroundings. Tinnitus :- More common in cochlear otosclerosis. Speech :- Monotonous, well modulated soft speech. Veigo :- is uncommon. Signs in otosclerosis Tympanic membrane is quite normal and mobile. In 10% of cases flamingo - pink blush is seen through the tympanic membrane called as Schwaze sign. Various tests show conductive hearing loss. Tuning fork tests in otosclerosis As otosclerotic patients have conductive deafness, the tuning fork tests results will be as follows :? Rinnes :- Negative Webers :- Lateralized to the ear with greater conductive loss. Absolute bone conduction (ABC) :- Normal (can be decreased in cochlear otosclerosis). Gelles test :- No change in the hearing through bone conduction when air pressure of ear canal is increased by Siegle's speculum. Audiometry in otosclerosis Audiometry is one of the impoant tools in evaluation of a patient of otosclerosis.Various audiometric tests are :? 1. Pure tone audiometry Shows loss of air conduction, more for lower frequencies with characteristic rising pattern. Bone conduction is normal. However in some cases, there is a dip in bone conduction curve which is maximum at 2000 Hz (2 KHz) and is called the Carha's notch. 2. Impedance audiometry Impedance audiometry shows :- Tympanometry Patient with early disease may show type A tympanogram (because middle ear areation is not affected) Progressive stapes fixation results in classical As type tympanogram. Acoustic (stapedial reflex) It is one of the earliest sign of otosclerosis and preceedes the development of airbone gap. In early stage, diphasic on-off pattern is seen in which there is a brief increase in compliance at the onset and at the termination of stimulus occurs. This is pathognomonic of otosclerosis. In later stage the reflex is absent.
Glomus Jugulare
Otosclerosis
Meniere's diseases
Acoustic neuroma