Correlation between audiological and radiological findings in otosclerosis: randomized clinical study

The standard methods for diagnosing otosclerosis (OS) include clinical and audiological testing. Radiologic imaging continues to expand with use in diagnosis, staging, surgery planning, and outcomes. To determine if high resolution computed tomography (HRCT) imaging advances to the audiological findings in the diagnosis of otosclerosis. This prospective randomized controlled study was conducted from June 2018 to June 2022. Fifty patients with OS who divided into two subgroups: group 2a, 50 early OS ears, and group 2b, 35 ears with late OS. The controls includes 50 individuals who have healthy ears (group 1). All participants had otorhinolaryngology examination, audiological evaluation and HRCT imaging. Early OS had higher air conduction thresholds than control, and late OS had considerably higher air conduction thresholds than either the early or control subjects (p < 0.001). Early OS patients had higher bone conduction threshold (BCT) than control, while late OS patients had higher BCT than both early and control subjects (p < 0.001). In early and late OS, there is a significant association between bone conduction of 11 dB and 21.6 dB, respectively (P = 0.004), and a significant air–bone gap of 25.5 and 31 dB, respectively (P = 0.03). HRCT showed a sensitivity of 75% and high specificity 92% with accuracy 83% in early OS and sensitivity of 78% and high specificity 94% with accuracy 86% in late OS. HRCT is a more sensitive and specific diagnostic tool for OS than audiometry. HRCT could discriminate between early and late OS, suggesting that it can be used to do so with a high degree of confidence.