Brazilian Society of Otology task force – Otosclerosis: evaluation and treatment

•There is no evidence that pregnancy increases the risk of developing or worsening otosclerosis.•The use of the endoscope in stapes surgery is equally as safe as the use of the microscope.•No prosthesis material is superior to another in stapedotomy regarding hearing outcomes.•Among nonsurgical trea...

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Published in:	Brazilian journal of otorhinolaryngology Vol. 89; no. 5; p. 101303
Main Authors:	Silva, Vagner Antonio Rodrigues, Pauna, Henrique Furlan, Lavinsky, Joel, Guimarães, Guilherme Corrêa, Abrahão, Nicolau Moreira, Massuda, Eduardo Tanaka, Vianna, Melissa Ferreira, Ikino, Cláudio Márcio Yudi, Santos, Vanessa Mazanek, Polanski, José Fernando, Silva, Maurício Noschang Lopes da, Sampaio, André Luiz Lopes, Zanini, Raul Vitor Rossi, Lourençone, Luiz Fernando Manzoni, Denaro, Mariana Moreira de Castro, Calil, Daniela Bortoloti, Chone, Carlos Takahiro, Castilho, Arthur Menino
Format:	Journal Article
Language:	English
Published:	Elsevier España S.L.U 01-09-2023 Elsevier Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial
Subjects:	Hearing loss, conductive Hearing loss, mixed conductive-sensorineural OTORHINOLARYNGOLOGY Otosclerosis Review Stapes surgery Hearing loss, mixed conductive-sensorineural Hearing loss, conductive Otosclerosis Stapes surgery conductive-sensorineural Hearing loss, mixed conductive Hearing loss
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Summary:	•There is no evidence that pregnancy increases the risk of developing or worsening otosclerosis.•The use of the endoscope in stapes surgery is equally as safe as the use of the microscope.•No prosthesis material is superior to another in stapedotomy regarding hearing outcomes.•Among nonsurgical treatment options, hearing devices provide the best result. To review and provide evidence-based recommendations for the diagnosis and treatment of otosclerosis. Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on otosclerosis were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. The topics were divided into 2 parts: 1) Diagnosis – audiologic and radiologic; 2) Treatment – hearing AIDS, pharmacological therapy, stapes surgery, and implantable devices – bone-anchored devices, active middle ear implants, and Cochlear Implants (CI). The pathophysiology of otosclerosis has not yet been fully elucidated, but environmental factors and unidentified genes are likely to play a significant role in it. Women with otosclerosis are not at increased risk of worsening clinical condition due to the use of contraceptives or during pregnancy. Drug treatment has shown little benefit. If the patient does not want to undergo stapedotomy, the use of hearing aids is well indicated. Implantable systems should be indicated only in rare cases, and the CI should be indicated in cases of profound deafness.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	1808-8694 1808-8686 1808-8686
DOI:	10.1016/j.bjorl.2023.101303