Imaging of otosclerosis

Background Otosclerosis is an important cause of hearing loss and a widespread pathology in ENT medicine. Although a high diagnostic value of CT with impact on therapy is emphasized in the literature, the disease is seldom seen in the radiological routine diagnostics due to ENT findings often being diagnostic. Radiologists detect it rather more often in cases of unclear hearing loss or cochlear implant candidates. The findings may be very subtle. They require a target search and an optimal imaging technique. Methods This review article is based on a selective search of the literature in PubMed without any time frame restrictions as well as on the long clinical experience of the authors. Results The paper focuses on imaging aspects of otosclerosis: current role, advice for imaging technique, characteristic imaging signs, radiological differential diagnoses and findings after stapedoplasty. Pathology, clinical signs and therapeutic options are summarized briefly. Conclusions With an optimal technique and sufficient radiological experience otosclerosis can be correctly diagnosed by imaging in a high percentage of cases. Radiology plays the key role in the diagnosis of retrofenestral otosclerosis. It can provide valuable information for the management of complications after stapedotomy.