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Puntastic Otosclerosis #ENT

It's a PUNtastic topic . 
To start with the distribution it's common in Indians ( pathologically rich nation , that we are ) and Whites ( racist Dhingra ).
Females are mostly affected but in India males predominate ( females are Pavitra savitris )
Age is 20-40 usually ( Yeh Jawani hai diwani) ( lol, I mean loud music)

The disease doesnot occur alone it is associated with two other diseases ,(teen patti ) . When together for convenience they are given a name called Van der hoeve syndrome ( wonder huiwi ? 😜) 
3 different organs are involved ear ,eye and bone ( bura dekha Ya kaha to haddi todh dungi ) blue sclera , otosclerosis and osteogenesis inperfecta. 

Types 
It's further divided into 3 types :
1. Stapedial OS : biscuit type - OVAL window and footplate of stapes is involved. Conductive deafness.
2. Cochlear type OS : SNHL . Round window & capsule involved. 
3. Histological OS : symptomless . No hearing loss ( no idea why it is even classified . He is too illogical )

Symptoms :
1. Paracusis Willisii : hears better in noisy surroundings .
2. Speech : Monotonous , soft ( robot like ... Fardeen Khan... PMs speech )
3. Hearing loss : painless progressive bilateral ( Pee Pee)
 
Signs :
1. Schwartz Sign : When you look at the tympanic membrane , you see a reddish hue on the promontory ( It blushes a little)
2. Tuning fork tests :
- Rinnie Test : negative ( Rinni says Nai!)
- Weber : lateralised to ear with greater hearing loss ( sympathy !)
-ABC : Decreased in cochlear otosclerosis 
3 . Carharts notch ( car $ heart ) appears dip at 20 dB at 2000 Hz 
4. Stapedial reflex absent after stapes is fixed. (Cold feet?)

Treatment ;
Stapedectomy 
Stapedotomy


Kbye

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