Three-dimensional reconstruction of the otosclerotic focus

Abstract

Conclusions: The location and three-dimensional (3D) shapes of the otosclerotic foci suggest a general centripetal distribution of otosclerotic bone remodeling around the inner ear space, whereas the normal bone remodeling is distributed centrifugally. The existence of an inverse spatial relation between normal and otosclerotic bone remodeling suggests that inner ear mechanisms in control of bone remodeling may have a pathogenetic role in otosclerosis. Objectives: To explore the 3D shape of otosclerotic lesions around the inner ear space by introducing the use of 3D reconstructions and to discuss the results in a new context of temporal bone dynamics and perilabyrinthine signaling pathways. Methods: Thirty-four otosclerotic lesions from 20 decalcified human temporal bones were rendered and visualized with the public 3D ‘Reconstruct’ software. Results: The majority of otosclerotic lesions were found close to the labyrinthine space at the well-established topographical sites of predilection with a smooth demarcation against the surrounding bone. However, in addition the virtual 3D technique revealed a new perilabyrinthine anisotropy of individual otosclerotic lesions, displaying a bulky end facing the inner ear space and a volumetric decline towards the capsular periphery.

Keywords::

• Otosclerosis
• 3D reconstructions
• 3D patterns
• osteoprotegrin
• bone remodeling
• osteocyte deficiency
• microcracks

Acknowledgments

The authors thank professor Poul Bretlau MD DSc for critical review of the manuscript and the Oticon foundation for supporting this study. Conflict of interest: none.