Hi, need to submit a 1250 words paper on the topic Otosclerosis Medicine. This is supported by the presence of RNA and antigens commonly associated with the virus in the perilymph of patients diagnosed with the disease. Hereditary play a huge role in the etiopathogenesis of the disease, whereby, Battta, Karosi and Sziklai (2009, p.1171) assert that the disease is passed to generations as an autosomal dominant gene. Cowan (2006) presents that otosclerosis is regarded as the common conductive hearing loss and is secondary to a pathologic change of the bones in the middle ear. In normal cases, the ossicles are usually hard, however, following an otosclerosis infection, the ossicles starts to soften, highly vascularised, spongy and may even become partially or permanently fixed. The fixation in turn results in a reduction of the transmission of the source waves to the fluids in the inner ear. Of the three bones that are found in the middle ear, the disease normally affects the stapes, which is are ossicles in the middle ear that transmit sound vibrations to the fenestra ovalis. According to deSouza and Glasscock (2002, p.245) the disease is the cause of nearly 10% of reported hearing loss cases and an average of 20% of conductive hearing loss cases. Moreover, White, Duncan and Laumie (2010, p.369) posit that the disease is usually common among adults than children with women being highly inclined to be infected.Karosi and Sziklai (2011, p.1337) points that the bone remodeling in otosclerosis disorder usually shows some form of organotropism to the otic capsule. Similarly, they further reveal that focal points of the disease tend to be limited to the temporal bones of the middle ear. In virtually all clinically reported cases of the disease, no lesions have been found outside the ear. It is in the otic capsule within the ear where enchondral ossification develops as well as the footplates of the stapes. The effect of the disease on the otic capsule implies that the three bone layers that form the capsule are also affected in the process. These three layers are the endosteal layer, interosseal globules as well as the periosteal layer. The interosseal layer has been identified as the site of the earliest otosclerotic foci. Karosi and Sziklai (2011, p.1338) further document that the common histopathological features of the disease are usually visible in areas such as those adjacent to oval and round windows, which accounts for 90% and 40% respectively, the pericochlear 35%, and the stapes footplate 95%. Additionally, numerous fibroblasts, osteoclasts and proliferating endothelial cells also tend to be affected by the disease. According to Gristwood and Venables (2003, p.399-341) otosclerosis is histologically divided into two distinct phases. The first phase is majorly characterized by bone resorption and elevated levels of vascularity. This in turn leads to the diminishing of the mature collagen content of the bone thereby making the bone to acquire a spongy appearance. In the second and the late stage of the disease, the reabsorbed phase is then replaced with a rather dense and sclerotic bone hence the derivation of the name otosclerosis.
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