Otosclerosis: Its Clinical Aspect

OTOLOGISTS will always take a lively interest in a discussion on otosclerosis. The first macroscopic descriptions were given, as you are aware, by Valsalva in 1704, Morgagni in 1767, and Meckel in 1771. In his descriptive catalogue (1857) your prominent countryman John Toynbee mentions several cases. Since that time the names of the best otologists of all nations have been connected with this chapter of otology. I may quote Troeltsch and Politzer, with their pupils, and among others, Gray, Wittmaack, Otto Mayer, and my revered chiefs, Bezold and Siebenmann. My contribution to this discussion will be strictly confined to the clinical aspect of otosclerosis. It is based on a survey of all my cases, observed in private practice, whereas the histological particulars are founded on some slides in my collection. As a pupil of Bezold and Siebenmann, who were especially interested in the clinical aspects, diagnosis, and pathology of otosclerosis, I believe I am able to offer an entirely uniform series of investigations. In the last nineteen years I have observed 835 cases of otosclerosis, of which I was able to follow up about one-fourth during several years. I was only able to see the others once or twice, for, as you are aware, incurable otosclerotic patients have a striking but easily explicable passion for going from one specialist to another. Incidence.—In regard to the relative frequency of this disease, my investigation shows that among 1000 ear patients, 208 were suffering from otosclerosis {i.e. 20 per cent), whereas Bezold observed this malady only in 7 per cent, of his patients. The recent statistics of Shambaugh give 30 per cent. There seem to be no other similar statistics, which is unfortunate, as they would be highly interesting. Differences might possibly be found in various countries, according as the population had maintained its pure racial characteristics or had absorbed a