Otosclerosis among South African indigenous blacks

To report cases of clinical otosclerosis histologically confirmed among indigenous South African blacks.

A retrospective study.

Referral tertiary center, MEDUNSA, Garankuwa Hospital, South Africa.

All fifteen indigenous South African blacks diagnosed with clinical otosclerosis at Garankuwa Hospital between January 1993 and January 2003 in the Ear, Nose and Throat Department.

A retrospective study of the records of all patients seen at the Ear, Nose and Throat (ENT)outpatient clinic of GaRankuwa Hospital between January 1993 and January 2003 was undertaken. In addition, data was obtained from operating theatre records and histology reports. The files of these patients with a diagnosis of otosclerosis were reviewed for details on demographics, symptoms, audiometric test results, radiology, surgical and pathology reports. All of these patients were included in the study.

From a weekly outpatient attendance of about 300 patients over a ten-year period, a total number of fifteen patients were identified with a definite diagnosis of clinical otosclerosis. Nine of them were confirmed surgically and histologically as having otosclerosis. These nine cases consisted of five females and four males, the mean age for females was thirty-five years and for males forty-seven years. They all presented with a progressive painless hearing loss with no ear discharge or previous surgery with negative family history. Audiometry confirmed a mixed hearing loss with a Carrhart notch at 2kHz typical for otosclerosis and all had normal tympanic membrane. All of these patients had a unilateral stapedectomy done. Schucknet wire prosthesis was used for surgical reconstruction. The outcome of surgery in all of these patients was satisfactory. The other six patients are still awaiting surgery.

This study confirms the existence of otosclerosis among indigenous South African blacks. Otosclerosis should be included in the differentials of a conductive hearing loss in blacks.