Schwartze sign seen in?

NEET PG
#1

Schwartze sign seen in?
a) Glomus Jugulare
b) Otosclerosis
c) Meniere’s diseases
d) Acoustic neuroma
Correct Answer - B
Ans. is ‘b’ i.e., Otosclerosis
Symptoms of otosclerosis
Hearing loss :- Bilateral conductive deafness which is painless and
progressive with insidious onset. In cochlear otosclerosis
sensorineural hearing loss also occur along with conductive
deafness.
Paracusis willissii :- An otosclerotic patient hears better in noisy than
quiet surroundings.
Tinnitus :- More common in cochlear otosclerosis.
Speech :- Monotonous, well modulated soft speech.
Vertigo :- is uncommon.
Signs in otosclerosis
Tympanic membrane is quite normal and mobile.
In 10% of cases flamingo - pink blush is seen through the tympanic
membrane called as Schwartze sign.
Various tests show conductive hearing loss.
Tuning fork tests in otosclerosis
As otosclerotic patients have conductive deafness, the tuning fork
tests results will be as follows :?

  1. Rinnes :- Negative
  2. Webers :- Lateralized to the ear with greater conductive loss.
  3. Absolute bone conduction (ABC) :- Normal (can be decreased in
    cochlear otosclerosis).
  4. Gelles test :- No change in the hearing through bone conduction
    when air pressure of ear canal is increased by Siegle’s speculum.
    Audiometry in otosclerosis
    Audiometry is one of the important tools in evaluation of a patient of
    otosclerosis.Various audiometric tests are :?
  5. Pure tone audiometry
  6. Shows loss of air conduction, more for lower frequencies with
    characteristic rising pattern. Bone conduction is normal. However in
    some cases, there is a dip in bone conduction curve which is
    maximum at 2000 Hz (2 KHz) and is called the Carhart’s notch.
  7. Impedance audiometry
    Impedance audiometry shows :-
    Tympanometry
    Patient with early disease may show type A tympanogram (because
    middle ear areation is not affected) Progressive stapes fixation
    results in classical As type tympanogram.
    Acoustic (stapedial reflex)
    It is one of the earliest sign of otosclerosis and preceedes the
    development of airbone gap. In early stage, diphasic on-off pattern is
    seen in which there is a brief increase in compliance at the onset
    and at the termination of stimulus occurs. This is pathognomonic of
    otosclerosis. In later stage the reflex is absent.