OTOSCLEROSIS: Hypothesis of Its Origin and Progress

Abstract

THE DIFFICULTY in giving a precise characterization of the histopathology of otosclerosis has long been recognized. Yet the microscopic picture is clearcut and easily identified. How can such a paradox be? A wealth of clinical and microscopic knowledge that comprises a multiple picture of otosclerosis has been inherited from men of great integrity. What is the significance of this fact? The architectonic structure of haversian systems in the normal otic capsule is very complicated. Because of the irregular shape of the capsule, the blood vessels supplying it are forced to make rapid and complicated curves in their course through it. Consequently, in every microscopic section there is a variety of patterns of bony lamellas. Very occasionally, haversian canals will be cut at right angles to the long axis of the vessel, thereby giving the textbook picture of a haversian system. Often, they will be cut at various tangents, and will