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Brazilian Society of Otology task force --- Otosclerosis:evaluation and treatment

Vagner Antonio Rodrigues Silva a, Henrique Furlan Pauna b, Joel Lavinsky c, Guilherme Corrêa Guimarães a, Nicolau Moreira Abrahão a, Eduardo Tanaka Massuda d, Melissa Ferreira Vianna e, Cláudio Márcio Yudi Ikino f , Vanessa Mazanek Santos g, José Fernando Polanski g,h, Maurício Noschang Lopes da Silva i , André Luiz Lopes Sampaio j , Raul Vitor Rossi Zanini k, Luiz Fernando Manzoni Lourenc¸one l,m, Mariana Moreira de Castro Denaro n, Daniela Bortoloti Calil a, Carlos Takahiro Chone a, Arthur Menino Castilho a,∗

Abstract Objectives: To review and provide evidence-based recommendations for the diagnosis and treatment of otosclerosis. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on otosclerosis were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: 1) Diagnosis --- audiologic and radiologic; 2) Treatment --- hearing AIDS, pharmacological therapy, stapes surgery, and implantable devices --- bone-anchored devices, active middle ear implants, and Cochlear Implants (CI). Conclusions: The pathophysiology of otosclerosis has not yet been fully elucidated, but environmental factors and unidentified genes are likely to play a significant role in it. Women with otosclerosis are not at increased risk of worsening clinical condition due to the use of contraceptives or during pregnancy. Drug treatment has shown little benefit. If the patient does not want to undergo stapedotomy, the use of hearing aids is well indicated. Implantable systems should be indicated only in rare cases, and the CI should be indicated in cases of profound deafness. © 2023 Associac¸ao˜ Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. ´ Published by Elsevier Espana, ˜ S.L.U. This is an open access article under the CC BY license (http://

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