{"id":808,"date":"2024-04-29T00:48:07","date_gmt":"2024-04-28T21:48:07","guid":{"rendered":"https:\/\/odyova.com\/haberler\/?p=808"},"modified":"2024-04-29T00:48:07","modified_gmt":"2024-04-28T21:48:07","slug":"otoskleroz","status":"publish","type":"post","link":"https:\/\/odyova.com\/haberler\/otoskleroz\/","title":{"rendered":"Otoskleroz"},"content":{"rendered":"

Otoskleroz, Herediter, bilateral ama simetrik olmayan, progresif (ilerleyici) tipte bir i\u015fitme azl\u0131\u011f\u0131d\u0131r. Otik kaps\u00fcl\u00fcn distrofik (Koklea ve ileri vakalarda koklea ve semisirk\u00fcler kanallar\u0131 tahrip edici) bir hastal\u0131\u011f\u0131d\u0131r. En s\u0131k gen\u00e7 bayanlarda g\u00f6r\u00fcl\u00fcr.<\/p>\n

Patoloji:
Otik kaps\u00fclde (labirentin kemik kaps\u00fcl\u00fc) ba\u015flang\u0131\u00e7ta ven\u00f6z staz, sonra kemik rezorbsiyonu, bunu takibende yeni kemik te\u015fekk\u00fcl\u00fc g\u00f6r\u00fcl\u00fcr. Bu baz\u0131 ara\u015ft\u0131r\u0131c\u0131lar periosteal kaynakl\u0131, baz\u0131lar\u0131 da endosteal kaynakl\u0131 olarak g\u00f6r\u00fc\u015f bildirmektedirler. <\/p>\n

Otosklerotik odaklar:
1) Semisirk\u00fcler kanallar\u0131n (Yar\u0131m daire kanallar\u0131n\u0131n) ampullalar\u0131,
2) Koklea'n\u0131n taban k\u0131sm\u0131 ve
3) Oval pencerenin \u00f6n k\u0131sm\u0131na rastlayan fissula antefenestram'\u0131n arkas\u0131n\u0131 olu\u015fturan alan b\u00f6lgedir.<\/p>\n

Klinik otosklerozdan sorumlu olan sonuncu odakt\u0131r, yani oval pencerenin \u00f6n k\u0131sm\u0131na rastlayan, Fissula Antefenestram b\u00f6lgesidir. Meydana gelen Otosklerotik odak (stapes kemi\u011fnde kiyeni kemik te\u015fekk\u00fcl\u00fc), Stapes'in ( \u00d6zengi Kemi\u011fi) hareketini \u00f6nce azalt\u0131r ve odak geli\u015ftik\u00e7e, Stapes Kemi\u011finin hareketini yok eder.
Stapez kemi\u011fi hareket edemez. Stapes kemi\u011fi oval pencerede meydana gelen bu yeni kemik dokusu ile hareket edemez, fikse olur. Bu patolojik durum sonucu d\u0131\u015f ortamdan gelen, d\u0131\u015f kulak yolu ve kulak zar\u0131n\u0131 ge\u00e7erek orta kulakta ki kemik zincire (Malleus, \u0130nkus, Stapes) ula\u015fan ses enerjjisi, hareket edemeyen \u00f6zengi kemi\u011fi taraf\u0131ndan i\u00e7 kula\u011fa naklettirilemez. <\/p>\n

Sonu\u00e7 olarak, meydana gelen patolojik olay progresif (ilerleyici) olmas\u0131 nedeniyle, otosklerotik yeni kemik te\u015fekk\u00fcllerinin labirent i\u00e7ine do\u011fru b\u00fcy\u00fcmesi, hatta meatus akustikus internada g\u00f6r\u00fclmesi sebebiyle, labirent i\u00e7inde bas\u0131n\u00e7 de\u011fi\u015fikli\u011fi olu\u015fur. Sonunda, koklea i\u00e7inde yer alan sensoriyel h\u00fccrelerin beslenmesi de bozulur olgular i\u015fitme kayb\u0131 yak\u0131nmalar\u0131 ile ba\u015f vururlar.<\/p>\n

Otosklerozun Etyolojisi:
Otik Kaps\u00fclde yeni kemik meydana geli\u015f nedeni, hen\u00fcz karanl\u0131kt\u0131r. <\/p>\n

Predispozan fakt\u00f6rler:
-Ya\u015f: B\u00fcy\u00fck ekseriyetle gen\u00e7 ya\u015flarda (20 ya\u015f\u0131ndan sonra aktif, 60 ya\u015f\u0131ndan sonra
durur)
-Cinsiyet: Daha s\u0131k olarak kad\u0131nlarda
-Irk: Beyaz \u0131rkta > siyah \u0131rk, sar\u0131 \u0131rkta hi\u00e7 g\u00f6r\u00fclmez
-Heredite: % 85 vakada rol oynar.<\/p>\n

Klinik:
\u0095 Objektif bulgular :
-Kulak zarlar\u0131, burun, bo\u011faz muayenesi iletim sa\u011f\u0131rl\u0131\u011f\u0131n\u0131 a\u00e7\u0131klayacak bulgular bak\u0131m\u0131ndan normal
-Kulak zar\u0131nda orta kulak i\u00e7 duvar\u0131n\u0131n (promontorium) mukozas\u0131n\u0131n pembe renginin bir reflesi tesbit edilebilir (Schwartze bulgusu) <\/p>\n

\u0095 Subjektif belirtiler:
-\u0130\u015fitme azl\u0131\u011f\u0131: Ba\u015flang\u0131\u00e7ta al\u00e7ak frekanslara ait sesleri i\u015fitemezler (kal\u0131n, erkek sesleri), kalabal\u0131k, g\u00fcr\u00fclt\u00fcl\u00fc yerlerde daha iyi i\u015fitirler ( willis parakuzisi)
\u0130lk evrede: \u0130letim tipi i\u015fitme kayb\u0131
\u0130leri evrede: Mikst tip i\u015fitme kayb\u0131.
-Kulak u\u011fultular\u0131 (de\u011fi\u015fik tipte seslere benzetilir!) %87 oran\u0131nda g\u00f6r\u00fcl\u00fcr
-Hastalar \u00e7ekingen, al\u00e7ak sesle konu\u015fan, i\u00e7e kapal\u0131 kimselerdir. <\/p>\n

Te\u015fhis:
\u0130\u015fitmenin fonksiyonel muayenesinde:
-F\u0131s\u0131lt\u0131 sesi ile: Mesafe normale g\u00f6re daral\u0131r. Ba\u015flang\u0131\u00e7ta al\u00e7ak frekansl\u0131 seslerin
i\u015fitilemedi\u011fi g\u00f6r\u00fcl\u00fcr.<\/p>\n

-Diapozon deneylerinde:
Rinne (-), Weber a\u011f\u0131r i\u015fiten tarafa lateralize, Schwabach uzam\u0131\u015f, Gelle (-), Bing (-)
-Tonal odyogramda: <\/p>\n

Bilhassa pes frekanslarda kayb\u0131 g\u00f6steren e\u011friler
-Vokal odyometride:
Normal \u015fiddet aks\u0131nda de\u011fi\u015fiklik g\u00f6steren e\u011friler.<\/p>\n

Tedavi:
Semptomatikdir.
Cerrahi:
1) Stapedotomi( \u00d6zengi kemi\u011fi \u00e7\u0131kar\u0131l\u0131p yerine kemik veya protez uygulama ameliyat\u0131): Bu fizyolojik bir i\u015fitme sa\u011flar. Oval pencereye a\u00e7\u0131lan fenestraya teflon piston protez yerle\u015ftirilir.
2) Horizontal semisirk\u00fcler kanala yeni bir pencere a\u00e7ma (Fenetrasyon): Ancak anatomik g\u00fc\u00e7l\u00fcklerden dolay\u0131 stapedektomi yap\u0131lamayacak vakalarda uygulanabilir.<\/span><\/span><\/p>\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Otoskleroz Konu hakk\u0131nda detayl\u0131 ve g\u00fcncel bilgiler i\u00e7in bu makaleyi okuyun<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[80,228,63,304,24],"class_list":["post-808","post","type-post","status-publish","format-standard","hentry","category-kulak-burun-bogaz","tag-isitme","tag-kemik","tag-kulak","tag-pencere","tag-ses"],"_links":{"self":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/808","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/comments?post=808"}],"version-history":[{"count":1,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/808\/revisions"}],"predecessor-version":[{"id":809,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/808\/revisions\/809"}],"wp:attachment":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media?parent=808"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/categories?post=808"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/tags?post=808"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}