A 32-year-old woman with bilateral progressive conductive hearing loss for 5 years, paracusis Willisii, and tinnitus undergoes audiometry. Findings include air-bone gap, type As tympanogram, absent stapedial reflexes, and Carhart's notch. Schwartze sign is positive. The finding of Schwartze sign indicates:
- A Active otospongiosis with vascular foci in the cochlear endosteum (flamingo pink blushing) ✓
- B Cholesteatoma eroding through the tegmen tympani
- C Glomus tympanicum tumor behind the tympanic membrane
- D Dehiscent jugular bulb
Correct answer: A. Active otospongiosis with vascular foci in the cochlear endosteum (flamingo pink blushing)
Explanation
Schwartze sign (also known as the 'flamingo pink blush') is a reddish blush seen through the anterior-superior quadrant of the tympanic membrane in active otosclerosis. It represents increased vascularity over the active otospongiotic foci (endosteal foci of active bone remodeling in the cochlear capsule). Its presence indicates active disease. It is visible through the intact TM because the fissula ante fenestram is adjacent to the anterior annulus. This finding is unique to otosclerosis and is not seen in cholesteatoma or glomus tumors.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.