A 32-year-old woman presents with progressive hearing loss. CT shows thickening of the skull vault with narrowing of the internal auditory meatus. Serum alkaline phosphatase is elevated. The hearing loss in Paget's disease is primarily due to:

• A Otosclerosis of the ossicular chain
• B Conductive hearing loss due to tympanic membrane calcification
• C Sensorineural hearing loss due to auditory artery stenosis
• D Compression of the eighth cranial nerve by enlarged bone ✓

Explanation

Hearing loss in Paget's is multifactorial but classically results from eighth cranial nerve compression within the narrowed internal auditory meatus due to petrous temporal bone enlargement. Both conductive and sensorineural components exist. The nerve compression mechanism is the most feared and disabling cause, directly related to pagetic bone overgrowth.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.