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Grissom & Otosclerosis
Grissom
has the medical condition
Otosclerosis
which eventually led to him undergoing corrective surgery .
has the medical condition
Otosclerosis
which eventually led to him undergoing corrective surgery .
See Also; Grissom & Sign Language
What is Otosclerosis?
Otosclerosis is a disease of the bones of the middle and inner ear (see Figure 1). The ossicles (bones) become knit together into an immovable mass, and do not transmit sound as well as when they are more flexible. Figure 2 illustrates one form of this called stapes fixation. Otosclerosis can also affect the other ossicles (malleus and incus) and the otic capsule.
Figure 1 - Cross section of ear. Otosclerosis involves the small bones of the middle ear, the malleus
(2), the incus (3) and the stapes (4),
as well as the bone that surrounds the inner ear, which is called the otic capsule.
 | Figure 2. Stapes fixation in otosclerosis. A bony ankylosis (knee) knits the bone of the middle ear to the stapes, preventing normal transmission of sound from the eardrum into the inner ear. |
We saw the first hint of Grissom & hearing issues in the episode;
Episode 1.20 Sounds of silence
Grissom reveals he learned to sign because his mother became deaf when she was eight.
Two teenage boys run over a deaf man but they didn't kill him- he was already dead. Grissom has to find out who did it and he's not getting help from the deaf man's school. Catherine and Nick investigate an apparent mob hit that leaves five dead in a coffee shop.
When Sara & Warrick experience some difficulties with the head teacher Dr Gilbert of the deaf school, Grissom intercepts & suddenly starts using American sign language to Dr Gilbert to communicate with her about the case. Outside in the hall after, Sara asks him about his signing, which he refuses to answer.
Episode 1.20 Sounds of silence
Grissom reveals he learned to sign because his mother became deaf when she was eight.
Two teenage boys run over a deaf man but they didn't kill him- he was already dead. Grissom has to find out who did it and he's not getting help from the deaf man's school. Catherine and Nick investigate an apparent mob hit that leaves five dead in a coffee shop.
When Sara & Warrick experience some difficulties with the head teacher Dr Gilbert of the deaf school, Grissom intercepts & suddenly starts using American sign language to Dr Gilbert to communicate with her about the case. Outside in the hall after, Sara asks him about his signing, which he refuses to answer.
(Grissom wouldn't tell them how he learnt sign language)
Sara: What was that all about? Grissom signs?
Warrick: What does Grissom drink when he goes out at night?
Sara: He goes out?
Warrick: Exactly. Who knows anything about that guy?
Later at the end of the episode we see Grissom communicating with ASL to Dr Gilbert
Hearing loss generally begins between the ages of 10 and 30. Early on, the disease is called otospongiosis. During this time there is active remodeling of bone of the otic capsule. There may be no conductive hearing loss at this point; however, there may be sensory hearing loss. The sensory hearing loss is attributed to leakage of enzymes from bone into the inner ear. Sensory hearing loss is also attributed to atrophy of the spiral ligament caused by involvement of lamellar bone at the inner surface of the cochlear capsule. A third cause is vascular, due to degeneration of the stria vascularis. In early stages, treatment with fluoride may be helpful. The sensory component of the disease may eventually lead to complete deafness, but fortunately, this is unusual. In most cases, both ears are affected, although in about 10 to 15% of patients, hearing loss occurs on one side only. Later on, a conductive pattern of hearing loss appears. The conductive type of otosclerosis usually progresses up to a maximum when patients are in their 30s. After this, it rarely progresses. Dizziness or imbalance is a feature of otosclerosis in roughly 25% of cases. Between 40% and 65% of patients have tinnitus (ringing in the ears) (Gristwood 2003, Sobrinho 2004).In about half of all patients, there is a family history of similar problems.
The next instance of a reference to hearing issues for Grissom was in the episode;
Episode 3.02 The Accused is Entitled
Grissom and his team investigate a crime involving a popular actor; one woman is dead in his hotel suite and another is missing. They must perform under not only the media spotlight, but also under the scrutiny of Grissom's mentor, Dr. Philip Gerard, who uses his knowledge of Grissom and the other CSIs to discredit their evidence in his role as hired expert for the defense. Phillip Gerard makes a comment about Grissom not collecting evidence & his hereditary hearing condition, not long before Grissom experiences yet another bout of his hearing fading out.
Phillip Gerard: You're not running evidence. Or have you changed your mind? (Grissom is silent) By the way, tell your mother I say 'Hello' next time you talk. I was so impressed that night we all had dinner. The sign language ... how you interpreted for her. Fluid, didn't miss a beat.
Grissom: What'd you do, subpoena my doctor?
Phillip Gerard: Knowing your genetic predisposition for hearing loss?
Grissom: You've become a bottom feeder, Philip.
Phillip Gerard: Your work is dependent upon your five senses. The fact that you're losing one of yours wouldn't bode well for any evidence you introduced.
Grissom: You know, all those years I worked for you, you never got to know me at all, did you?
After a short period of time of his hearing fading out again as Grissom takes the stand, he manages to read Marjory Westcott's lips as she questions him, so he can deliver his findings on the case. As he leaves the court he makes a comment to Dr Gerard & uses a simple ASL sign.
How is Otosclerosis Treated?
To date, the only proposed medical treatment has been sodium fluoride, which is a dietary supplement (not a drug). This treatment is not widely accepted, and has not been proven to be effective. A large uncontrolled study of about 1500 patients by one of the founders of the AHRF, Dr. Shambaugh, suggested that it was effective (Shambaugh, 1990). A recent study found patients treated with flouride to have smaller otosclerotic foci on CT scanning, also supporting a beneficial effect (Naumann, 2005).The idea of using fluoride is not unlike that of using it for teeth -- fluoride speeds up hardening of bone.
Grissom finally seeks a medical consult in the episode;
Episode 3.10 High and Low
Grissom, Warrick, and Nick investigate the case of man who apparently was murdered and pushed off a six story building. Grissom's involvement is cut short by renewed hearing problems & him seeking a consult with his doctor, later we see him researching the condition on the Internet. Catherine looks into the murder of a man outside of his regular bar.
Grissom:Hmm
(Catherine chuckles)
(Grissom looks down at his laptop screen. He's looking up information on "Otosclerosis").
Catherine looks down at the laptop.)
Catherine; New case?
Grissom:Ongoing.
(She leans in to look at what he's reading. Unwilling to let anyone in, Grissom
changes the screen to show something on "The Longhorned Beetle".)
Catherine: Oh ... bugs.
Grissom: (nods) Mm.
Catherine: Enjoy.
(Catherine leaves the office. Grissom switches screens back to "Otosclerosis".
He sighs and goes back to reading.)
What causes Otosclerosis?
Most doctors and scientists believe that otosclerosis is an inherited, an autosomal dominant disease with variable penetrance. As there is also evidence of viral influences in otosclerosis, a recent hypothesis is that otosclerosis requires a combination of a specific gene with exposure to a specific virus (for example measles) for it to be expressed and for hearing loss to occur (McGuirt et al, 1998).
Grissom's hearing issues are also briefly mentioned in the episode;
Episode 3.15 Lady Heathers Box
Episode 3.02 The Accused is Entitled
Grissom and his team investigate a crime involving a popular actor; one woman is dead in his hotel suite and another is missing. They must perform under not only the media spotlight, but also under the scrutiny of Grissom's mentor, Dr. Philip Gerard, who uses his knowledge of Grissom and the other CSIs to discredit their evidence in his role as hired expert for the defense. Phillip Gerard makes a comment about Grissom not collecting evidence & his hereditary hearing condition, not long before Grissom experiences yet another bout of his hearing fading out.
Phillip Gerard: You're not running evidence. Or have you changed your mind? (Grissom is silent) By the way, tell your mother I say 'Hello' next time you talk. I was so impressed that night we all had dinner. The sign language ... how you interpreted for her. Fluid, didn't miss a beat.
Grissom: What'd you do, subpoena my doctor?
Phillip Gerard: Knowing your genetic predisposition for hearing loss?
Grissom: You've become a bottom feeder, Philip.
Phillip Gerard: Your work is dependent upon your five senses. The fact that you're losing one of yours wouldn't bode well for any evidence you introduced.
Grissom: You know, all those years I worked for you, you never got to know me at all, did you?
After a short period of time of his hearing fading out again as Grissom takes the stand, he manages to read Marjory Westcott's lips as she questions him, so he can deliver his findings on the case. As he leaves the court he makes a comment to Dr Gerard & uses a simple ASL sign.
How is Otosclerosis Treated?
To date, the only proposed medical treatment has been sodium fluoride, which is a dietary supplement (not a drug). This treatment is not widely accepted, and has not been proven to be effective. A large uncontrolled study of about 1500 patients by one of the founders of the AHRF, Dr. Shambaugh, suggested that it was effective (Shambaugh, 1990). A recent study found patients treated with flouride to have smaller otosclerotic foci on CT scanning, also supporting a beneficial effect (Naumann, 2005).The idea of using fluoride is not unlike that of using it for teeth -- fluoride speeds up hardening of bone.
Grissom finally seeks a medical consult in the episode;
Episode 3.10 High and Low
Grissom, Warrick, and Nick investigate the case of man who apparently was murdered and pushed off a six story building. Grissom's involvement is cut short by renewed hearing problems & him seeking a consult with his doctor, later we see him researching the condition on the Internet. Catherine looks into the murder of a man outside of his regular bar.
Grissom:Hmm
(Catherine chuckles)
(Grissom looks down at his laptop screen. He's looking up information on "Otosclerosis").
Catherine looks down at the laptop.)
Catherine; New case?
Grissom:Ongoing.
(She leans in to look at what he's reading. Unwilling to let anyone in, Grissom
changes the screen to show something on "The Longhorned Beetle".)
Catherine: Oh ... bugs.
Grissom: (nods) Mm.
Catherine: Enjoy.
(Catherine leaves the office. Grissom switches screens back to "Otosclerosis".
He sighs and goes back to reading.)
What causes Otosclerosis?
Most doctors and scientists believe that otosclerosis is an inherited, an autosomal dominant disease with variable penetrance. As there is also evidence of viral influences in otosclerosis, a recent hypothesis is that otosclerosis requires a combination of a specific gene with exposure to a specific virus (for example measles) for it to be expressed and for hearing loss to occur (McGuirt et al, 1998).
Grissom's hearing issues are also briefly mentioned in the episode;
Episode 3.15 Lady Heathers Box
Source medical Information - American Hearing Research Foundation
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Latest page update: made by gsrbritfan
, Nov 23 2009, 10:45 AM EST
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