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Otosclerosis

​​​​​​​Otosclerosis is a condition affecting the stapes bone.

A normal stapes bone moves like a small piston; sounds cause the piston to vibrate. In otosclerosis, a callus of bone accumulates on the stapes creating a partial fixation. This limits the movement of the stapes bone, which results in hearing loss.

What causes otosclerosis?

There are several potential causes of otosclerosis. Otosclerosis largely develops due to genetic factors, although exposure to the measles virus may play a role in developing the condition. In some women with otosclerosis, pregnancy can accelerate the process.

Is there anything the patient did to cause otosclerosis?

There is nothing a person does or does not do to cause otosclerosis. Most people do not have the gene that causes otosclerosis, and patients do not have control over their genetic make up.

What are the symptoms of otosclerosis?

Hearing loss is the most common symptom in patients with otosclerosis. Commonly, the hearing loss is noticed during the patient's late teens or early adulthood. 

The hearing loss progresses slowly in most cases. Many patients with otosclerosis experience tinnitus or a sound in the affected ear.

How is otosclerosis diagnosed?

A history of gradually progressive hearing loss in one ear, beginning in a patient's late teens or early adulthood, suggests otosclerosis. On examination, the ear canal and eardrum are normal. 

Otosclerosis cannot be seen on an office examination. The audiogram indicates a conductive type of hearing loss. A special type of testing, stapedial reflexes, indicates limited or no movement of the bones of hearing.

Is otosclerosis inherited?

About 50 percent of patients with otosclerosis have a family history of otosclerosis.

Does otosclerosis affect both ears?

Generally, otosclerosis begins in one ear. About 60 percent of the time, the other ear may become involved. Many times the involvement of the second ear occurs months or years later.

Will the hearing loss caused by otosclerosis get worse?

In most cases, the hearing loss associated with otosclerosis will worsen with time. Generally, it is considered a slowly progressive hearing loss. 

There are some patients who experience a rather rapidly progressive hearing loss with otosclerosis. Pregnancy can accelerate the otosclerosis process, thus accelerating hearing loss.

What are the treatment options for otosclerosis?​

There are three general treatment options for otosclerosis:

  • Observe and recheck: For some patients, the hearing loss may not present a major problem. Therefore, one option is observation. However, it is best to recheck the hearing some time in the future, perhaps in one year. Patients with a milder degree of hearing loss may elect this option.
  • Hearing aid: A hearing aid is a device that amplifies sounds. Although it does not correct the underlying problem of otosclerosis, it does give the patient a non-surgical option. Some hearing instrument specialists will allow a trial time of the hearing aid for a nominal fee. This gives the patient a chance to try the hearing aid before proceeding with a full purchase. There are other considerations. Some patients are concerned about the cost, the appearance, and the upkeep of the hearing aid and prefer a surgical option.
  • Surgery (stapedectomy): A stapedectomy​ is a surgical procedure that involves either a total or partial removal of the stapes bone. A prosthesis is then used to restore function.