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What is otosclerosis?Otosclerosis is an inherited condition that affects the middle ear and causes gradual hearing loss. It is the most common cause of hearing loss in adults and affects about 1 in 200 people. Show
Otosclerosis normally begins in the teens or early twenties. Spongy bone forms in the middle ear. The tiny bones fuse, preventing sound vibrations from passing through to the inner ear. The condition can develop in just one or in both ears. It tends to run in families, affects women more than men, and often comes on during pregnancy. What are the symptoms of otosclerosis?Otosclerosis causes hearing loss that gradually gets worse over time. But it very rarely causes total deafness. People with otosclerosis find it particularly hard to hear low, deep sounds. In contrast to other causes of hearing loss, it can be easier for them to hear when there is background noise. Other symptoms of the condition include tinnitus (ringing in the ears) and dizziness. If not treated, otosclerosis can start to affect the inner ear, which can result in profound hearing loss. How is otosclerosis diagnosed?Otosclerosis is normally diagnosed by an ear, nose and throat specialist. They will do a series of tests to see what type of hearing loss you have. These may include hearing tests with tuning forks; audiometric tests to find out which tones you can hear; and tests to measure how the bones inside your ear are moving. How is otosclerosis treated?There are 2 treatment options for otosclerosis: a hearing aid or surgery. Either a bone-conduction hearing aid or a bone anchored hearing device can be used to help you hear. These hearing aids are small enough to fit inside the ear, so they are not obvious. They do not carry the risks of surgery. Surgery can involve removing the tiny bones of the middle ear and replacing them with an implant. This procedure is called a stapedectomy. The advantage of surgery is that it can make your hearing come back, and may stop the otosclerosis from progressing to the inner ear. The disadvantage is that surgery may not work, and the hearing loss may return in time. When should I see my doctor?As with any surgery, there is a small risk of complications. Tell your surgeon straight away if:
Living with otosclerosisIt is normally OK to swim, go diving and travel by air if you have otosclerosis, but be careful if you have a middle ear infection. Ask your doctor for advice on what physical activities are safe for you. It may help if you eat a diet containing a lot of calcium. Some women also find their hearing improves if they stop taking the contraceptive pill. If you have otosclerosis, it is particularly important to protect your hearing from noise damage, for example, due to loud music or a noisy environment such as a building site. Resources and supportFind out more here about hearing loss prevention and the Australian Government's hearing services program. What are the Symptoms?Hearing loss Tinnitus (Ear Noises) Vertigo (Dizziness) What are the Tests for Otosclerosis?Hearing tests are essential in diagnosing otosclerosis. There are specific patterns of hearing loss that are suggestive of this process. Hearing tests are also used to monitor progression of disease, and to assess treatment results. Radiologic studies, especially high resolution CT scanning, are occasionally used to confirm the diagnosis of otosclerosis. What is the Treatment for Otosclerosis?There are several ways to manage otosclerosis. Treatment options are selected on a number of factors and should be customized to each affected individual. The options are discussed briefly below: Watchful waiting -- You do not have to do anything about otosclerosis. This is not the type of disease that requires that something be done soon to prevent progression, and there is no "cure" that gets rid of the underlying bone growth in the inner ear. Many people are not particularly troubled by their symptoms, and so may elect to wait, and obtain a hearing test every so often to see if the problem is progressing. Medicines -- Unfortunately, there is no medicine that can reverse the effects of otosclerosis. In some people who have progressive inner ear injury, fluoride treatment may be of help in preventing the progression of symptoms. Fluoride may strengthen the inner ear bone similar to the way it can strengthen teeth. It does not, however, help with the "conductive" hearing loss caused be stapes immobility. For fluoride to be effective, it must be taken daily over a prolonged period of time. Fluoride likely works by converting active, bone-destroying “otospongiosis” lesions to less active “otosclerosis” scar. The side effects of fluoride therapy are few, and taking the medication with meals can minimize any stomach upset. Since fluoride is readily incorporated into growing teeth and bones, the large doses given should usually be avoided in children and pregnant women. Hearing Aids -- The great majority of individuals with otosclerosis can do quite well with hearing aids. Most people with the disease have a "conductive" hearing loss from a problem with mobility of the stapes bone. In most cases, the inner ear works quite well. This means that if a hearing aid can be used to increase the level of the sound vibrations, enough sound can usually get to the inner ear, and the inner ear can make appropriate use of the information. Hearing aids are not for everyone, but they can usually be tried safely to see if they are a benefit. Surgery -- Surgery can be a highly effective treatment for otosclerosis. The procedure is called a "stapedectomy" (or "stapedotomy"). The procedure is intended to "bypass" the fixed part of the stapes bone by removing it, and replacing it with a new, mobile, prosthetic bone. In the procedure, all or part of the stapes bone is removed with either a laser or micro-drill. A tiny “piston” is then placed between the second bone of hearing (the incus) and the inner ear. Occasionally, additional tissue is taken from the external ear to help seal the opening into the inner ear. Patients undergoing otosclerosis surgery usually go home the same day of surgery. The operation takes about 1 to 2 hours, and most patients are able to resume normal activity after about 1 week. It usually takes 4-6 weeks for the ear to fully heal, and for the hearing to improve. Surgery can only help the "conductive" part of the hearing loss (that from immobility of the stapes bone). Surgery cannot help inner ear hearing loss. Does otosclerosis cause conductive or sensorineural hearing loss?Otosclerosis typically presents as progressive bilateral conductive hearing loss in middle-aged white women. It is the leading cause of conductive hearing loss in adults who do not have a middle ear effusion or a history of otitis media.
What does otosclerosis cause?Otosclerosis is a condition caused by abnormal bone growth in the middle ear. This often leads to hearing loss. Some people may also develop dizziness, balance problems or ringing in the ears. Otosclerosis treatments include hearing aids and surgery.
Does otosclerosis cause mixed hearing loss?Mixed hearing loss occurs when otosclerosis affects both the auditory ossicles (conductive hearing loss) and the cochlea or hair cells of the inner ear (sensorineural hearing loss). It's true that bone tissue in the body renews itself as part of a lifelong process known as bone remodeling.
How does otosclerosis affect hearing?Otosclerosis is most often caused when one of the bones in the middle ear, the stapes, becomes stuck in place. When this bone is unable to vibrate, sound is unable to travel through the ear and hearing becomes impaired (see illustration).
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