Otosclerosis

What is otosclerosis?

Otosclerosis is a condition that sees abnormal bone growth occur within the middle ear. It causes the stapes, otherwise known as the ‘stirrup’ bone, to fuse with the bone that surrounds it, preventing sound from being efficiently transmitted to the inner ear.

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Symptoms of otosclerosis

The most common symptoms associated with otosclerosis include: gradual hearing loss; difficulty hearing low pitched sounds while finding it easier to hear in situations with background noise; tinnitus; dizziness and vertigo; balance issues.

Most people living with the condition tend to start noticing the symptoms of otosclerosis as they enter their 20s and 30s. The condition may affect one ear or both, with its severity varying from case to case.

How is otosclerosis diagnosed?

An otosclerosis diagnosis may be confirmed through a combination of medical imaging and hearing tests. Common hearing tests, including audiograms (measuring hearing sensitivity) and tympanograms (measuring middle ear conduction), can help to determine the type of hearing loss experienced, as well as its extent. Otosclerosis typically causes conductive hearing loss, so the audiologist conducting the testing will look for any signs that it is present. Medical imaging, such as a CT scan, may also be used to identify potential damage to the labyrinth or the cochlear nerve, as well as any excess bone growth.

If the symptoms of otosclerosis go unnoticed or are ignored, the condition will continue to worsen. If you notice that your hearing has changed, it is always best to seek medical advice.

Treatment and remedies for otosclerosis

For those living with otosclerosis, limited treatment options are available. Non-surgical treatments for otosclerosis currently include regular monitoring and the use of hearing aids.

Mild cases of otosclerosis may not initially require treatment but it is important that the progression of the condition is monitored closely. Regular hearing tests make it easier to identify if there has been any progression in the hearing loss experienced or if any additional symptoms have developed.

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Although they cannot cure otosclerosis or stop the progression of its symptoms, hearing aids can be effective in helping those living with the condition to hear more clearly. Modern hearing aids are far more discreet than earlier models, with a wide variety of makes and models available to suit almost every lifestyle.

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Surgery: stapedotomy and stapedectomy

For more severe cases of otosclerosis, surgery may be recommended. One of two procedures may be performed: a stapedectomy or a stapedotomy.

A stapedectomy is a procedure that sees a surgeon remove the affected stapes, replacing it with a plastic or metal prosthesis. The prosthesis helps to restore the normal movement of the delicate bones within the ear, assisting in restoring the patient’s hearing.
During a stapedotomy, a small hole is made in the footplate of the stapes using a medical laser. A prosthesis is then inserted into the hole, helping to improve the movement of the tiny middle ear bones.

Success rate and risks of surgery

The success rate of otosclerosis surgery is quite high, with the procedures successfully restoring the hearing of those living with otosclerosis in more than 90% of cases. As with any form of surgery, however, it is important to remember there are some risks that accompany otosclerosis surgery. These include increased hearing loss, the development or worsening of tinnitus, vertigo, an altered sense of taste and facial weakness.

Before you decide whether to proceed with surgery, it’s a good idea to discuss the potential risks with your surgeon.

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