Otosclerosis

• Alternative Names

  Otospongiosis; Stapedectomy

• Causes, incidence, and risk factors

  The cause of otosclerosis is unknown, but there appears to be a hereditary component, meaning it can be passed down through families. In this condition, an abnormal sponge-like bone grows in the middle ear. This growth prevents the ear from vibrating in response to sound waves -- which must happen in order for you to hear. This lack of vibration leads to hearing loss that continues to get worse with time.

  Otosclerosis is the most frequent cause of middle ear hearing loss in young adults. It affects about 10% of the U.S. population. It is a disorder that gets worse slowly, usually beginning in early to mid- adulthood. It is more common in women than in men. Otosclerosis usually affects both ears.

  Otosclerosis can lead to not only conductive hearing loss, but to nerve loss as well.

  Risks include pregnancy (which may trigger onset) and a family history of hearing loss. Caucasians are more susceptible than others to otosclerosis.

• Symptoms
  • Hearing loss
    • Slow hearing loss that continues to get worse
    • Hearing may be better in noisy environments than quiet areas.
  • Ringing in the ears (tinnitus)
• Signs and tests

  A hearing test (audiometry/audiology) may determine the extent of hearing loss. Temporal-bone CT may be used to distinguish otosclerosis from other causes of hearing loss.

• Treatment

  Otosclerosis may slowly get worse. The condition may not require treatment until you having severe hearing problems.

  Medications such as oral fluoride, calcium, or vitamin D may help to control the hearing loss, but the benefits have not yet been proved.

  A hearing aid may be used to treat the hearing loss. This will not cure or prevent hearing loss from getting worse, but may help relieve some of the symptoms.

  Surgery to remove part of the ear (stapes) and replace it with a prosthesis can cure the condition. A total replacement is called a stapedectomy. Sometimes a laser is used to make a hole in the stapes to allow placement of the prosthetic device. This is called a stapedotomy.

• Expectations (prognosis)

  Otosclerosis gets worse without treatment, but surgery may restore at least partial hearing. Most complications of surgery get better by themselves within a few weeks.

  To reduce the risk of complications after surgery:

  • Do NOT blow your nose for 1 week after surgery.
  • Avoid people with respiratory or other infections.
  • Avoid bending, lifting, or straining, which may cause dizziness.
  • Avoid loud noises or sudden pressure changes such as scuba diving, flying, or driving in the mountains until healed.

  If surgery is unsuccessful, total hearing loss may occur. Treatment then involves developing skills to cope with deafness, including use of hearing aids and visual cues.

• Complications
  • Complete deafness
  • Infection, dizziness, pain, or blood clot in the ear after surgery
• Calling your health care provider

  Call your health care provider if hearing loss occurs.

  Call your health care provider if fever, ear pain, dizziness, or other symptoms develop after surgery.

• References

  Battista RA, Wiet RJ, Joy J. Stapedectomy. Otolaryngol Clin North Am. 2006;39(4):677-697.

Review Date: 7/15/2008

Reviewed By: Alan Lipkin, MD, Otolargyngologist, private practice, Denver, CO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.