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Ear anatomy
Ear anatomy

Otosclerosis
Definition:
Otosclerosis is an abnormal bone growth in the middle ear that causes hearing loss.

Alternative Names:
Otospongiosis

Causes, incidence, and risk factors:
Otosclerosis is an inherited disorder involving the growth of abnormal spongy bone in the middle ear. This growth prevents the stapes (stirrup bone) from vibrating in response to sound waves, thus leading to progressive (worsening over time) hearing loss.

Otosclerosis is the most frequent cause of middle ear hearing loss in young adults, affecting about 10% of the population of the US. Otosclerosis usually affects both ears, and is most commonly seen in women, 15 to 30 years old.

Risks include pregnancy (which may trigger onset) and a family history of hearing loss. Caucasians are more susceptible to otosclerosis than others.
Symptoms:
Signs and tests:
An examination of the ears may rule out other causes of hearing loss.
Treatment:

Otosclerosis may be slowly progressive, and the condition may not require treatment until the extent of hearing loss is significant.

Medications such as oral fluoride, calcium or vitamin D may help to stabilize the hearing loss, but their benefit has not been proven.

A hearing aid may be used to treat the hearing loss. This will not cure or prevent the progression of the disease, but may help alleviate the symptoms of hearing loss.

Surgery to remove the stapes and replace it with a prosthesis is curative. This may be total replacement (stapedectomy) or a laser may be used to make a hole in the stapes (stapedotomy) to allow placement of the prosthesis.

To reduce the risk of complications after surgery:

  • Nose blowing is discouraged for 1 week after surgery.
  • Avoid people with respiratory or other infections.
  • Protect the ears against cold.
  • Avoid bending, lifting, straining (may cause dizziness).
  • Avoid loud noises or sudden pressure changes (scuba diving, flying, driving in the mountains) for 6 months or until healed.
If surgical repair is unsuccessful, total hearing loss may occur. Treatment then involves developing skills to cope with deafness, including use of hearing aids or other technology, and use of visual cues.
Expectations (prognosis):
Otosclerosis is progressive without treatment; however, surgery may restore at least partial hearing. Most complications of surgery correct themselves within a few weeks.
Complications:
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.
Review Date: 8/29/2002
Reviewed By: Jason Newman, M.D., Department of Otolaryngology, Kaiser Permanente Medical Group, Washington, DC. Review provided by VeriMed Healthcare Network.
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