What is otosclerosis?
Otosclerosis (oh-tuh-skli-roh-sis) is a condition that causes hearing loss. The term “oto” means “of the ear” and “sclerosis” means “abnormal hardening of body tissue," Otosclerosis happens when irregular bone remodeling/growth occurs in your middle ear. Bone remodeling is a lifelong process in which existing bone tissue repeatedly restores itself. In otosclerosis, irregular bone remodeling interferes with sound’s ability to travel. Otosclerosis causes mild to severe hearing impairment, but it rarely results in total deafness.
Who does otosclerosis affect?
Otosclerosis can affect males and females of all ages. It occurs most often in white females over the age of 45. Sometimes otosclerosis runs in families.
How common is otosclerosis?
Over three million Americans have otosclerosis. It’s the most common cause of middle ear mechanical hearing loss among young adults.
Symptoms and Causes
What are the symptoms of otosclerosis?
The most common symptom of otosclerosis is hearing loss that happens gradually over time. People with otosclerosis may notice that they can no longer hear whispering or low-pitched/tone sounds. In most cases, people with otosclerosis have hearing loss in both ears. Approximately 10% to 15% of individuals with otosclerosis have hearing loss in one ear.
Other possible otosclerosis symptoms include:
If you have otosclerosis, you may speak quietly because your voice sounds loud to you.
What is the main cause of otosclerosis?
Deep inside your ear, there are three tiny bones that vibrate to amplify the sound waves pass that through them. These sound waves are then transmitted to the inner ear (cochlea), where they’re converted into signals and sent to your brain. Otosclerosis develops when the stapes bone (a small, triangular bone in your middle ear) fuses with the surrounding bone tissue. As a result, sound is no longer transmitted effectively.
Think about the musical instrument, the triangle. When held properly by the loop at the top, the triangle hangs free and creates a rich sound through vibration when struck. But if you place your hand around the triangle itself, the sound is muffled. The stapes bone reacts in a similar way when excess bone grows around it.
Diagnosis and Tests
How is otosclerosis detected?
Otosclerosis is usually diagnosed by an ear, nose and throat specialist (ENT). First, they rule out other health problems that share similar symptoms. Next, hearing tests are performed to determine the extent of hearing loss. These tests may include an audiogram, which measures your hearing across a range of frequencies, and a tympanogram, which tells your provider how well your eardrum is working.
Your healthcare provider may also request a CT scan. This imaging test helps your medical team see the bones and tissues inside your ear in great detail.
Management and Treatment
How is otosclerosis treated?
Otosclerosis treatment depends on the severity of your condition. Mild cases may be addressed successfully with a hearing aid. In select cases, surgery can help improve the hearing.
Otosclerosis surgery is called a stapedectomy (stay-puh-dek-tuh-mee). During this procedure, your surgeon places a prosthesis (replacement hearing bone) in your middle ear. This prosthesis bypasses the stapes bone, allowing sound waves to travel to the inner ear. As a result, hearing is improved. If otosclerosis is affecting both of your ears, your surgeon will operate on one ear at a time. Once the first surgery is complete, you’ll probably have to wait at least six months to schedule the other procedure.
Are there complications associated with treatment?
Like any surgical procedure, a stapedectomy carries the risk of complications. While the procedure helps about 80% to 90% of people with otosclerosis, it may not be successful in some cases. In rare instances, hearing may even be worse after surgery. So, it’s important to talk with your healthcare provider about the possible risks and limitations of otosclerosis surgery.
How long does it take to recover from otosclerosis surgery?
Most people who have a stapedectomy can return to normal routines in about one week. However, if your job requires heavy lifting or strenuous activity, you may need to take up to one month off of work. Be sure to ask your healthcare provider what to expect if you’re about to undergo a stapedectomy.
Can I prevent otosclerosis?
Unlike other hearing problems, there are no preventable risk factors for otosclerosis (such as exposure to loud noises). Some people simply have a genetic predisposition for the condition. As a result, there's no way to prevent otosclerosis from developing.
Outlook / Prognosis
What can I expect if I have otosclerosis?
You’ll likely need a hearing aid or surgery, depending on the severity of your condition. In some cases, your healthcare provider may monitor your condition and recommend treatment only when symptoms worsen.
Can otosclerosis be cured?
Otosclerosis can't be cured. Surgery can greatly improve the hearing loss caused by otosclerosis. Hearing aids can successfully manage your hearing loss as well.
When should I see my healthcare provider?
Any time you notice a change or decrease in your hearing ability, it’s important to schedule an appointment with your healthcare provider. Prompt diagnosis and treatment can help ease troublesome symptoms so you can return to normal life.
What questions should I ask my healthcare provider?
If you’ve been diagnosed with otosclerosis, you may want to ask the following questions:
- How serious is my condition?
- Would hearing aids help or do I need surgery?
- How long can I wait before scheduling surgery?
- How long will it take for my hearing to worsen without treatment?
A note from Cleveland Clinic
Otosclerosis can cause mild to severe hearing loss. But hearing can be significantly improved with treatment in many cases. Ask your healthcare provider about personalized treatment options, including hearing aids and otosclerosis surgery.
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