What Is Otosclerosis

Otosclerosis, which is an abnormal bone growth in the middle ear, can causing hearing loss and other associated symptoms. Fortunately this is a condition that’s usually treatable, but without treatment the patient eventually loses his or her hearing. The ear is a delicate instrument that is easily damaged and this is but one of a surprising number of conditions that can damage the inner ear and cause hearing loss.

Causes and risks

Nobody knows what causes otosclerosis. Although there’s some evidence that it’s a family trait in some cases, there aren’t any studies that confirm that this is the case.

Patients who develop otosclerosis have an abnormal bone that grows in the middle ear. This spongy bone growth interferes with the normal functioning of the ear by preventing it from vibrating normally when a sound wave hits it. As a result, the proper sound-producing nerve impulses don’t reach the brain and the patient cannot hear properly.

Otosclerosis usually begins developing in young to middle-aged adults, and is more common in women than in men. It’s the most frequent cause of hearing loss in this age group. Most of the time the patient develops the condition in both ears at the same time.

Even though doctors don’t know what causes otosclerosis, they have learned a few things about it. For instance, a family history of hearing loss may indicate a predisposition toward developing otosclerosis. Caucasians are more likely to develop this particular condition than other races; nobody knows the reason for that. Also unknown is why pregnant women are more at risk for this condition than the rest of the population.

Symptoms of Otosclerosis

The first symptom you may notice with otosclerosis is that you hear better in noisy environments than in quiet ones. This is the opposite experience that most people with hearing loss will notice.

At some point you’ll also become aware that you’re losing your hearing. It starts gradually, and continues to get worse. You ears may or may not ring with it (tinnitus).

Diagnosing Otosclerosis

The first test you’ll have is audiometry and audiology tests to find out how bad your hearing loss actually is. Then the doctor will order an imaging test of your head called a temporal-bone CT scan. This is to eliminate any other causes of hearing loss.

What to Expect

Over time, otosclerosis may gradually worsen, but it may be a long time before you need treatment. Generally speaking, most doctors prefer to treat the symptoms (hearing loss) for as long as possible.

Some patients take fluoride, vitamin D and calcium to try to slow down hearing loss. Although they won’t hurt, there’s no proof that they help.

At some point you probably will need a hearing aid. This won’t affect the course of the growth, but it will allow you to go on with your life in a normal way.

As a last resort, you can have surgery on the stapes (one of the small bones in the ear). There are two types of surgery. One is to totally remove the stapes and replace it with a prosthesis; this is a stapdectomy. In a stapedotomy, the surgeon uses a laser to make a hole in the stapes and then places a prosthetic device in it. Either one can help restore part of your hearing, but neither one is guaranteed to be a success. It the surgery doesn’t work, the worst case scenario is that eventually you will lose most or all of your hearing and need to learn skills to cope with deafness.

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