Otosclerosis is a condition of the bone of the inner ear where the bone of the inner ear grows and stiffens the stapes bone (the third bone of hearing).
You may reference the Anatomy of the Ear page for better understanding of the anatomy.
Otosclerosis most commonly present with hearing loss. In women, the hearing loss may present or suddenly worsen during pregnancy.
The cause of otosclerosis is unknown. It is generally hereditary, but there is also evidence that a virus may cause it.
Anyone can get otosclerosis. 10% of Caucasian males, and 18% of Caucasian females have otosclerosis. Of those, 10% will have symptomatic hearing loss. This means that in the white population, 1% of males and 2% of females will have otosclerosis to the degree that causes significant hearing impairment. The disease progresses at a faster rate during pregnancy. It is a hereditary and in some people involves both sides. In African Americans, only about 1% of people show histologic otosclerosis, so the rate of clinical problems is much lower than in whites. Oriental people have about half as many cases of otosclerosis as whites, and it is also very rare in Native Americans.
Generally after a complete history and physical exam, some tests need to be performed to diagnose otosclerosis. A test of the hearing (audiogram and tympanogram) and CT scan (special x-ray) of the temporal bone (ear bone) is necessary for diagnosis and to rule out other causes of the hearing loss.
There are 3 options for the treatment of otosclerosis.
1. Do nothing. Otosclerosis is not a fatal disease, if the hearing loss does not bother you, you do not have to do anything about it. The disease is generally progressive though. So, as time goes on, the hearing will get worse.
2. Use a Hearing Aid. Depending on the nature of the hearing loss, the patient’s medical condition, and patient preference, a hearing aid may be recommended for the treatment of otosclerosis.
3. Stapedectomy. Stapedectomy is a surgery for the treatment of otosclerosis. During this surgery, the 3rd hearing bone (stapes) is removed under the microscope with a laser and replaced with a prosthesis which connects the 2nd hearing bone (incus) to the inner ear. The surgery takes less than an hour and is 90-95% successful in restoring the hearing to the normal (inner ear function) level. The main risk of the operation is a 1% chance of permanent hearing loss and persistent dizziness.
A comprehensive evaluation of your hearing and a consultation with your ear specialist is necessary to decide the best treatment option.
A subspecialist in the field of ear surgery (neurotologist) generally performs this surgery as it is a highly technical surgery.
The placement of prostheses that clip onto the second bone of hearing by activation with heat. The placement of this prosthesis, called "SMART" piston, is thought to be safer because the small likelihood of complications in manually clipping the prosthesis onto the 2nd bone is reduced. Other techniques developed by Dr. Djalilian have been found to reduce the likelihood of dizziness and high frequency hearing loss after surgery. In our surgeries we have found that we never have to cut or stretch the chorda tympani (taste nerve) which can cause problems. This nerve is cut routinely by some surgeons to obtain better access to the stapes, leaving a taste change/loss in most of the patients. We have not found this to be necessary. Medications used and innovative techniques during surgery have been found to for the most part eliminate stretch injury to that nerve.
To Make an Appointment with our ear experts, Drs. Djalilian or Lin, Please Call 714-456-7017 or click here to request an appointment via the web.
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