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.
Presenting Symptoms
Otosclerosis most commonly present with hearing
loss. In women, the hearing loss may present or suddenly worsen during
pregnancy.
Causes
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.
How is a Diagnosis Made?
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.
Treatment
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.
Watch a Stapedectomy Surgery Video Below
What option is best for
you?
A comprehensive evaluation of your hearing and
a consultation with your ear specialist is necessary to decide the best
treatment option.
Who should you have do your
surgery?
A subspecialist in the field of ear surgery (neurotologist)
generally performs this surgery as it is a highly technical surgery.
New Innovations in the
Treatment of Otosclerosis
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 specialist, Dr. Djalilian, Please Call
714-456-7017 or click
here
to request an appointment via the web.
Dr. Djalilian's book on
diagnosis and treatment of Ear Nose, and Throat
Diseases. Click
here
for
more information.
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.