Otosclerosis, a condition also known as “ear ossification,” may have a genetic component. While the exact cause is not fully understood, hormonal factors and certain viruses are suggested to contribute to the disease. Otosclerosis is characterized by structural calcification at the base of the stapes bone in the ear, which leads to stiffening and limits the movement of the stapes bone. This, in turn, hampers the transmission of sound waves to the inner ear fluids, resulting in a type of hearing loss known as conductive hearing loss. At this stage, the disease can be treated with surgery to restore the patient’s hearing to a normal level. If left untreated, otosclerosis can progress, affecting the inner ear wall and causing irreversible sensorineural hearing loss.
What are the symptoms of otosclerosis?
The primary symptom of otosclerosis is gradual, progressive hearing loss that can affect one or both ears. The extent of hearing loss can vary with the severity of the calcification. The condition is typically seen in the age range of 15 to 45 years and is more common in women than in men. During pregnancy, the disease may progress rapidly. In addition to hearing loss, individuals with otosclerosis may experience ringing in the ears (tinnitus), dizziness, and balance problems.
How is otosclerosis diagnosed?
The diagnosis of otosclerosis begins with a physical examination of the ear, but a hearing test is essential for a preliminary diagnosis. The eardrum typically appears normal in otosclerosis because the problem lies between the middle ear and the inner ear. Imaging techniques such as tomography or magnetic resonance imaging do not directly reveal otosclerosis but may be used to rule out other ear conditions.
What is the treatment for otosclerosis?
In cases where otosclerosis is mild and not significantly impacting the individual’s life, it may be monitored through regular hearing tests. For those experiencing hearing loss that affects their quality of life, treatment options include surgery or hearing aids.
How is otosclerosis surgery performed?
The preferred surgical method for treating otosclerosis is called “exploratory tympanotomy.” During the surgery, the immobilized stapes bone is identified, confirming the diagnosis of otosclerosis. Using the “stapedotomy/stapedectomy” technique, the immobile stapes bone is removed, and a prosthesis (usually made of Teflon) is placed between the anvil bone and the inner ear to facilitate the transmission of sound waves. This surgery, which can be performed under general anesthesia, often yields high success rates, and most patients experience significant improvement in their conductive hearing loss.
What can be expected after otosclerosis surgery?
After surgery, there is typically no pain or bleeding. Some patients may experience mild dizziness for a few days, but this is usually temporary. While complications are rare, they may include ongoing or worsening hearing loss, the formation of a hole in the eardrum, damage to the facial nerve, middle ear infections, or dislodgement of the prosthesis, though these occur very infrequently.
What precautions should be taken after otosclerosis surgery?
In the early post-operative period, patients should avoid activities such as air travel, diving, coughing, heavy lifting, and straining. Tinnitus that existed before the surgery generally does not improve.