Otosclerosis is a condition that causes hearing loss, rarely total deafness.  The hearing loss can be mild to severe.  This condition is caused by irregular bone growth in either the middle ear or the inner ear.  It is most common for this to be caused by the stapes bone which is in the middle ear.  The stapes bone has to vibrate to hear.  When the bone remodels or regrows abnormally it causes the stapes to not vibrate which stops the sound from traveling from the middle ear to the inner ear. 

Women who are between the age of 15 and 30 are at higher risk of getting otosclerosis.  Other risk factors are family history, pregnancy, having the measles, having immune disorders, or having a stress fracture to the ear.  Otosclerosis is very common and is the most common cause of middle ear mechanical hearing loss.  



Symptoms worsen over time gradually.  The first symptom that is usually noticed is hearing loss.  You may start to notice that you no longer can hear whispering or low pitched sounds.  Other symptoms you could experience are balance issues, vertigo, ringing in the ears, and dizziness.  You might start speaking softer because your voice may sound very loud to you.  



If you go to the doctor and suspect that you may have some hearing loss, your primary care provider will refer you to an otolaryngologist, or ear, nose, and throat specialist.  The otolaryngologist will run some different tests to rule out other issues that could cause similar symptoms.  They may want to run an audiogram which measures your hearing across a range of frequencies.  Another test is a tympanogram which tests how well the eardrum is working.  A CT scan can be done to check the bones and tissues inside your ear.  X-rays can be taken from different angles so your doctor can look at the bones with that as well.  



Without treatment otosclerosis will worsen over time.  Not getting treatment can cause the otosclerosis to spread to the inner ear causing cochlear otosclerosis.  Complete deafness can occur without any treatment in some cases that are more severe.  You may experience abnormal taste in the mouth or loss of taste that can either be temporary or permanent.  Infection, dizziness, pain, or blood clots can be a complication after surgery.  Nerve damage can also be a complication of otosclerosis.  

If you have a mild case of otosclerosis and your symptoms haven’t progressed very far your doctor may just want to monitor you.  They will watch and wait with regular hearing tests. During this time depending on how much hearing loss you have had, your doctor may suggest a hearing aid.  A hearing aid doesn’t stop hearing loss from getting worse.  It will help you be able to hear better.  If you have cochlear otosclerosis your doctor may suggest a cochlear implant.  A cochlear implant bypasses the inner ear creating a new pathway for sound to travel to your brain.  

A stapedectomy is a surgical procedure you can have done to help.  During the surgery a surgeon puts a device in the middle ear that moves the stuck stapes bone.  This will allow sound waves to travel to the inner ear.  In some cases this surgery can lead to worsened hearing.  If you have otosclerosis in both ears your surgeon will do one surgery on one ear, you will wait six months before having the surgery on the other ear.  This will help to see how you heal and if there were any complications from the surgery.  After surgery it is important to make sure you take care of yourself and allow yourself to heal properly.  After surgery do not blow your nose, make sure to avoid cold temperatures, avoid others who are sick with respiratory illnesses, avoid loud noises, and avoid changes in air pressure.  If you experience pain, dizziness, or fever after surgery you will want to reach out to your doctor or surgeon because these are signs of infection.  



You cannot prevent otosclerosis.  Progression is usually slow.  Only in rare cases does it progress quickly.  There is no cure, but with treatment symptoms are manageable.  It is important to get treatment.  Leaving otosclerosis untreated can lead to complications such as complete deafness or spread to the inner ear.  Any time you experience a hearing change you will want to reach out to your doctor, getting quick treatment can help ease symptoms and improve the quality of life.  



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