The definition of otosclerosis is the abnormal formation of new bone in the middle ear that stops the stapes (a small bone in the middle ear) from moving, which stops it from vibrating in response to sound, leading to progressive conductive hearing loss. Your stapes bone needs to vibrate for you to hear well. So, when this doesn’t happen, the sound is unable to travel from your middle ear to your inner ear, making it hard for you to hear.
It isn’t entirely clear as to why otosclerosis happens or why it affects certain people. However, it does seem to run in families. You can start developing otosclerosis between 10 and 45 years old but you are more likely to get otosclerosis when you are in your 20s, with symptoms getting worse in your 30s. Both women and men can get otosclerosis but women have a higher risk, especially during pregnancy. Certain medical conditions such as measles, stress fractures and immune disorders are thought to increase your risk of developing it.
The most common symptom of otosclerosis is hearing loss, which can affect one or both ears, and is often what alerts people that there is a problem in their ears. People can notice a change to their hearing around their 20s or 30s. But as the hearing loss generally happens gradually, people often only really being very aware of it when there is a more substantial drop in their hearing later as they get much older. Otosclerosis symptoms can often start with your hearing seeming to be a lot better in environments that are loud and noisy. You may also find that your voice sounds much louder to you which makes you want to speak much more quietly.
Other symptoms frequently associated with otosclerosis include:
As it’s common for otosclerosis to get progressively worse as the bone becomes more immobile, it’s important to get treatment to protect your hearing. Once you have received a diagnosis, you can then consider your treatment options which are otosclerosis surgery or wearing hearing aids.
Hearing aids are a much less invasive option than surgery and offer a quick improvement to your hearing by amplifying the sounds that enter your ear. They are electronic devices that are worn inside or behind the ear and most modern hearing aids are very small and discreet. Your hearing care professional will identify the kind of sound situations where your hearing needs improvement and will recommend the right hearing aid for your needs.
Surgery is an additional option to treat otosclerosis. The procedure, called stapedectomy surgery, involves removing some of the enlarged bone and replacing it with a plastic or metal implant to help the bones work normally. In most cases, patients are helped by the surgery and their hearing and tinnitus symptoms substantially improve. However, for a very small number of people, surgery doesn’t benefit them at all and may even make their tinnitus symptoms worse.
In most cases, otosclerosis just affects the stapes bone in your middle ear. However, it can sometimes spread into the inner ear and affect your cochlea. This is what creates the electrical signals to send to the brain. Hearing loss that results from cochlear otosclerosis is significantly worse than with otosclerosis and cannot be treated with surgery.
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