Otosclerosis is one of the rarer ear diseases of the middle ear and the bones in the inner ear that can lead to hearing loss. 

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.

Causes of otosclerosis

It isn’t entirely clear as to why otosclerosis happens or why it affects certain people, but 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. However, 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.

Otosclerosis symptoms

Hearing loss is considered the main symptom of otosclerosis, which can occur in just one or both of your ears. Most people tend to notice hearing problems associated with otosclerosis in their 20s or 30s. It does tend to be a gradual hearing loss, so most people only begin to notice a change in their hearing later in life.

To begin with, you might find that your hearing is significantly better when you are in noisy or crowded environments. This is because otosclerosis affects how low-pitched or deep sounds are heard. So if a person is speaking loudly, it is much easier to hear and doesn’t get lost in the background noise. For some people, it can make their voice seem louder to them so they tend to speak more quietly. Other symptoms can include:

  • Tinnitus (ringing in the ears)
  • Difficulty hearing low-pitched sounds or whispers
  • Problems with your balance or dizziness

Otosclerosis treatment

Otosclerosis will likely get progressively worse because the bone will become increasingly immobile. If you don’t get it treated, you will find that your hearing will continue to get worse. Once you have been diagnosed with otosclerosis you then have two key treatment options to choose from which will help to improve your hearing.

Hearing aids

Hearing aids offer the simplest and less invasive treatment option for otosclerosis and you will notice a rapid improvement to your hearing. Hearing aids are small electronic devices worn behind or inside the ear and will amplify the sounds that enter your ear. Your hearing care professional will be able to assess your hearing and the kind of sound situations where you most need help with your hearing and will then be able to recommend the best hearing aid for your needs.

Otosclerosis surgery

Another effective but more invasive treatment for otosclerosis is a procedure called a stapedectomy. This is a surgical operation which involves a surgeon removing the stapes from behind the eardrum and replacing it with a prosthesis which will either be a piece of metal or plastic. This implant will vibrate just like the stapes would and enable sound to move to the inner ear.

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.

If you have any concerns about your hearing, you should schedule a consultation with your hearing care professional as soon as possible.

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