What Is Otosclerosis?
The name of “otosclerosis" comes from the phrases “oto” (“of the ear”) and “sclerosis” (“abnormal hardening of body tissue”). It's an ear disease that affects the bones in the middle ear, which leads to gradual hearing loss. Early diagnosis and treatment can help preserve hearing and management of this condition.
Read on to explore the definition, symptoms, causes and treatments for this condition that affects 3 million Americans. [1]
Otosclerosis Definition
Otosclerosis is a condition where abnormal bone growth occurs in the middle ear, fixating or freezing the connections between the three tiny middle ear bones, preventing them from moving properly, which disrupts the transmission of sound and causes conductive hearing loss. [2]
Hearing healthcare providers may use a combination of tools to confirm an otosclerosis diagnosis, including:
- An audiogram – a hearing test that can reveal a characteristic dip in bone conduction thresholds.
- Acoustic immittance testing. Acoustic reflex testing stimulates a tiny muscle in the middle ear. If otosclerosis is present, this reflex response will be abnormal due to the stiffening of the middle ear bones.
- CT scans – imaging that can detect bone changes in the middle ear or cochlea.
Otosclerosis typically develops gradually, often starting in early to mid-adulthood. It may affect one or both ears.
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Otosclerosis Causes
The exact otosclerosis causes are not fully understood, but research points to several possible factors:
Otosclerosis Symptoms
Otosclerosis symptoms generally develop slowly and may include:
- Gradual hearing loss, usually starting in one ear and possibly progressing to both.
- Difficulty hearing low-pitched sounds.
- Trouble understanding speech, especially in noisy environments.
- Tinnitus. [5]
- In rare cases, dizziness or balance issues.
Otosclerosis symptoms typically worsen over time. Many patients first notice difficulty hearing whispers or soft-spoken voices. As the condition progresses, hearing aids or surgical intervention may be necessary. For most cases, if caught early, surgery can help completely reverse otosclerosis.
Otosclerosis Treatment
The right otosclerosis treatment depends on the severity of hearing loss, overall health, and patient preferences. Common approaches include:
- Hearing Aids
For many patients, an otosclerosis hearing aid can amplify sound and improve hearing without surgery. This option is often recommended in early or moderate stages of the disease. - Otosclerosis Surgery.
There are two otosclerosis surgeries:
- Stapedectomy involves removing both the stapes and the footplate of the stapes and replacing both with a prothesis. Stapedectomies have a high success rate, with many patients experiencing significant hearing improvement. [6]
- Stapedotomy is a much more common otosclerosis surgery. In this procedure, only the crus of the stapes is removed, leaving the footplate intact and replacing the crus with a prosthesis.
Stapedotomies are far less risky and more often performed, but the choice of surgery depends on the degree of fixation.
It’s important to note that, when caught early, most otosclerosis is completely reversible with surgery. Early diagnosis is critical, so if you’re noticing hearing loss, schedule an appointment with a hearing health care provider sooner rather than later.
Special Considerations and Diagnoses
Hearing healthcare experts often classify otosclerosis into two different types:
- Fenestral otosclerosis – Involves the stapes (bone in the middle ear) and the surrounding oval window (a membrane-covered opening located in the middle ear).
- Cochlear otosclerosis – Affects the cochlea, which leads to mixed or sensorineural hearing loss.
For accurate diagnosis, hearing healthcare experts rely on:
- Detailed hearing tests including an audiometric assessment and acoustic immittance testing.
- Imaging such as CT scans.
The diagnosis is documented using medical coding systems, such as the otosclerosis ICD codes, for insurance and treatment planning.
When to See Your Doctor
If you notice gradual hearing loss, especially if it runs in your family, schedule an evaluation with a hearing healthcare professional. Early detection can make a significant difference in treatment options and long-term hearing preservation.
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For those seeking diagnosis and treatment, it’s important to work with experienced professionals. The experts at Amplifon Hearing Healthcare can guide you through getting the proper care that you need.
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1. Cleveland Clinic. “Otosclerosis.” Retrieved from https://my.clevelandclinic.org/health/diseases/22033-otosclerosis
2. Cleveland Clinic. “Otosclerosis.” Retrieved from https://my.clevelandclinic.org/health/diseases/22033-otosclerosis
3. American Hearing Research Foundation. “Otosclerosis.” Retrieved from https://www.american-hearing.org/disease/otosclerosis/
4. National Institute on Deafness and Other Communication Disorders. “Otosclerosis.” Retrieved from https://www.nidcd.nih.gov/health/otosclerosis
5. National Institute on Deafness and Other Communication Disorders. “Otosclerosis.” Retrieved from https://www.nidcd.nih.gov/health/otosclerosis
6. Cleveland Clinic. “Otosclerosis.” Retrieved from https://my.clevelandclinic.org/health/diseases/22033-otosclerosis
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