Otosclerosis - Guide to Causes, Symptoms and Treatment

Otosclerosis - Guide to Causes, Symptoms and Treatment
An abnormal growth of spongy bone can occur at the entrance to the inner ear and immobilize the base of the stirrup, a tiny bone through which sound waves pass into the inner ear. As a result, the stirrup cannot transmit some or all of the sound waves that enter the ear. This causes conductive hearing loss in that ear. In about 80 per cent of all cases of otosclerosis, both of the ears are affected, either the two at the same time or one after the other.

What are the Symptoms?

Without treatment, otosclerosis usually leads to a slow loss of hearing, eventually ending with total deafness in both ears within 10 to 15 years. In a few cases, usually in children, the hearing loss progresses much faster. In some other cases the hearing loss stops well short of deafness. For example, someone with the disorder may be able to hear loud speech and other loud sounds.
At first, the affected person’s voice sounds normal, unlike the abnormally loud voices of people with other types of hearing loss, As the disease progresses, some sensorineural hearing loss may occur. If this happens, it may cause noises in the ear and louder speech.
A woman with otosclerosis who becomes pregnant may find that the rate of hearing loss accelerates, Usually the change is not significant enough to cause added concern.

What are the Risks?

The risks are the dangers associated with deafness and the emotional effects of the social isolation that this sometimes produces,

What should be done?

If your hearing deteriorates or you hear ringing in your ears, see your physician, who will examine your ears and probably give you some simple hearing tests, If otosclerosis is suspected, and particularly if you have a blood relative who has the disease, you will probably have to take several special hearing tests.

What is the Treatment?

The only treatment that will halt or cure otosclerosis is an operation called a stapedectomy. A stapedectomy improves hearing significantly in 90 per cent of cases. However, about two to five per cent of these operations result in total deafness in the affected ear. You and your physician should consider this risk as you decide whether you should underĂ‚­go the procedure. If you have rapidly progressive otosclerosis in both ears, you will probably be advised to have the procedure done immediately to prevent quick onset of total deafness. Usually only one ear is operated on at a time, so that if the operation fails. there is a possibility of a successful operation on the other ear. If the procedure was successful, the second ear may be operated on a year after the first one.
In a stapedectomy, a surgeon folds the eardrum out of the way, removes the diseased stirrup, and replaces it with a tiny metal substitute. The patient usually feels dizzy for a short time after the operation, but can leave the hospital after one or two days. The eardrum heals naturally in one to two weeks. In another two to three weeks, the patient can usually return to normal activities.
In some cases, there is no immediate improvement in hearing after a stapedectomy because a blood clot is left in the middle ear and blocks sound conduction. The clot usually disappears in time and hearing improves.

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