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 underÂgo 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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