Otosclerosis is a disorder of bone metabolism that affects only the ear.

The bone where the inner ear and the third hearing bone (stapes) meet is called the oval window. This is where otosclerosis affects . In otosclerosis, there is new bone formation at the oval window hampering the smooth movement of the stapes bone thus causing conductive hearing loss.

Hearing loss is the main symptom.

Unlike many problems with the ear that can cause hearing loss, ear drainage, infections, or dizziness, otosclerosis mainly causes hearing loss. Sometimes the hearing loss is accompanied by tinnitus (ringing in the ear or head noise). The hearing loss is usually conductive, meaning sound is blocked from reaching the inner ear. The inner ear, hearing nerve, and brain often process the limited sound that reaches them completely normally.

People affected by otosclerosis are usually born with normal hearing. They may develop hearing loss in their late 30s but this can occur from teens to midlife.

Otosclerosis is inherited from parents.

The pattern of inheritance is autosomal dominance. This means that if one parent has it, the children have a chance of getting it. However, there is variable penetrance.

Complete Deafness from otosclerosis is unlikely.

Because it typically only blocks the conduction of sound, there is a limit to the hearing loss that it can cause. It will progress until the hearing bones are completely stuck. At this point hearing loss is around 50%. It commonly does affect both ears though rarely it can present in one ear also. Rarely, it progresses from the oval window into the inner ear. This is called cochlear otosclerosis. In these cases, it decreases processing of sound in the inner ear as well. In these instances, hearing loss is more severe.

If you have hearing loss, you need to first have a hearing test to find the cause.

We will provide a hearing test and evaluation. We will examine your ear to check for other causes of hearing loss and evaluate your ability to hear by doing a audiometry followed by impedence evaluation.

The goal of surgical therapy is to correct the conductive hearing loss associated with otosclerosis. During surgery, an incision is made in the ear canal allowing the surgeon to elevate the ear drum and look behind it. The suprastructure of stapes (third hearing bone) is removedpartially and a very small 0.5mm to 0.7 mm fenestra is made in the footplate and a prosthesis is placed to connect the incus (second hearing bone) and the inner ear. The ear drum is then returned to its normal position. The procedure is called a stapedotomy.

Patients who are unfit for surgery can be treated by giving hearing aid though it is not the treatment of choice.

There are minor risks associated with stapedotomy.

General risks of surgery apply to stapedotomy surgery. Specific to the procedure, there is a 1% chance of hearing loss. After surgery, there may be a metallic taste in the mouth temporarily. Very rarely, injury to the facial nerve may occur.

Sometimes we may have to abandon the surgery due to unfavourable anatomy of the middle ear and inner ear.