Otosclerosis: The invasion Of The Stapes

Have you been bothered by progressively increasing hearing loss? Otosclerosis is one of the causes of advancing hearing loss which affects the small bones or ossicles: malleus, incus and stapes in the middle ear. 

What is Otosclerosis?   

Otosclerosis means oto, of the ear and sclerosis, abnormal hardening of body tissue. Otosclerosis results from abnormal bone remodeling in the middle ear. Bone remodeling is a continuous process which involves the replacement of old tissue with new tissue and abnormal bone growth leads to obstruction in the conduction of sound from the middle ear to the inner ear. The unusual growth of bone occurs around the stapes, one of the three small bones in the middle ear space; therefore, Otosclerosis is also known as the invasion of the stapes. The movement of the bone is restricted which limits its ability to transmit the sound correctly leading to hearing loss. The decreased movement of the bone, the increase in the degree of hearing loss.

Incidence Of Otosclerosis

Otosclerosis is a condition of younger ages, the most common age group is 10-45 years of age. It appears more frequently in Caucasians of European descent than in those with other backgrounds.  White women are affected more often than men.                                                         

Causes Of Otosclerosis

Otosclerosis possibly is an outcome of both the environmental and genetic factors, even though the exact cause is not known.                                                              

• Environmental factors include viral infection such as measles, trauma or stress fractures to your middle ear, and abnormal responses of your immune system. Increased incidence of Otosclerosis has also been reported in pregnancy.
• Genetic factors include the involvement of genes in causing Otosclerosis as revealed by the research studies. The process of transmission of the gene causing Otosclerosis is complicated and everyone with the gene will not develop this condition. However, the condition has a strong tendency to run in families. This suggests that in case one of your parents had Otosclerosis then you have a 25% chance of inheriting the condition and with both parents having this condition, your incidence is 50%.

Symptoms of Otosclerosis

Hearing loss: Hearing loss usually begins in one ear and then moves to the other, unable to hear low-pitched sounds or can’t hear a whisper. The features of hearing the loss in Otosclerosis include:                                                                       

• Otosclerosis generally causes conductive hearing loss, which means there is an issue with how the middle ear ossicles: malleus, incus, stapes, conduct sound vibrations. The unusual bone growth from Otosclerosis may affect the inner ear causing disruption in the function of the nerve, leading to sensorineural hearing loss and balance issues. Thus, mixed hearing loss can also occur with Otosclerosis.
• The symptoms worsen with the passage of time since abnormal bone keeps adding on, leading to deterioration in condition. Generally, it is realized by most people that they have Otosclerosis when the abnormal bone reaches the stapes and they manifest the symptoms of hearing loss, called Clinical Otosclerosis by the physicians. On the contrary, they had Otosclerosis before without clinical symptoms which is known as Histological Otosclerosis.

Tinnitus: Ringing, roaring, buzzing, hissing sound or tinnitus in the ears develops as hearing loss progresses.

Dizziness and difficulties in balance might be encountered by you.

Diagnosis of Otosclerosis

You must be assessed by a health care professional who specializes in this field such as ENT specialist or otolaryngologist, to establish the diagnosis of Otosclerosis as the symptoms are shared by other medical conditions. Your symptoms and medical history will be reviewed thoroughly by the physician and several diagnostic tests will be used to assess hearing and conduction.

 Diagnostic tests

• Hearing assessment: The hearing test or audiometry in Otosclerosis shows that you have conductive hearing loss which is worse in low frequencies. In addition, you can have a sensorineural loss if inner hear is affected.                                                                    
• Assessment of sound conduction: Tympanogram measures sound conduction in the middle ear and assesses the movement of middle ear ossicles: malleus, incus, and stapes.
• Imaging tests: CT scan is used to detect the alternation of bony structure in otosclerosis.

Treatment of Otosclerosis

At present, no potent drug treatment for Otosclerosis is available. Bone remodeling research is ongoing to recognize likely new therapies. The available treatments include:

• Observation: Otosclerosis advances at different rates for different individuals depending on the bone remodeling which affects the degree of hearing loss. Your physician may recommend observation for some time to assess the rate of progression of the condition.
• Hearing aid: Hearing aids are used to amplify sound in mild Otosclerosis. You can use hearing aids to make up for the hearing loss and program them to your particular hearing needs. In addition to hearing aids, supplemental assistive devices are available which can assist you to hear better.
• Surgery: Stapedectomy is the surgery in which the abnormal bone is removed and a prosthetic device is inserted into the middle ear which permits sound waves to be conducted to the inner ear and restore hearing.                                                                                                                                                                    

You must not underestimate your symptoms of hearing loss and take appropriate action to reach an accurate diagnosis. Once a management plan has been decided by your physician, our team of experts can guide you on the usefulness and appropriateness of the hearing aids and devices.  We can coordinate with you to find a hearing device best suited to your needs.