Otosclerosis

What is Otosclerosis?

Otosclerosis is a condition where extra bone grows in the middle ear, making it harder for sound to travel to the inner ear. Over time, this can lead to hearing loss.

It often affects the tiny bone called the stapes, which normally moves freely to help transmit sound. When this bone becomes fixed in place, sound cannot get through to the inner ear as well.

  • Otosclerosis usually starts between ages 15 and 45.

  • It’ is slightly more common in women and sometimes runs in families.

  • Pregnancy can sometimes make the condition progress faster.

What are the Symptoms?

People with otosclerosis might notice:

  • Gradually worsening hearing loss

  • Tinnitus (ringing or buzzing in the ears)

  • Hearing better in noisy places (called paracusis Willisii)

  • Occasional dizziness (rare)

Most people do not have ear pain, and the eardrum usually looks normal on examination.

How is Otosclerosis Diagnosed?

Your doctor or an Ear, Nose, and Throat (ENT) specialist may:

  • Ask about your hearing and any family history.

  • Perform hearing tests (audiometry) to check how well you hear sounds at different pitches.

  • Do simple tuning fork tests to compare hearing in each ear.

  • Often order a CT scan to look at the bones in the ear and exclude other causes for this type of hearing loss.

How is Otosclerosis Treated?

Treatment depends on how much your hearing is affected and your personal preferences. Options include:

1. No Immediate Treatment

  • If your hearing loss is mild and not bothersome, we recommend monitoring your hearing over time.

2. Hearing Aids

  • Many patients manage well with hearing aids that amplify sound.

  • A good option if you prefer not to have surgery or if surgery is not suitable for you.

3. Surgery

If hearing loss is significant or worsening, surgery can be very effective. The most common operation is called a stapedotomy.

  • Part of the stapes bone is carefully opened, and a tiny prosthesis replaces its function.

  • This allows sound to travel properly into the inner ear again.

  • About 90% of people notice significant improvement in hearing after surgery.

Possible risks of surgery include:

  • Changes in taste

  • Dizziness for a short time

  • Ringing in the ears (tinnitus)

  • Rarely, worsening hearing (less than 1%)

Can Otosclerosis Affect the Inner Ear?

In some people, the bone growth can extend  into the inner ear (cochlear otosclerosis), causing sensorineural hearing loss (hearing loss related to the inner ear or nerves).

  • Hearing aids are often helpful.

  • In severe cases, a cochlear implant may be considered.

When Should You Seek Help?

See your doctor if:

  • You notice gradual hearing loss

  • You have persistent ringing in your ears

  • Your hearing loss affects your daily life

Early diagnosis and treatment can preserve your hearing and quality of life.

Key Points

Otosclerosis causes gradual hearing loss due to extra bone growth in the middle ear.
Many people manage well with hearing aids.
Surgery can successfully improve hearing in most cases.
Regular hearing checks help monitor the condition over time.