What is otosclerosis?
Otosclerosis is an inherited condition that affects the middle ear and causes gradual hearing loss. It is the most common cause of hearing loss in adults and affects about 1 in 200 people.
Otosclerosis normally begins in the teens or early twenties. Spongy bone forms in the middle ear. The tiny bones fuse, preventing sound vibrations from passing through to the inner ear.
The condition can develop in just one or in both ears. It tends to run in families, affects women more than men, and often comes on during pregnancy.
What are the symptoms of otosclerosis?
Otosclerosis causes hearing loss that gradually gets worse over time. But it very rarely causes total deafness.
People with otosclerosis find it particularly hard to hear low, deep sounds. In contrast to other causes of hearing loss, it can be easier for them to hear when there is background noise.
If not treated, otosclerosis can start to affect the inner ear, which can result in profound hearing loss.
How is otosclerosis diagnosed?
Otosclerosis is normally diagnosed by an ear, nose and throat specialist. They will do a series of tests to see what type of hearing loss you have. These may include hearing tests with tuning forks; audiometric tests to find out which tones you can hear; and tests to measure how the bones inside your ear are moving.
How is otosclerosis treated?
Either a bone-conduction hearing aid or a bone anchored hearing device can be used to help you hear. These hearing aids are small enough to fit inside the ear, so they are not obvious. They do not carry the risks of surgery.
Surgery can involve removing the tiny bones of the middle ear and replacing them with an implant. This procedure is called a stapedectomy.
The advantage of surgery is that it can make your hearing come back, and may stop the otosclerosis from progressing to the inner ear. The disadvantage is that surgery may not work, and the hearing loss may return in time.
When should I see my doctor?
As with any surgery, there is a small risk of complications. Tell your surgeon straight away if:
- your hearing gets worse after surgery
- your sense of taste changes
- you develop tinnitus or it gets worse
- you develop vertigo
- you develop facial weakness
Living with otosclerosis
It is normally OK to swim, go diving and travel by air if you have otosclerosis, but be careful if you have a middle ear infection. Ask your doctor for advice on what physical activities are safe for you.
If you have otosclerosis, it is particularly important to protect your hearing from noise damage, for example, due to loud music or a noisy environment such as a building site.
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Last reviewed: April 2021