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Otosclerosis is an inherited condition that affects the middle ear. It's the most common cause of deafness in adults and normally begins in the teens or early twenties. It can be treated with a hearing aid or with surgery.

What is otosclerosis?

In people with otosclerosis, spongy bone forms in the middle ear. The tiny bones fuse, which prevents 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.

Otosclerosis symptoms

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.

Other symptoms of the condition include tinnitus (ringing in the ears) and dizziness.

If not treated, otosclerosis can start to affect the inner year, which can result in profound hearing loss.

Otosclerosis diagnosis

Otosclerosis is normally diagnosed by an ear 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.

Otosclerosis treatment

There are 2 treatments for otosclerosis: a hearing aid or surgery.

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 your ear, so they aren't obvious. They also don't 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 other option is to drill a small hole in part of the bone. This procedure is is known as stapedotomy.

The advantage of surgery is that it can make your hearing come back, and may stop the otosclerosis from progressing to the middle ear.

When to seek help

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.

It may help if you eat a diet containing a lot of calcium. Some women also find their hearing improves if they stop taking the contraceptive pill.

It is particulary important to protect your hearing from noise damage – for example, due to loud music or a noisy environment such as a building site.

More information

Find out more here about hearing loss prevention and the Australian Government's hearing services program.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: March 2019

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