What is otosclerosis?

Otosclerosis is a health condition that affects a tiny bone inside your ear. It usually starts slowly and gets worse over time. It often begins in early adulthood and is more common in females. In some females, it may get worse during pregnancy. Otosclerosis is the most common cause of middle ear hearing loss in adults.

What are the symptoms of otosclerosis?

Symptoms may develop slowly. You may not notice the early signs right away. Common symptoms include:

• hearing loss that gets worse over time, especially for lower-pitched sounds, such as deep voices
• tinnitus— ringing in your ears
• dizziness and balance problems

What causes otosclerosis?

Otosclerosis happens when the bone in your middle ear is slowly replaced by soft, spongy bone with more blood vessels. This then hardens over time, making it harder for sounds to travel through your ear.

The exact cause is not known but several things may contribute:

• genetics — many people with otosclerosis have a close relative who also has it
• hormones — changes in hormones, for example during pregnancy, might make it worse
• infections — some viruses might be linked to otosclerosis
• inflammation — inflammation inside the ear may also be involved
• autoimmunity — when your immune system attacks healthy cells and tissues

When should I see my doctor?

See your doctor if you are concerned or notice hearing changes. You can also ask your doctor for a referral to an audiologist for a hearing test.

How is otosclerosis diagnosed?

An audiologist will do a hearing test called an audiogram to see what type of hearing loss you have. Your doctor may also refer you to an ear, nose and throat (ENT) specialist for more tests.

Other tests may include:

• tympanometry — to check how well your eardrum moves
• otoscopic exam — your doctor will look inside your ear
• CT scan — to see bone changes in the ear and help with your treatment plan

How is otosclerosis treated?

There are different ways to manage otosclerosis. Treatment depends on how much hearing loss you have and what type it is. Treatment options include:

• hearing aids — make sounds louder and can be adjusted to suit the type of hearing loss you have
• cochlear implants — may be used when hearing aids don't help enough
• surgery — such as stapedectomy may help improve hearing loss by fixing how sound moves through your middle ear
• medicines — some medicines may help slow down the bone changes in your ear

Living with otosclerosis

Living with otosclerosis can affect your daily life but there are ways to manage it. Treatment can help improve your hearing.

Otosclerosis slowly gets worse over time, so it's important to have regular hearing check-ups. An audiologist can guide you and adjust your hearing support as needed.

What are the complications of otosclerosis?

Otosclerosis can cause hearing loss to get worse over time. For some people, the hearing loss becomes serious or affects both ears. It can also cause mixed hearing loss, which means both the middle and inner ear are affected. This type of hearing loss is harder to treat.

Without treatment or support, hearing problems may affect your social life, work and emotional wellbeing. Regular follow-up and early treatment can help prevent or reduce these issues.

Can otosclerosis be prevented?

There is currently no known way to prevent otosclerosis. Early diagnosis and treatment can help manage hearing loss and may stop it from getting worse.

Resources and support

• Expression Australia has a fact sheet on otosclerosis.
• The Australian Government Hearing Services Program provides subsidised hearing services for eligible people.
• The National Disability Insurance Agency offers information about accessing the National Disability Insurance Scheme.
• You can also access a guide to hearing technology through the Department of Health and Aged Care website.
• The National Relay Service allows people with hearing loss or deafness to make free phone calls 24 hours a day. These include calls using the internet, SMS and video.
• Hearing Australia offers information on hearing loss in adults and children, hearing technologies and online tests.

Pregnancy, Birth and Baby has information on hearing loss in children.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Languages other than English

Hearing Australia offers information and hearing services - click the toggle in the bottom left corner to access other community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

The National Acoustic Laboratories offers a program called Plum and Hats for Aboriginal and/or Torres Strait Islander children with ear and hearing trouble.