• Otosclerosis

    (Otospongiosis)

    Definition

    Otosclerosis occurs when abnormal new bone forms in the inner ear. This growth prevents proper functioning of other ear structures. This condition is a common cause of hearing loss.
    The Inner Ear
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    Causes

    The cause of otosclerosis is still unknown. However, otosclerosis tends to run in families, and may be hereditary. Otosclerosis has also been linked to hormonal changes, especially pregnancy, and viral infections.

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition. Risk factors for otosclerosis include:
    • Age: late teens through late 40s
    • Family history of otosclerosis
    • Sex: female
    • Race: Caucasian or Asian
    • Drinking nonfluoridated water: Some studies suggest that nonfluoridated water may cause a susceptible person to develop otosclerosis
    • Pregnancy: may accelerate symptoms

    Symptoms

    Gradual hearing loss is the main symptom of otosclerosis. Hearing loss may be of two types:
    • Conductive—involving the small bones of the inner ear
    • Sensorineural—involving the following structures:
      • Cochlea—the sensory organ in the inner ear
      • The major nerve pathway (8th cranial nerve) and/or area of the brain responsible for hearing
    Early in the disease, you may first notice trouble hearing low-pitched sounds or whispers. Other symptoms may include:
    • Dizziness
    • Balance problems
    • Tinnitus or sensation of ringing, roaring, or buzzing in the ear

    Diagnosis

    The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
    • Hearing tests by an audiologist
    • Computed tomography (CT) scan —a type of x-ray that uses a computer to make pictures of the inside of the ear and head
    • Examination of the middle ear at the time of surgery

    Treatment

    Treatments may include:

    Hearing Aid

    Hearing aids may be effective for conductive and sensorineural hearing loss.

    Surgery

    In many cases, a procedure called a stapedectomy may improve hearing. The purpose of this operation is to replace the diseased bone with an artificial device that can transmit sound waves to the inner ear. Stapedectomy is very effective and frequently returns hearing to a near normal level.

    Oral Treatment

    Fluoride tablets are sometimes prescribed to stabilize the condition and prevent further sensorineural hearing loss. However, this treatment remains controversial and unproven.

    Prevention

    Drinking fluoridated water may help prevent otosclerosis in people who are susceptible. There are no other known ways of preventing this condition.

    RESOURCES

    American Academy of Audiology http://www.audiology.org/

    American Academy of Otolaryngology–Head and Neck Surgery http://www.entnet.org/

    American Speech-Language-Hearing Association http://www.asha.org/

    CANADIAN RESOURCES

    Canadian Family Physician http://www.cfpc.ca/

    Canadian Society of Otolaryngology–Head and Neck Surgery http://www.entcanada.org/

    References

    Department of Otolaryngology-Head and Neck Surgery, Northwestern University Medical School website. Available at: http://www.oto-hns.northwestern.edu/ .

    National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health website. Available at: http://www.nidcd.nih.gov/ .

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