Otosclerosis is an abnormal growth of the bone at the entrance of the inner ear, which prevents the movement of the base of the stapes (small bone that vibrates when the sound waves strike the eardrum). Because of this growth, very few sound waves (or none) will penetrate the inner ear, leading to partial or complete deafness in the ear. In 80% of people affected by this disease both ears are affected, either at the same time or one after the other.
If otosclerosis is not treated, it usually progresses toward complete deafness of both ears in the period of 10 to 15 years. In some cases (usually in children), the disease progresses rapidly. However, sometimes the condition calms before the complete deafness – e.g. the patient can still hear loud speech. Often, for reasons unknown, the noise of the environment is better heard.
With the progression of the disease, the perceptive deafness may occur. The symptom is a ringing in the ear (tinnitus), and the patient speaks louder to compensate for lack of hearing. Otosclerosis may worsen in pregnancy.
One person out of 250 suffers from otosclerosis annually; women suffer twice as much as men. The disease usually occurs between the ages of 20 and 40.
There is a danger of total deafness and inevitable social isolation of the patient. Since this disease usually develops only in adulthood, there is no danger of speech impairment.
What to do?
If you feel your hearing is getting worse or if you hear a ringing in your ears, contact a doctor who will look at your ears and examine your hearing. If he suspects you have otosclerosis, especially if you have a relative with this disease, he will refer you to special hearing tests.
If the patient is partially deaf on one ear, he usually gets a hearing aid. But, that’s just a helper, not a remedy. The usual procedure for stopping or treating otosclerosis is an operation called stapedectomy.
This operation improves the performance of the sound transmission by removing the stationary stapes. Stapedectomy significantly improves hearing in 90% of cases. But, in 2 to 5% of the cases, the operation ends with total deafness in the operative ear. Occasionally, hearing will not improve until a blood clot that remains in the middle ear after the operation is resorbed. Your doctor will consider the danger of deafness when evaluating the need for hearing improvement. For example, in patients with rapid onset of otosclerosis in both ears, urgent surgery is recommended to prevent complete deafness. Usually, the operation is performed on only one ear, because some hearing will still be preserved if the operation fails.
During the stapedectomy, an eardrum is perforated, stapes is removed and replaced with a tiny metal or plastic substitute. An eadrum heals by itself after one to two weeks. A patient, who usually feels dizzy after a surgery, leaves a hospital after one to two weeks, and he can start with normal daily work and activities after another two or three weeks.