An inner ear with a focus on the ossicles and the stapes

What Is Otosclerosis and How Is It Treated?

Otosclerosis is a condition that affects the middle ear, specifically the tiny bones known as the ossicles. This condition can cause hearing loss as it interrupts the ability of sound waves to travel from the outer ear to the inner ear. This article will explore the definition, causes, symptoms, diagnosis, and treatment options for otosclerosis.

Understanding Otosclerosis

Definition and Causes

Otosclerosis is a condition that affects the hearing ability of an individual. It is caused by the abnormal growth of bone tissue in the middle ear. This growth can cause the ossicles to become fixed and unable to move freely, resulting in hearing loss. The condition is typically caused by an abnormal response to bone remodeling in the body and can be hereditary.

There are two types of otosclerosis: fenestral and retrofenestral. Fenestral otosclerosis affects the stapes bone and the surrounding structures, while retrofenestral otosclerosis affects the bone surrounding the cochlea, the organ responsible for hearing.

Prevalence and Risk Factors

Otosclerosis affects approximately 10% of the population worldwide. This condition is more common in women than in men and usually develops in individuals between the ages of 15 and 45. There are certain risk factors for otosclerosis, including genetics, pregnancy, hormonal imbalances, and a history of measles.

Studies have shown that individuals with a family history of otosclerosis are more likely to develop the condition. Additionally, pregnancy and hormonal imbalances can increase the risk of developing otosclerosis due to the changes in hormone levels that occur during these times.

The Anatomy of the Ear and Otosclerosis

The human ear is a complex organ responsible for hearing and maintaining balance. It is divided into three parts: the outer ear, the middle ear, and the inner ear. The middle ear contains the ossicles, which are the smallest bones in the human body. The ossicles are responsible for transmitting sound waves from the eardrum to the inner ear.

When otosclerosis occurs, the stapes bone, one of the three ossicles in the middle ear, becomes fixed and unable to move freely. This results in a reduction in the transmission of sound waves to the inner ear, leading to hearing loss.

It is important to note that otosclerosis can also affect the inner ear, leading to a condition known as cochlear otosclerosis. This can result in a more severe form of hearing loss and may require surgical intervention.

Treatment and Management

There are several treatment options available for individuals with otosclerosis, depending on the severity of the condition. In mild cases, hearing aids may be sufficient to improve hearing ability. In more severe cases, surgical intervention may be necessary.

The most common surgical procedure for otosclerosis is a stapedectomy, which involves the removal of the stapes bone and replacement with a prosthesis. This procedure has a high success rate and can significantly improve hearing ability.

It is important for individuals with otosclerosis to have regular hearing evaluations and to manage any associated symptoms, such as tinnitus or vertigo. Additionally, individuals with otosclerosis should avoid exposure to loud noises and take steps to protect their hearing.

Symptoms and Diagnosis

Common Symptoms

Otosclerosis is a condition that affects the bones of the middle ear, leading to hearing loss. It is a common cause of hearing loss in young adults and middle-aged individuals. The most common symptom of otosclerosis is hearing loss, which can occur gradually or suddenly. Individuals with otosclerosis may notice that they have difficulty hearing low-pitched sounds or that they need to turn up the volume on the television or radio. In some cases, individuals may also experience tinnitus, which is a ringing or buzzing sound in the ear. Some individuals may also experience dizziness or vertigo.

How Otosclerosis Progresses

Otosclerosis typically progresses slowly over time. The rate of progression may vary from person to person and may be influenced by various factors such as genetics and hormonal changes. Individuals with otosclerosis may experience intermittent periods of hearing loss followed by periods of normal hearing. As the condition progresses, the hearing loss may become more severe and may eventually become permanent. In some cases, otosclerosis may also affect both ears.

Diagnostic Tests and Procedures

If you suspect that you have otosclerosis, you should visit your doctor or an audiologist. A diagnosis of otosclerosis is typically made through a combination of a physical examination of the ear, a hearing test, and imaging studies such as a CT scan or an MRI. During the physical examination, the doctor or audiologist will look for signs of damage to the middle ear, such as a decrease in the movement of the eardrum. The hearing test will evaluate your ability to hear sounds at different pitches and volumes. Imaging studies such as a CT scan or an MRI may be used to get a more detailed look at the structures of the ear and to help confirm the diagnosis of otosclerosis.

It is important to note that hearing loss can have many different causes, and not all hearing loss is due to otosclerosis. Other conditions that can cause hearing loss include exposure to loud noises, infections, and aging. Your doctor or audiologist will work with you to determine the underlying cause of your hearing loss and to develop an appropriate treatment plan.

Treatment Options

Otosclerosis is a condition that affects the middle ear and can cause hearing loss. There are a variety of treatment options available for individuals with otosclerosis, including both non-surgical and surgical options.

Non-Surgical Treatments

Non-surgical treatments are often recommended for individuals with mild to moderate hearing loss. These treatments can include hearing aids and medications.

Hearing Aids

Hearing aids are a common non-surgical treatment option for individuals with otosclerosis. These devices work by amplifying sounds and can be particularly effective for individuals with mild to moderate hearing loss. Hearing aids come in a variety of styles and can be customized to fit your specific needs.


There are several medications that are used to treat otosclerosis, including fluoride supplements. However, these treatments are typically not effective for all individuals and are not recommended for everyone. Your doctor will determine if medications are a viable treatment option for you.

Surgical Treatments

If non-surgical treatments are not effective or if you have severe hearing loss, your doctor may recommend surgical treatments for otosclerosis. These procedures can include a stapedectomy or stapedotomy.


A stapedectomy is a surgical procedure that involves removing the stapes bone and replacing it with a prosthetic stapes. This procedure is highly effective and can improve hearing in up to 90% of individuals with otosclerosis. The procedure is typically done under local anesthesia and can take up to two hours.


A stapedotomy is a less invasive surgical procedure that involves making a small hole in the stapes bone and inserting a prosthesis. This procedure is typically recommended for individuals with less advanced cases of otosclerosis and can improve hearing in up to 80% of individuals. The procedure is also done under local anesthesia and typically takes less time than a stapedectomy.

Risks and Benefits of Surgery

Surgery for otosclerosis is typically safe and effective. However, there are some risks associated with these procedures, including infection, hearing loss, and damage to the facial nerve. Your doctor will discuss the risks and benefits of these procedures with you before making any recommendations. It’s important to note that while surgery can improve hearing, it may not restore it completely.

In conclusion, otosclerosis is a condition that can cause hearing loss and other symptoms. Fortunately, there are effective treatments available, both surgical and non-surgical. If you suspect you may have otosclerosis, it’s important to visit your doctor or an audiologist for a proper diagnosis and treatment plan. They can help you determine the best course of action to improve your hearing and overall quality of life.