This condition impairs the transmission of sound from the eardrum to the inner ear, causing it to become stiff and immobile. Otosclerosis is a condition that affects the middle ear bones. Otosclerosis usually affects both ears, but one ear may be worse than the other. Otosclerosis is more common in women than in men, and it is a family disease. Hearing loss caused by otosclerosis can be treated with medications, surgery, or hearing aids. Otosclerosis can also be prevented by avoiding loud noises, infections, and toxins that can damage the ear bones.
Causes
Otosclerosis is unknown in its exact cause, but it is believed to be caused by abnormal bone growth or remodeling in the middle ear. In otosclerosis, new bone tissue grows faster than old bone tissue, resulting in the formation of excess or abnormal bone. Bone remodeling is the process of replacing old bone tissue with new bone tissue. An excess or abnormal bone can interfere with the movement of the three tiny bones in the middle ear, called the ossicles, which transmit sound vibrations to the inner ear.
Otosclerosis may be caused by a number of factors, including:
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Family history: Otosclerosis is often inherited as an autosomal dominant trait, which means only one copy of a faulty gene is needed to develop it. Nevertheless, not everyone who inherits the gene will develop otosclerosis, and the severity of the condition varies from person to person.
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In women, otosclerosis is more common than in men, and hormone changes, such as pregnancy, menopause, or oral contraceptive use, may influence the condition. Studies indicate that estrogen may stimulate abnormal bone growth in the ear.
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As a result of infection of the ear, nose, or throat, such as measles, mumps, or otitis media, otosclerosis may develop or worsen.
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The immune system or bone metabolism can be affected by certain toxins, such as fluoride, lead, or mercury, which may cause or aggravate otosclerosis.
Symptoms
Otosclerosis causes hearing loss, which may be mild, moderate, or severe, and may affect either or both ears. There is a possibility that the hearing loss will occur gradually or suddenly, and it may be worse in low-frequency sounds, such as deep voices or bass music, and in noisy environments like crowded places or parties.
Otosclerosis can also cause the following symptoms:
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A ringing, buzzing, or hissing sound in the ear, which may be constant or intermittent, and whose pitch or volume may vary.
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When you change positions or move your head, you may experience dizziness, which is a feeling of spinning, swaying, or losing balance.
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Altitude or weather changes can worsen ear fullness, which is a feeling of pressure or discomfort in the ear.
Diagnosis
A medical history, a physical examination, and hearing tests are used to diagnose otosclerosis. In addition to asking about the symptoms, the onset and duration of the symptoms, the medical history, and the family history of the patient, the doctor will also perform a physical examination which includes:
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Examining the ear for signs of infection, inflammation, or wax buildup.
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Checking the ear for tenderness or swelling by palpation.
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Hearing and balance tests are performed on the patient.
Some hearing tests may also be ordered by the doctor, including:
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By presenting different sounds at different frequencies and volumes, and asking the patient to indicate when they hear them, audiometry measures hearing ability.
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The procedure of tympanometry involves inserting a small device into the ear canal and changing the air pressure inside to measure the movement of the eardrum and pressure in the middle ear.
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During the acoustic reflex test, a small muscle in the middle ear called the stapedius is measured, which stiffens the ossicles and reduces sound transmission.
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A bone conduction test measures the patient's hearing ability by placing a vibrating device behind the ear and bypassing the middle ear.
A hearing test can determine the type, degree, and cause of the hearing loss, as well as rule out other conditions that may affect hearing such as earwax, infection, or tumors.
Treatment
Treatment for otosclerosis depends on the severity and type of hearing loss, as well as the patient's overall health and preferences. The main goal of treatment is to improve the patient's hearing and quality of life.
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Medications include:
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The mineral sodium fluoride can slow down or stop the abnormal bone growth in the ear, preventing further hearing loss. It may also reduce the symptoms of tinnitus and dizziness.
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Inhibitors of bone resorption, bisphosphonates may reduce bone growth and hearing loss similarly to sodium fluoride.
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In women with otosclerosis related to hormonal changes, such as pregnancy or menopause, hormone therapy may involve taking estrogen or progesterone or using an intrauterine device (IUD) that produces hormones.
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An anti-inflammatory drug called steroids may reduce swelling and inflammation of the ear tissues and improve symptoms and hearing.
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It involves removing or replacing the affected middle ear bone and restoring sound transmission to the inner ear.
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One of the most common surgeries for otosclerosis is a stapesectomy, which involves removing the stapes bone, the most affected bone in the middle ear, and replacing it with a small prosthesis that vibrates and transmits sound to the inner ear.
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Stapedotomy, which is a variation of stapedectomy, involves making a small hole in the stapes bone and inserting a piston-like prosthesis that vibrates and transmits sound.
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A laser beam is used to vaporize or cut the stapes bone and insert a prosthesis, with less bleeding and trauma to the ear.
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In addition to improving the patient's hearing and communication, hearing aids are devices that amplify sound and deliver it to the ear. Depending on the type and degree of hearing loss, as well as the patient's preference, hearing aids can be worn behind the ear, in the ear, or in the canal.
Prevention
Some measures can be taken to reduce the risk or progression of otosclerosis, such as:
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Avoid loud noises, which can damage ear cells and worsen otosclerosis.
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Infections of the ear, nose, or throat, which can cause inflammation or scarring, can affect bone remodeling.
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Otosclerosis is caused by toxins, such as tobacco smoke, alcohol, or drugs, which can affect the blood circulation, immune system, or bone metabolism.
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Getting regular check-ups and hearing tests, especially if you have a family history of otosclerosis, and reporting any changes or symptoms to your physician.
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For bone health and growth, a balanced diet rich in calcium and vitamin D is essential.
