What Is Otosclerosis?
Otosclerosis (Middle Ear Calcification) is one of the common causes of hearing loss. Otosclerosis, which is a genetically inherited disease, may also appear after skipping several generations.
The first stage of hearing is that sound waves travel through the external ear canal, reach the eardrum, and cause it to vibrate. These vibrations are transmitted to the inner ear fluids through the tiny bones in the middle ear called the malleus, incus, and stapes. Here, the sound waves are converted into electrical energy by the nerve endings and transmitted through the auditory nerve to the hearing centers in the brain, enabling hearing.
Problems that occur during the transmission of sound waves through the outer and middle ear to the inner ear fluids cause “conductive hearing loss.” In this type of hearing loss, the hearing organs in the inner ear are intact, but sound waves cannot reach these organs. Hearing loss originating from the inner ear and auditory nerve is called “sensorineural hearing loss.” Otosclerosis (middle ear calcification), which may also affect the inner ear, generally presents with both types of hearing loss together. This type of hearing loss is referred to as “mixed hearing loss.”
HEARING LOSS CAUSED BY OTOSCLEROSIS:
In otosclerosis, new spongy bone formations develop in the form of foci within the bone structure that houses the hearing organs of the inner ear. When these changes affect the hearing organs of the inner ear, sensorineural hearing loss called “cochlear otosclerosis” occurs. The most common site of the disease is the area called the oval window, where the base of the stapes bone that transmits sound wave vibrations to the inner ear is located. The otosclerotic focus in this area prevents the vibration of the stapes bone, disrupting the transmission of sound waves to the inner ear and resulting in conductive hearing loss.
The type and degree of hearing loss caused by otosclerosis vary depending on the extent of involvement (restriction of movement) of the stapes bone and the degree to which the hearing organs in the inner ear are affected by the disease.
OTOSCLEROSIS TREATMENT:
Medical Treatment:
Some treatments are used to slow the progression of hearing loss, especially in rapidly progressing cases diagnosed at a young age. However, there is no medical treatment for otosclerosis.
Surgical Treatment:
In the “stapedectomy” procedure, the immobilized stapes bone is removed and replaced with a prosthesis that transmits sound waves to the inner ear. This surgery, which can be performed under local or general anesthesia, provides highly successful results in 90–95% of cases, and conductive hearing loss can be almost completely corrected in the vast majority of patients. Surgery is not recommended for patients with very mild conductive hearing loss or those with advanced sensorineural hearing loss in whom the hearing organs of the inner ear are severely affected. Except for these cases, stapedectomy is recommended for all patients with otosclerosis unless there is a serious health problem preventing surgery. Dizziness may occur for a few days after surgery. The surgical sponges placed inside the ear at the end of the operation are removed within 7–10 days, and patients can return to their normal lives at the end of this period.
Although the risks of stapedectomy performed with appropriate surgical equipment and techniques are very low, there is approximately a 1% risk of hearing loss, as with any surgery. In addition, much rarer complications such as perforation of the eardrum, facial nerve injury, ear infection, and early displacement of the piston prosthesis may occur.
Hearing Aids:
Every patient who is suitable for surgery can also benefit from a hearing aid. Especially patients with bilateral otosclerosis who do not prefer surgery are advised to use hearing aids in order to prevent inner ear function from deteriorating in parallel with worsening hearing.
Frequently Asked Questions
What Is Otosclerosis (Middle Ear Calcification)?
Otosclerosis is an ear disease that occurs when the stapes bone in the middle ear loses its mobility due to abnormal bone formation, which can lead to hearing loss.
What Are the Symptoms of Otosclerosis?
The most common symptoms include progressive hearing loss, tinnitus, and balance problems in some patients. Symptoms usually develop gradually over time.
What Causes Otosclerosis?
Although the exact cause is unknown, genetic predisposition, hormonal changes, and certain viral infections are thought to play a role in the development of otosclerosis.
How Is Otosclerosis Diagnosed?
Diagnosis is made through an Ear, Nose, and Throat examination, hearing tests (audiometry), tympanometry, and imaging methods when necessary.
How Is Otosclerosis (Middle Ear Calcification) Treated?
Treatment is planned according to the degree of hearing loss and the patient’s overall condition. Hearing aids, surgical treatment (stapedotomy or stapedectomy), and follow-up may be considered in appropriate cases.
Is Otosclerosis Surgery Successful?
Stapedotomy or stapedectomy procedures performed by experienced surgeons are treatments with high success rates that provide significant improvement in hearing for many patients.
Are Hearing Aids Effective in the Treatment of Otosclerosis?
Yes, in patients who are not suitable for surgery or who prefer not to undergo surgery, hearing aids can significantly improve quality of life by enhancing hearing performance.
Can Otosclerosis Affect Both Ears?
Yes, otosclerosis may affect both ears in some patients. However, the severity of symptoms may differ between the two ears.
Can Otosclerosis Cause Permanent Hearing Loss?
If left untreated, hearing loss may progress over time. With early diagnosis and appropriate treatment, the effects of hearing loss can be greatly reduced.
When Should You See a Doctor for Otosclerosis?
If progressive hearing loss, tinnitus, or other hearing-related complaints are noticed, it is recommended to consult an Ear, Nose, and Throat (ENT) specialist without delay.
