What is Otosclerosis: Causes, Symptoms, and Treatment Options

Otosclerosis is a common but often misunderstood ear condition that can impact one’s hearing.In otosclerosis, one or more foci of irregularly laid spongy bone replace part of normally dense enchondral layer of bony otic capsule.In other words, Otosclerosis is a disease in which there is formation of new bone around the base of the stapes

What is Otosclerosis?

Otosclerosis is an abnormal bone growth in the middle ear that can cause hearing loss. This condition primarily affects the stapes bone, one of the three small bones in the middle ear responsible for transmitting sound vibrations to the inner ear.

Causes of Otosclerosis:

The exact cause of otosclerosis is not fully understood, but both genetic and environmental factors are believed to play a role.

Anatomical basis: in this hard bone there are areas of cartilage rests  which are sometimes activated to form a new spongy bone eg fissula ante fenestram causing stapedial type of otospongiosis.

•Heredity. About 50% of otosclerotics have positive family history

•Sex ; females 2x more than males

•Age of onset. Hearing loss usually starts between 20 and 30 years of age and is rare before 10 and after 40 years.

•Other factors; eg pregnancy, menopause, after an accident or a major operation.

•Viral infection

Symptoms of Otosclerosis:

Identifying the symptoms of otosclerosis is crucial for early diagnosis and effective management. Common symptoms include:

  1. Hearing Loss:Hearing loss; painless, progressive and mostly of bilateral conductive type
  2. Tinnitus: Ringing or buzzing in the affected ear.
  3. Vertigo: Some individuals may experience dizziness or a sensation of spinning.
  4. Paracusis Willisii
  5. Monotonous, well modulated soft speech

What is van der Hoevesyndrome?

The triad of symptoms of osteogenesis imperfecta, otosclerosis and blue sclera is called van der Hoeve syndrome.

Types of Otosclerosis:

1.Stapedial otosclerosis.

Causes stapes fixation and conductive deafness, involves region around oval window

2. Cochlear otosclerosis.

Cochlear otosclerosis involves region of round window or other areas in the otic capsule, and may cause sensorineural hearing loss probably due to liberation of toxic materials into the inner ear fluid.

3. Histologic otosclerosis.

Asymptomatic and causes neither conductive nor sensorineural hearing loss.


If you suspect otosclerosis, it is essential to consult with an ear specialist. Diagnosis often involves a combination of a thorough medical history, physical examination, and hearing tests.

1.Otoscopy: Normal tympanic membrane and eustachian tube.

2.Tuning fork tests show conductive deafness(negative Rinne, Weber test lateralized to the ear with greater conductive loss. )



5.History of hearing loss

Treatment Options:

1. Hearing Aids:

In the early stages, hearing aids may be sufficient to manage the symptoms of otosclerosis.

2. Stapedectomy:

A surgical procedure where the stapes bone is replaced with a prosthesis (prosthesis,teflon piston, stainless steel piston etc)to improve hearing.

3. Stapedotomy:

Similar to a stapedectomy but involves creating a small hole in the stapes footplate.

4. Medications:

In some cases, medications such as fluoride may be prescribed to slow down the progression of otosclerosis.

Lifestyle Tips for Managing Otosclerosis:

  1. Protect Your Ears: Avoid exposure to loud noises that can exacerbate hearing loss.
  2. Regular Check-ups: Schedule regular check-ups with an ear specialist to monitor the condition.
  3. Healthy Lifestyle: Adopt a healthy lifestyle that includes a balanced diet and regular exercise to support overall well-being.

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