Otosclerosis or otosclerosis


What is it about ?

The human ear is made up of the external auditory canal, the middle ear, and the inner ear. The eardrum is located between the ear canal and the middle ear, and the oval window between the middle ear and the inner ear. The middle ear is therefore a closed chamber with inside the ossicles (hammer, anvil and stirrup) which serve to transmit sound vibrations from the external auditory canal to the inner ear. In the inner ear, we find the vestibular organ, the cochlea which picks up sound and the auditory nerve which transmits sound to the brain.

Otosclerosis, or otosclerosis, is an abnormal ossification of the middle ear and / or cochlea that causes hearing loss. The caliper can then anchor itself in the oval window so that the sound vibrations are not transmitted as well. The ossification can also extend into the cochlea, so that sounds are less well received.

It is not known what causes otosclerosis. The presence of a hereditary factor is observed about half of the time.

Where and how often?

Symptomatic otosclerosis affects 3 in 1,000 people. Symptomatic otosclerosis affects 1 in 10 people. Otosclerosis usually begins around the age of 30 or 40 years. It is twice as common in women as in men.

Genetic factors influence the risk of developing the disease. About half the time an inherited cause is obvious. A sister or daughter of a person with otosclerosis has a 2 in 10 chance of developing the disease; a brother or a son has a 1 in 10 chance.

How to recognize it?

The main symptom is a gradual decrease in hearing, which usually begins on one side and only affects the other ear after sometimes several years. The person turns their good ear to the conversation so that they can follow what is being said. In extreme cases, complete deafness is observed.

Ringing in the ears (tinnitus) and dizziness can be symptoms of otosclerosis.

How is the diagnosis made?

The doctor will refer you to the otolaryngologist (ENT). Since the abnormalities are located behind the eardrum, it is not possible to diagnose them by ordinary inspection of the ear. This is why it is sometimes necessary to perform a hearing test, a balance exam and sometimes a CT scan.

What can your doctor do?

It is not possible to treat otosclerosis with medication. Surgery usually gives excellent results. It consists of removing the ankylosed stirrup and replacing it with a prosthesis.

If surgery or a conventional hearing aid is not sufficient, it is sometimes possible to have an acoustic hearing aid implanted. A cochlear implant can be placed in case of damage to the cochlea. It works through electrical stimulation of the auditory nerve.

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Source

Foreign clinical practice guide ‘Otosclerosis (or otosclerosis)’ (2000), updated on 06.09.2017 and adapted to the Belgian context on 08.01.2020 – ebpracticenet