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Otosclerosis is a middle ear disease that is diagnosed in almost 10% of test subjects due to hearing loss. Otosclerosis is a very dangerous disease as it can lead to complete deafness - usually bilateral. Fortunately, early diagnosis can save your hearing completely. What are the causes and symptoms of otosclerosis? What is its treatment?
Otosclerosis(otospongiosis) is adisease of the middle ear , specifically the ossicles, which particularly affects one of them - the stapes. The essence of otosclerosis is the excessive formation (growth) of bone tissue within the auditory ossicles and immobilization of its base, which impairs hearing. In order to hear correctly, the bones must be able to move in response to sound waves. The bones perceive and amplify vibrations coming from the eardrum and transfer them to the inner ear.
Otosclerosis - causes
The causes of otosclerosis are unknown. However, the risk factors are known. Ear otosclerosis appears most often in people aged 15-30. Women are sick twice as often as men. Particularly at risk of developing otosclerosis are those undergoing hormonal changes, especially during pregnancy (possibly due to increased estrogen levels).
Risk factors also include autoimmune disorders (when the immune system responds incorrectly) and measles infection.
The disease can also have a genetic background (runs in the family). The probability of inheriting a disease with clinical symptoms from a parent is approx. 20%.
Otosclerosis - symptoms
The main symptom of the disease is a gradual deterioration of hearing ( although in some cases it can be a rapid process), usually bilateral. Hearing loss is most often conductive (about 80% of cases). Then the patient hears worse in the range of low sounds. They hear speech better in noise than in silence (also calledparacusis ). Sensorineural hearing loss is less common. In such a case, patients most often hear high pitched sounds worse, e.g. knocking on the door is better heard than the sound of a bell. In addition, there are:
- tinnitus and (usually low-frequency) whistles that do not originate in the environmentexternal;
- dizziness;
- balance problems;
- quiet speech;
Otosclerosis - diagnosis
For the diagnosis of otosclerosis, the following is usually done:
- otoscopic examination (ear speculum) - it is a basic hearing test;
- so-called reed tests - allow to assess whether the hearing loss is conductive or sensing;
- tone audiometry (PTA) test shows the patient's hearing threshold for given audio frequencies;
- tympanometry - is a test that determines the efficiency of the movement of the bones inside the ear;
- computed tomography and magnetic resonance imaging (in some cases);
Otosclerosis - treatment
In order to improve hearing, a surgical procedure is usually performed -stapedectomy or stapedotomy.The procedures consist in partial (stapedotomy) or complete (stapedotomy) removal of immobile, fossilized fragments of the stapes and replacing them with a special prosthesis. Unfortunately, the procedure is not effective if the otosclerosis has already affected parts of the inner ear. Then only pharmacological treatment remains (including the administration of fluoride, which prevents the growth of the ossicles, and vascular drugs that improve the blood supply to the central nervous system and the external ear), but it is not very effective. That is why early detection of the disease is so important.
In the initial stage of otosclerosis, the patient may be offered a hearing aid. However, if it is not effective, hearing improvement can be achieved by implanting a cochlear implant.