Otosclerosis is a degenerative disease of the inner and middle ear. The transmission of sound from the eardrum to the inner ear is impeded by so-called bony changes in the petrous bone. The result is hearing loss, which can lead to deafness as the otosclerosis progresses.
What is otosclerosis?
A bony change in the petrous bone is referred to as otosclerosis . The three auditory ossicles malleus, anvil and stirrup are connected to the petrous bone via the inner ear. In front of this arrangement is the eardrum, which transmits sound via the auditory ossicles and the inner ear to the auditory nerve. See eshaoxing for Histoplasmosis Definition and Meaning.
In a healthy inner and middle ear, the auditory ossicles are flexibly connected to each other. In otosclerosis, the stapes become ossified as a result of inflammation-like and degenerative processes. This restricts the mobility of the stapes, whereupon the sound is no longer transmitted or only partially transmitted.
Hearing problems such as B. Tinnitus on. As the disease progresses, it leads to hearing loss and eventually deafness. Otosclerosis generally occurs in both ears at the same time and predominantly between the ages of 20 and 45.
Otosclerosis can have various causes, although a primary cause of ossification has not yet been clearly identified.
Since inflammatory diseases and viral infections often precede otosclerosis, measles, rubella and mumps can be possible triggers for the disease. Furthermore, so-called autoimmune processes can cause otosclerosis. The body’s own immune system reacts allergically to its own body and fights it.
There is also a hereditary component to otosclerosis. The disease occurs more frequently in families in which other family members are already ill. The associated gene has not yet been decoded, but studies show that children whose parents have otosclerosis are very likely to develop it too.
Another reason could be the hormonal balance. Since otosclerosis mainly affects women, hormonal influences could trigger the disease. Especially because pregnant women and women who take contraceptives (“ birth control pills ”) are more likely to develop otosclerosis.
Typical Symptoms & Signs
- deafness (deafness)
- Complaints similar to sudden hearing loss
Diagnosis & History
Otosclerosis is diagnosed by the ear, nose and throat doctor. However, the diagnosis is difficult, especially in the early stages of the disease. When the disease begins, there are no symptoms, and otosclerosis can go undetected for several years.
If otosclerosis is suspected, a hearing test is carried out at the beginning. Furthermore, the stapedius reflex – the function of the middle ear muscles – is checked. This test can be used to detect pathological changes. There is also a hearing test with a tuning fork. These examinations are used to determine how severe the hearing loss is already. Conductive hearing loss is usually diagnosed here.
A language test shows whether the person concerned understands spoken words worse than a healthy person. Imaging methods such as X-ray, CT, MRT and scintigraphy are also used to confirm the diagnosis. With these examination methods, inflammations as well as bony changes can be detected, so that the stage of otosclerosis can be determined.
The course of otosclerosis depends on several factors. The earlier otosclerosis is recognized and treated, the better the prognosis. If surgical treatment is carried out in good time, the hearing loss can be significantly improved. With treatment in the early stages, the hearing loss can e.g. T. even be completely eliminated. If the otosclerosis is not treated in time, the result is hearing loss, which can eventually lead to complete deafness.
Due to otosclerosis, those affected primarily suffer from problems in the ears. Sudden deafness occurs for no particular reason. In the worst case, the person concerned can become completely deaf if no therapy is initiated. Especially in young people, hearing loss can lead to severe psychological problems or depression and thus significantly reduce the quality of life.
Furthermore, it is not uncommon for tinnitus or other noises in the ears to occur, which significantly reduce the quality of life. This can further lead to trouble sleeping, which can result in general irritability and dissatisfaction for the sufferer. However, the further course of otosclerosis depends heavily on its severity and the time of diagnosis.
In many cases, otosclerosis can be treated completely without any particular complications. Hearing aids can also be used to reduce the symptoms of hearing loss. The treatment itself is carried out by means of a surgical procedure and does not lead to further complaints. The patient’s life expectancy is also not affected or reduced by the disease.
When should you go to the doctor?
Decreased hearing is a concern. A doctor’s visit is necessary as soon as certain frequencies in the environment can no longer be heard or there is a general impairment of hearing. If the person concerned finds that he can no longer hear noises as usual in everyday life or that he can hear less in direct comparison to his fellow human beings, a doctor should be consulted. In general, a check-up is recommended at regular intervals over the course of life in order to be able to adequately assess the hearing quality and to be able to react immediately to changes. If there is one-sided hearing or the development of ringing in the ears, it is advisable to consult a doctor.
In the event of an increase in symptoms or deafness, medical care must take place as quickly as possible. Otherwise there is a risk of lifelong deafness. Changes in behavior, an increased risk of accidents or injuries, and irritability also indicate an irregularity. A visit to the doctor is advisable as soon as withdrawal behavior or an aggressive appearance occurs. A ringing in the ears, ringing in the ears or insomnia and headaches should be examined and treated. If the symptoms occur suddenly and unexpectedly, a doctor must be consulted immediately. It is an acute, although not life-threatening, condition that requires medical attention as soon as possible.
Treatment & Therapy
There is currently no drug treatment for otosclerosis. If surgery cannot be performed, a hearing aid can improve hearing. However, if the disease has progressed so far that deafness is present, hearing aids can only help to a limited extent or not at all.
Otosclerosis is treated with surgery. A distinction is made between two interventions, stapedectomy and stapedotomy. During a stapedectomy, the stapes and the adjacent portion of the stapes footplate are removed. The auditory ossicles are then replaced with a stapes plastic (also known as a prosthesis). The Stapesplasty takes over the function of the stapes and transmits the vibrations of the sound. Stapedectomy is usually performed under local anesthesia (local anesthetic). The doctor can already check during the operation whether there are any hearing changes.
Stapedotomy does not remove the entire stapes, only the stapes. This involves drilling a small hole in the stapes footplate and inserting a small prosthesis, which is then attached to the incus. This prosthesis (made of platinum Teflon) transmits the vibrations of the sound and thus improves the hearing ability of the person concerned.
Outlook & Forecast
The further course and the prospects for recovery of patients affected by otosclerosis depend primarily on the time and type of treatment. In general, there is a chance of at least partial regeneration of the hearing abilities. Initially, the hearing ability continues to decline despite medical countermeasures or stagnates at the level already diagnosed. Without appropriate therapy, the risk of significantly reduced acoustic perception is considered very high. The result is long-term hearing loss and, in severe cases, deafness.
Early surgical intervention significantly increases the probability of recovery. About 90 percent of patients achieve noticeable or complete relief of symptoms. Dizziness is a common complication after surgery. These impairments usually only last a few days. Sometimes dizziness can last for a long time. Rarely does the intervention remain unsuccessful and lead to a further deterioration of hearing.
Familial clusters of otosclerosis can serve as warning signals. However, a preventive examination is also advisable in the case of frequent occurrences of tinnitus or inexplicable hearing impairments. An ear, nose and throat specialist can identify changes in the auditory canal at an early stage and thus increase the chance of a complete elimination of the symptoms. Difficult courses can be avoided by thorough control.
There are currently no preventive measures to prevent otosclerosis. If there is a family disposition, an ENT doctor should be consulted regularly to have the sound transmission of the hearing examined.
If ringing in the ears such as buzzing, buzzing, etc. occurs frequently, you should see a doctor for a thorough examination. If tinnitus has already been diagnosed, regular check-ups should be carried out so that any otosclerosis can be recognized and treated in good time.
After surgery, pain and complications should be avoided. After the operation, an initial hearing test is carried out. In addition, wound care and wound healing are in the foreground. Antibiotics are given to prevent possible infection. The sutures and the tamponade are removed as part of the follow-up treatment to the operation. Follow-up care is carried out by an ENT doctor.
Getting used to a hearing aid takes time. Using the hearing aid not only amplifies voices, but also sounds and noise in the background. Spatial hearing is no longer possible. Whenever possible, hearing aids should be fitted and used. Close contact persons are to be included in the help for self-help.
The social environment of the patient must be informed about this change in health. You should be shown the best possible ways of communicating with the patient. Follow-up care is also provided by a hearing care professional. He checks the technical functionality and the fit.
If the patient suffers from the hearing impairment, an accompanying psychotherapeutic treatment can reduce the suffering and positively influence the acceptance of the impairment. In addition, patients can exchange information about coping with everyday life and problems with other people with otosclerosis in a self-help group.
You can do that yourself
People suffering from otosclerosis can support medical therapy with various measures. It is important to check the symptoms regularly. The patient can create a complaints diary and note, for example, hearing ability or pain in the ear area. In addition, the follow-up checks suggested by the doctor should also be used, because otosclerosis can progress relatively quickly.
Hearing can be improved with hearing aids and other aids. If the hearing ability continues to deteriorate despite all measures, the doctor must be informed. Patients who suffer greatly from osteosclerosis are best advised to speak to a therapist. While the condition is not life-threatening, deafness, dizziness, and other symptoms can significantly impact quality of life. Close monitoring of symptoms and regular adjustment of medication are all the more important.
Finally, possible triggers for inner ear disease must be found. Talking to the doctor can determine when the hearing problems first appeared and in which situations they become more severe. It is often sufficient to adjust one’s lifestyle or correct the hormonal balance with medication.