At Stanford Health Care, our world renowned ear care professionals specialize in diagnosing and treating otosclerosis. We provide personalized treatments to ease your symptoms and restore your hearing.
What is otosclerosis?
The term “otosclerosis” means abnormal hardening of body tissue (“sclerosis”) in the ear (“oto”). Otosclerosis begins in the otic capsule, which is the strong bone that surrounds your inner ear.
In the early stages of the disease, areas of soft bone appear around the otic capsule. This process is called otospongiosis and can result in bone loss from the otic capsule. Over time, the bone loss stops, and the soft areas scar and harden, causing otosclerosis.
This process of abnormal growth and scarring can extend beyond the otic capsule, usually to the nearby stapes. The stapes is one of three tiny bones in the middle ear that transmits sound vibrations from the eardrum to the inner ear. Scarring of the stapes may limit or prevent the transmission of sound, resulting in conductive hearing loss.
Otosclerosis can also injure the inner ear directly and cause sensorineural hearing loss and balance problems.
How common is otosclerosis?
Otosclerosis is more common among people with white European or Indian ancestry. Researchers estimate up to 10% of white people have otosclerosis, though only a fraction develop symptoms . Otosclerosis occurs less frequently in people who are Black or Asian. Women are twice as likely to develop otosclerosis than men.
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Understanding Otosclerosis
The main symptom of otosclerosis is hearing loss. Typically, hearing loss starts in early adulthood and gradually worsens over time.
People with otosclerosis may also experience ringing in the ears (tinnitus). These noises may improve after surgery or with the use of a hearing aid. Dizziness (vertigo) can also be a symptom of otosclerosis but is much less common.
Doctors know that otosclerosis develops due to abnormal bone growth but do not know what triggers this process. It is likely a complex combination of genetic, environmental, and hormonal factors.
Potential factors associated with otosclerosis include:
- Family history: About half of people who develop otosclerosis have a family member with the condition. But not all people with a family history of otosclerosis develop symptoms. Researchers are trying to better understand the genetic mechanisms that control family inheritance.
- Immune response: Autoimmunity occurs when your immune system becomes confused and attacks your body. An autoimmune response may cause otosclerosis by disrupting the normal bone growth process.
- Measles infection: Viral illnesses, especially the measles, may play a role in otosclerosis. Researchers have found the measles virus in bone samples taken from the ears of people with otosclerosis. Studies have also reported that people vaccinated against the measles have lower rates of otosclerosis.
How to Prevent Otosclerosis
Since doctors do not know the cause of otosclerosis, you cannot prevent it.
Diagnostic Tests for Otosclerosis
When you lose your ability to hear, our specialists are to here help you figure out the cause. Your doctor will ask you about your symptoms, family history, and medical history. To help make an accurate diagnosis, they may recommend tests such as:
During an ear exam, your doctor uses a lighted device called an otoscope to see inside your ear. An ear exam usually cannot detect otosclerosis but it may help rule out other conditions.
Hearing tests assess your response to several aspects of sound, such as tone, pitch, and loudness. Our specialists look for specific patterns of hearing loss that are specific to otosclerosis. We also use hearing tests to monitor progression of the disease and to assess treatment results.
Types of hearing tests your doctor may order include:
- Pure-tone test: This test plays tones of different pitch and loudness.
- Tuning fork tests: These tests (also called Rinne and Weber tests) play a tone using a tuning fork to determine which kind of hearing loss you have.
- Tympanometry test: We gently place a probe into your ear that changes the pressure against your eardrum. A readout from the test helps your doctor distinguish otosclerosis from other middle ear conditions.
- Speech and word recognition tests: You’ll listen to words spoken at different volumes.
Your doctor will sometimes order a CT scan, especially if you are considering surgery. This test allows your doctor to view the bones of the ear and identify thickened or scarred areas.
Otosclerosis
Otosclerosis is one cause of conductive hearing loss in adults. It is caused by irregular turnover of the bone that surrounds the inner ear.
Otosclerosis
Hearing loss
stapes