What is otosclerosis?
Otosclerosis, also known as ear bone disease, can be a genetically inherited condition. While the exact cause is not known, it is believed that hormonal factors and certain viruses may contribute to the disease. In otosclerosis, there is structural calcification and hardening at the base of the stapes bone in the middle ear, which restricts the movement of the stapes bone. As a result, sound waves cannot be effectively transmitted to the fluids in the inner ear, leading to conductive-type hearing loss. At this stage, the disease can be treated with surgery, restoring the patient’s hearing to normal levels. If left untreated, the disease can progress and affect the inner ear wall, leading to irreversible sensorineural hearing loss.
What are the symptoms of otosclerosis?
The primary symptom of otosclerosis is slow-progressing hearing loss that can affect one or both ears. The degree of hearing loss can vary depending on the severity of the calcification. The disease is generally seen between the ages of 15 and 45 and is more common in women than in men. During pregnancy, the disease can enter a rapidly progressive phase. In addition to hearing loss, patients may experience ringing in the ears (tinnitus), dizziness, and balance problems.
How is otosclerosis diagnosed?
The initial diagnosis of otosclerosis begins with a physical examination of the ears. However, to establish a preliminary diagnosis of the disease, hearing tests are essential. The eardrum typically appears normal in otosclerosis because the problem lies between the middle ear and the inner ear. Imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) do not show otosclerosis specifically, but they may be preferred to differentiate it from other ear conditions.
How should otosclerosis be treated?
In cases of newly developed and clinically non-disruptive conditions, patients can be monitored through hearing tests. For patients whose hearing loss affects their quality of life, rehabilitation with surgery or hearing aids may be considered.
How is otosclerosis surgery performed?
The preferred method for treating otosclerosis with surgery is called “exploratory tympanotomy.” During surgery, if the immobilized stapes bone is identified, it confirms the diagnosis of otosclerosis. Using the “stapedotomy/stapedectomy” technique during surgery, the immobilized stapes bone is removed, and a prosthesis (usually made of Teflon) is placed between the anvil bone and the inner ear to transmit sound waves. This surgery, which can be performed under general anesthesia, can achieve a high success rate, and most patients with conductive hearing loss can have their hearing restored.
What can be expected after otosclerosis surgery?
There is no pain or bleeding after the surgery. Some patients may experience dizziness for a few days, but this is usually temporary. Complications such as ongoing or worsening hearing loss, perforation of the eardrum, damage to the facial nerve, middle ear infection, or dislocation of the prosthesis can occur, but they are extremely rare.
What precautions should be taken after otosclerosis surgery?
In the early postoperative period, patients should avoid activities such as air travel, diving, coughing, heavy lifting, and straining. Tinnitus, if present before surgery, generally does not improve after the procedure.