Otosclerosis | Ear Wax

Otosclerosis

Otosclerosis is a progressive disease that affects approximately 0.5% of the population, affecting females twice as often as males.  The most common symptom is hearing loss that gets worse over time, sometimes in one ear, but typically in both ears.  Patients frequently complain of a ringing or buzzing sound in the affected ear or ears.  Dizziness or vertigo is not a typical symptom of otosclerosis, although it can occur.

The hearing loss that occurs with this disease is what is called a conductive hearing loss.  In most cases, the hearing nerves and the inner ear are working normally.  The problem has to do with the sound conducting bones inside the middle ear.  The 3 tiny bones, commonly known as the hammer, anvil and stirrup, transmit sound waves from the eardrum (tympanic membrane) to the inner ear (cochlea).  Otosclerosis typically causes disease of the third bone, the stirrup (stapes).  Excess calcium is deposited around the base of this bone which prevents normal vibrations from occurring.  This dampens the sound waves that are being transmitted to the inner ear and results in loss of hearing.

It is not known why this disease occurs and there is currently no cure.  Fortunately, the hearing loss can be treated effectively in two ways.  One way is with hearing aids.  This type of hearing loss responds very well to hearing aids.  For those who do not want to wear hearing aids, for whatever reason, surgery is the second option.

Stapedectomy, the surgical removal of the stapes bone and replacement with a prosthetic bone, is one of several types of operations.  This can usually be performed in an outpatient facility, requiring the patient to spend the night at the facility.  General anesthesia is required and the surgery, which is performed through a tiny incision inside the ear, typically takes about 1 hour.  Post-operative pain is usually mild but in some cases dizziness can be experienced for 1 to 10 days.  Ninety percent of people report excellent results and these are confirmed on post-op hearing tests.  In cases where both ears are involved, we usually wait 6-12 months between surgeries.

While the surgery can return useful hearing, it does not cure or stop the disease.  Most people eventually start to lose hearing again, but usually get 5-20 years out of the surgery.  When the hearing decreases enough, surgery can be repeated.  In some people with otosclerosis, nerve damage starts to occur as they get older.  Unfortunately, this form of hearing loss cannot be fixed with surgery.