What is Otosclerosis? 
Otosclerosis is a disease in which there is abnormal hardening of the bone of the ear. This hardening causes the third middle ear bone, known as the stapes, to become fixed. Fixation of the stapes prevents it from moving and thus, prevents the transmission of sound of the middle ear to the inner ear. 
 

What causes Otosclerosis?
There are many interesting studies that pertain to the abnormalities of bone in the ear. We know that otosclerosis is an inherited disorder and that many people with this disorder will report similar symptoms in their parents or siblings. Other patients report no family history of this disorder. This is not because their family members were not affected by otosclerosis, but rather because the hardening of the bone within the ear did not take place in the region of the stapes. 
 

How is otosclerosis diagnosed? 
Otosclerosis is diagnosed by a combination of the patient history, physical examination, and a hearing test that shows significant middle ear (conductive) hearing loss. This diagnosis can only be confirmed at the time of surgery when the abnormal bony growth is visualized within the middle ear. 
 

What are the treatments for Otosclerosis?
Patients with a mild degree of hearing loss may require no immediate treatment. However, when the hearing loss becomes substantial, it is advisable for the patient to obtain some form of treatment to improve their hearing. The following are options for patients with otosclerosis. 
 

Hearing Aids
Hearing aids will amplify sounds so that they are better heard by the patient. Given that the inner ear is usually normal in otosclerosis, hearing aids work very well for patients with this disorder. The advantage of a hearing aid is that wearing them bares no risk to the patient and the patient does not have to undergo any surgery. However, the hearing aid will have to be worn throughout the remainder of the patient's life and can be somewhat of an inconvenience. While hearing aids remains a safe and effective treatment for most forms of otosclerosis, many patients prefer not to be burdened by wearing these devices permanently. 
 

Stapedectomy Operation
This operation, in which the abnormal stapes is replaced by an artificial bone of hearing, is one of the most gratifying procedures performed by ear surgeons. This surgical procedure has been performed and refined over the past 40 years offers the patient with otosclerosis normal or near normal hearing. We routinely perform this operation under general anesthetic and through the ear canal utilizing the microscope. We lift the eardrum and analyze the stapes under a microscope to confirm the diagnosis of otosclerosis. Once the diagnosis is confirmed, the abnormal stapes is removed and is replaced by an artificial one. This procedure is performed as outpatient surgery and generally takes between one to one half hours. 
 

What can I expect after the operation?
A slight amount of pain and dizziness is normal after the operation. Call our office immediately if these symptoms are getting worse rather than improving.  Hearing will not return to normal immediately after the surgery as a small amount of packing will be in the ear for the first week after the operation.  Call our office immediately if you notice any drop in hearing. 

Keep the ear dry after surgery.  Plug the ear with a cotton ball coated with vaseline when you are showering or washing your hair.  Avoid straining for the first 2 weeks after surgery, that is, no heavy lifting and sneeze with an open mouth.  Avoid air travel until cleared by your surgeon. 
 

What are the complications of surgery?
Although, the stapedectomy is one of the most gratifying surgeries for both patient and surgeon, there are certain potential complications of this surgery which must be considered by the patient prior to embarking on this course of treatment. All of these complications are rare, occurring in one percent or less of cases. When replacing the stapes, the inner ear is temporarily opened to allow for the replacement of the new artificial bone of hearing. Damage can occur to the inner ear at this point in the procedure and in a small minority of cases hearing loss will actually worsen as a result of surgery. If the inner ear was adversely affected by the surgery, then the patient may develop spinning vertigo on rare occasions. In addition, the nerve that supplies the facial muscles passes through the ear. Anytime ear surgery is done this nerve is at a slight risk. We are very careful to identify the nerve and any abnormality in its course, however, although rare, the facial nerve can be damaged as a result of this surgery. A small nerve that supplies taste to the anterior one-half of the tongue passes through the inner ear in the vicinity of the stapes. Sometimes this nerve must be moved in order to better access the stapes. When this occurs, this fine nerve may be damaged leaving a temporary alteration in taste in the patient.