| Otosclerosis FAQ |
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What is otosclerosis? Otosclerosis is a progressive condition caused by the deterioration of a bone inside the ear. It can lead to hearing loss and other symptoms, but its effects appear so slowly that you may have been experiencing the effects for a long time and not even noticed. Your ear has three ossicles, made of small bones. These bones receive sound from your eardrum, vibrate and help send sound to your inner ear. In otosclerosis, excess bone growth causes the ossicles to fuse together so they become “fixed” and don’t vibrate, or at least don’t vibrate as freely as they should. As the condition worsens, hearing becomes impaired. Who suffers from this condition? Women seek treatment more often than men, but men actually are just as likely to develop it. Maybe that’s because men just don’t like to admit they have hearting loss. But the condition is definitely not gender-specific. There’s a genetic component, so if someone in your family has it there’s a better chance that you will too. There’s about a 50 percent chance you’ll get it if one of your parents has it. But that figure is a little tricky because not everyone who has otosclerosis shows symptoms. Your father could have it but not know it because his hearing isn’t affected, but you could develop it and have symptoms, or vice versa. There’s some evidence of a viral cause, and therefore some speculation that you need to have a certain gene and then be exposed to a certain virus to develop otosclerosis If your doctor finds otosclerosis in one ear, there’s about a 40 percent chance he or she will find it in the other ear, too. How common is it? Different races are more prone to develop the condition. It’s very common among white people: something like 6 to 10 percent of all white people have it, according to the National Institute of Deafness and Other Communication Disorders (NIDCD). But only about 10 or 15 percent of the people who have it actually suffer hearing loss. So among white people, maybe 1 percent of the Caucasian population has hearing loss from otosclerosis. Only about one in 200 Asians and South Americans will have hearing loss from otoscelorisis, and only about one in 1,000 Africans, according to NIDCD statistics. Is this something only old people get? Not at all. In fact, hearing loss from otosclerosis will usually begin when you’re in your early 20s, and sometimes even in your teen years. Kids as young as 7 or 8 can even experience it. In general, though, it most commonly manifests itself between ages 15 and 35. Have I had this condition for a long time? Otosclerosis robs your ability to hear in such small increments you may not even notice for a long time, so by the time you actually notice hearing loss you’ve probably had the condition for years. Lots of people compensate for losing some hearing by anticipating sounds from memory or unconsciously learning to read lips. Sufferers may be so unaware of their condition that they’re startled when friends or relatives call it to their attention. How do we know it’s there? Imaging studies or blood tests won’t reveal the presence of otosclerosis. Your doctor will diagnose it through your medical history and through hearing tests. Most often, you will have lost the ability to hear low frequencies. Sometimes, you’ll lose the ability to hear other frequencies. That could mean the otosclerosis has also involved the cochlea, and caused neural hearing loss in addition to vibratory, or conductive, hearing loss. There’s no treatment for cochlear otosclerosis. Your otologist will look at your family history and a progression of hearing loss over the course of several years to make a diagnosis of otoscerosis. Is this dangerous? No; otosclerosis isn’t dangerous, other than its effect on your hearing. You could ignore it, or choose to use a hearing aid. Surgery is also an option Are there other symptoms besides hearing loss? Ironically, even as you lose your normal hearing, you may sense other sounds that aren’t caused by the outside world. One such acquisition is the sensation of background sounds, which is called tinnitus. When otosclerosis is involved, tinnitus may be present itself as a broad, ever-present hissing sound, or perhaps separate tones or pulses. This sensation is more pronounced if the otosclerosis is connected with nerve damage. About 15 percent of otosclerosis patients also report dizziness. What can I do? An alternative to hearing aids is surgery on the stapes bone, called stapedectomy or stapedotomy. It’s a day surgery that requires a general anesthetic. The procedure lasts only about half an hour. Many patients choose this surgery rather than using a hearing aid. If otosclerosis is detected very early, though, treatment with sodium fluoride, used as a dietary supplement, can sometimes be helpful. But it’s not generally thought to be very effective. How do I choose between surgery and a hearing aid? If you’ve lost only a little of your hearing, and you feel the loss in only one ear, then surgery is not the answer. If you’re older or have severe health problems, a hearing aid may work better than surgery. Generally, though, people in good health will elect surgery to correct their hearing loss. What’s involved in surgery? In stapedectomy, the surgeon removes the troubled stapes bone. He or she then creates a small window to the inner ear. An artificial replacement (made of Teflon and platinum or other material) replaces the non-functioning stapes bone. (Remember this bone is less than 1/8- inch in height.) The beneficial effects of surgery can last for several years. It often helps alleviate tinnitus, but usually doesn’t affect the vertigo that some otosclerosis patients experience. Another surgical option is a cochlear implant. It’s effective but it’s a much more complex procedure. What changes may I expect after surgery? When tinnitus is involved, surgery will eliminate it in about half the cases. It’s uncommon for tinnitus to get worse after surgery. |