Otosclerosis: Definition, Causes, Symptoms and Treatment

Otosclerosis is the abnormal hardening of the bones in the middle ear. The stapes, one of the middle ear's bones, can become trapped in position and lead to otosclerosis. Hearing is hampered when this bone cannot vibrate because sound cannot get through the ear. Otosclerosis is also known as Otospongiosis.

Generally, many people with otosclerosis first experience gradual hearing loss. Some people may also experience the following signs and symptoms of otosclerosis:

1. Dizziness
2. Experiencing ringing in the ear  (Tinnitus)
3. Speaking in a low voice because the voice seems to be louder for the patient
4. Vertigo (feeling that everything is spinning)
5. Roaring sound in the ear

The exact cause of otosclerosis is unknown. Otosclerosis can be caused due to genetic transmission as the condition that runs in the family. However, it can also develop due to the following factors:

1. Recurrent middle ear infections
2. Faulty bone formation
3. Low levels of Fluoride

Otosclerosis generally tend to run in families. However, chances of developing a otosclerosis increase with the following risk factors:

1. Gender: Women are at an increased risk of getting affected by otosclerosis as compared to men.
2. Age: People can develop otosclerosis between the ages of 10 and 45. But the risk of developing otosclerosis is higher in the 20s. 
3. Family history: Otosclerosis may run in the family. It shows that otosclerosis is also transferred via genes.
4. Race: White people are more affected by this condition than Asian or African people.
5. Measles virus: In some of the studies, it has been found that it can also cause otosclerosis. The measles virus particularly causes it.
6. Osteogenesis imperfecta: It is a condition when the bones become brittle. People suffering from osteogenesis imperfecta are more likely to develop otosclerosis.

There is no way to prevent otosclerosis as genetic predisposition has no cure. However, one can reduce the risk of developing otosclerosis by undertaking the following preventive measures:

1. Living a healthy lifestyle
2. Better management of stress
3. Regular exercise
4. Healthy diet
5. Adequate sleep
6. Not exposing the ears to very loud music
7. Avoiding unhealthy substances like nicotine

If there is any issue with hearing, the patient must visit a doctor who specializes in ear disorders. He/she may be an ENT specialist or an otologist. Some of the techniques implemented for the diagnosis of otosclerosis are:

1. Visual examination: The doctor may see into the ears of the patient using a scope. It may be done to check for any obstruction of foreign particles in the ear.
2. Weber test: In this method, the base of the struck tuning fork is placed on the mastoid bone behind the ear. The patient is asked when the sound is no longer heard. Then move the fork beside the ear and ask if now it's audible. In normal conditions, the patient will hear the tuning fork, but in loss of conduction, the patient will not hear any sound near the ear.
3. Hearing test: This test is also known as audiometry. This treatment may be used to know the extent of loss of hearing ability. In this test, the sensitivity of the hearing and the conductivity of the middle ear is checked.
4. CT scan: In some cases, an imaging test like a CT scan is also performed. It is done to check for the other causes of hearing impairment.
5. X-ray: X-ray is used to obtain a clear image of the bones.
6. Tympanogram: It is a method to diagnose the condition and mobility of the tympanic membrane present in the middle ear.

How to prepare for the doctor's consultation?

Below mentioned are some of the information that a patient can prepare before the appointment with the doctor.

1. Explain all the symptoms in detail: Any minor signs and symptoms may be of use, so describe all the symptoms to the doctor in detail. It will help him/her in diagnosing the medical condition in a better way. Hiding any information might result in misdiagnosis or no diagnosis.
2. List down the relevant events that may be related to the condition.
3. The patient should also tell the specialist the list of medications and supplements he/she takes.
4. Ask about the diagnosis in detail. Also, ask the doctor about the precautions that the patient needs to take. 
5. Do not forget to ask about the risks associated with the treatment procedure.

Otosclerosis is a progressive disease and tends to get worse with time. Some of the approaches of the treatments are:

Otosclerosis treatment without surgery

1. Medicines: Some medicines like fluoride, calcium, and vitamin D help decrease hearing loss. However, the benefits of these medicines are still not confirmed. Among these medicines, fluoride has been actively used to slow the progression of otosclerosis.
2. Hearing aids: If, after the diagnosis, the doctor finds that the otosclerosis is not progressing, then he/she might recommend the use of a hearing aid to ease the hearing. However, the hearing aid would not completely cure otosclerosis, but it can improve the hearing ability of the person.

Otosclerosis treatment with surgery

The treatment of choice for treating otosclerosis is stapedotomy and stapedectomy. Irrespective of the surgical approaches used, the surgical treatment for otosclerosis has shown comparatively good results.

1. Stapedotomy: The surgeon makes a hole in the stapes footplate using the laser during this procedure.
2. Stapedectomy: In this surgery, the surgeon makes a cut either in the front or on the back of the ear and removes the stape bone. It is then replaced by an artificial device or prosthesis.

If the treatment is delayed or otosclerosis remains untreated, the patient may have:

1. Progressive loss of hearing
2. Total deafness (rarely)

When to see a doctor?

1. The patient should call an ENT specialist if there are any symptoms present related to hearing.
2. If the patient experiences any kind of roaring or ringing sound in the ear or if the patient is speaking in a low-pitched voice because the voice seems louder, then he/she must book an appointment with the ENT doctor.

In the fight to keep the body healthy and functional, vitamins and minerals play a vital role. Some of the minerals are also critical elements in improving hearing health. These include:

1. Potassium: regulates the fluid in the inner ear. Foods rich in potassium include potatoes, spinach, lima beans, tomatoes, raisins, apricots, bananas, melons, oranges, yoghurt and low-fat milk
2. Folic acid: helps the body to generate new cell growth and helps increase the circulation of blood in the body. Foods rich in folic acid include fortified breakfast cereal, liver, spinach, and broccoli.
3. Magnesium: acts as a protective barrier to hair cells in the inner ear when loud noises are emitted. Foods rich in magnesium include bananas, potatoes, spinach and broccoli.
4. Zinc: is known for increasing cell growth and healing wounds. Zinc-rich foods include cashews, almonds, peanuts, beans, and split peas.
5. Omega 3 Fats and Vitamin D: have anti-inflammatory and anti-ageing properties. Foods rich in Omega 3s include flaxseed oil, krill oil, salmon, and soybean oil.