Dr. James Prueter, DO

Southwest Ohio ENT Specialists

Otosclerosis is a disease that is specific to the otic capsule (inner ear). This condition often presents in patients with a family history of hearing loss because it is genetically autosomal dominant. Otosclerosis effects the third bone of hearing known as the stapes. The otic capsule bone changes over time. The bone is broken down by enzymes from osteoclasts and the bone is rebuilt by osteoblasts. When this bone turnover occurs it creates increased blood flow and abnormal deposition of bone material which leads the fixation of the stapes bone.

Otosclerosis most commonly causes a conductive hearing loss (problem with the hearing bone) but can cause nerve hearing loss in severe cases. In a normal ear, sound vibrations are funneled by the outer ear onto the ear drum, or tympanic membrane. The ear drum sends these vibrations to the small bones in the middle ear: the malleus (hammer) then incus (anvil), and finally the stapes (stirrup). If there is a problem with the hearing bones, a conductive hearing loss develops.  When the stapes bone moves (after surgery), fluid in the inner ear moves and stimulates hair cells in the inner ear. These cells turn sound vibrations into electrical signals that are sent to the brain.

The treatment for otosclerosis is primarily surgery however, observation and hearing aids are reasonable options.

The surgery for otosclerosis is called stapedectomy or stapedotomy and is done as an outpatient and takes less than an hour.   The surgery requires a very small incision in the ear canal to elevate the ear drum and expose the hearing bones. Each hearing bone is tested to ensure mobility. Once verified that the stapes is fixed a laser is used to remove the stapes and create a small opening to the inner ear. A prosthesis is attached to the incus (second bone of hearing) and delicately placed into the opening to the inner ear. The prosthesis is secured by crimping the hook of the implant onto the incus. Complete mobility of the hearing bones are confirmed. The ear drum is then returned to normal position and the ear canal is filled with antibiotic ointment.

Post-operative recovery is limited. Most patients can resume typical activity the following day.   There is a limited amount of pain, most patients don’t need any pain medicine and some simply use Tylenol or ibuprofen.

Technically, hearing will be improved immediately, however it can take a couple to few weeks for blood products to dissolve. Once this occurs hearing is restored. A hearing test is repeated 3 months after surgery to validate improvement.

The surgery can be seen in the link below:

Endoscopic Stapedotomy

If you would like to make an appointment:  https://soents.com/appointments

Skip to content