What are the treatment options for otosclerosis?
At first, when the hearing loss is mild, you may not need any treatment. As the disease progresses and hearing loss becomes worse, hearing aids can make a big difference. However, when the hearing loss becomes severe, hearing aids may not be of much help.
The most common operation that is done is to replace the stapes with an artificial bone made of plastic or metal. The operation is called a stapedectomy (or sometimes a stapedotomy). In most cases, this operation is successful and restores hearing. It may also reduce the chance of otosclerosis progressing to affect your inner ear.
However, it is a very delicate operation. There is a small risk that the operation will fail and cause total deafness in the operated ear. Also, there is a small risk of damaging other nerves during the operation and of causing disturbance to balance or taste. The operation may not cure tinnitus and will not improve hearing in the small number of cases which affect the cochlea. You should ask your surgeon about their success rates for this type of surgery.
So, although the operation is usually successful, it may be a difficult decision about if, or when, to opt for an operation. Because of the small chance of serious complications, some people decide to stick with hearing aids. They do so until their hearing becomes so bad that hearing aids are not helping very much. Other people opt for surgery earlier so as not to need hearing aids. When surgery is decided upon, the ear that is most badly affected is operated on first. This is the ear with most to gain if the operation is successful. It means that the best ear is still preserved in the small number of cases where the operation does not work.
There is debate about whether the second ear should be operated on in the future. Some surgeons feel not, because if anything were to go wrong with the ear already operated on, you would still have the possibility of wearing a hearing aid and hearing something with your second ear. You should discuss this with your surgeon.
There is some limited evidence that fluoride tablets may possibly slow the progression of the otosclerosis in some cases. They may help to preserve hearing and also help to reduce the symptoms of dizziness and balance problems. However, such treatment is not widely used in the UK.
Hormone tablets and the contraceptive pill
Some doctors feel that taking the contraceptive pill or hormone replacement therapy may make otosclerosis worse. If you have otosclerosis and are considering taking hormone treatment such as this, you should discuss the pros and cons fully with your doctor.
Further reading and references
Niedermeyer HP, Arnold W; Otosclerosis and measles virus - association or causation? ORL J Otorhinolaryngol Relat Spec. 200870(1):63-9
Vicente Ade O, Yamashita HK, Albernaz PL, et al; Computed tomography in the diagnosis of otosclerosis. Otolaryngol Head Neck Surg. 2006 Apr134(4):685-92.
Cruise AS, Singh A, Quiney RE; Sodium fluoride in otosclerosis treatment: review. J Laryngol Otol. 2010 Jun124(6):583-6. Epub 2010 Feb 18.
Otosclerosis; British Tinnitus Association
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