Calcification of the ossicles (Otosclerosis)

Otosclerosis is a disease of the bone capsule in the inner ear. In this disease, on the one hand, there is a destruction in the bone tissue in the bone capsule, on the other hand, a new bone formation with a different structure continues in place of the destroyed bone. Although otosclerosis is usually described as calcification of the ear ossicles, it is not actually an calcification. There is only a new bone formation. Otosclerosis is a disease seen only in humans. It is clinically characterized by progressive conductive hearing loss. When the disease affects the stirrup, it prevents the bone from moving and causes a conductive hearing loss.

The exact cause of otosclerosis is not known. It is accepted that the measles virus has a serious role in the formation of the disease. Hereditary factors are of great importance. Otosclerosis is an autosomal dominant inherited disease. It is known that fluorine deficiency has an effect on the formation of the disease.

Otosclerosis is more common in women than men. The female/male ratio is approximately 2/1. The most common age is between the ages of 15-45.

WHAT ARE THE SYMPTOMS AND FINDINGS IN OTOSCLEROSIS AND HOW IS IT DIAGNOSED?

The typical history in otosclerosis is the presence of progressive hearing loss, usually beginning in the 20s. Hearing loss is bilateral in 70% of patients. Tinnitus is associated with hearing loss in 75% of patients. Some of the patients have a similar disease in their families.

In the ear examination of the patients, the eardrum is normal. Rarely, during the active phase of the disease, a red highlight may be seen behind the eardrum. In the hearing test, an impulse type hearing loss is observed. In the tympanometric examination, an As-type tympanogram is obtained and acoustic reflexes cannot be obtained.

 

In the differential diagnosis, the following should be considered.

Congenital stapes fixation

Tympanosclerosis

Disruption of ossicular chain integrity

Osteogenesis imperfecta

Superior canal dehiscence syndrome

TREATMENT IN OTOSCLEROSIS

There is no cure for otosclerosis itself. Treatment is the treatment of hearing loss caused by otosclerosis disease. There are two options in this. The first is surgical correction of hearing loss, and the second is the correction of hearing loss with the use of hearing aids.

Surgery in otosclerosis is called stapedectomy surgery. In this surgery, the stapes that do not move due to the disease are removed and a prosthetic ossicle is placed in its place. It is a surgery with a very high success rate. Hearing is improved in 95% of patients. Rarely (1%) patients may develop permanent inner ear type hearing loss in the operated ear.

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