• Ear Calcification

Otosclerosis is a disease that results from abnormal bone formation in the middle ear and inner ear. This new bone formation prevents the transmission of sound to the inner ear, which is the main hearing organ, and hearing loss occurs in the patient.

  • How Do We Hear?

The middle ear is responsible for transmitting sound vibrations from the membrane to the inner ear by amplifying them. This function is performed with the help of 3 ossicles in the middle ear:

  1. malleus (hammer)outermost, attached to the eardrum.
  2. incus (anvil)is located in the middle.
  3. Stapes (stirrup)transmits vibrations from the incus to the inner ear.

Sound waves vibrate the membrane first, then the hammer and anvil, and finally the stirrup. Stapes (stirrup) The sound vibrations transmitted to the inner ear fluids by the ossicles are perceived by the hearing receptors in the inner ear and the information is transmitted to the brain. When these signals are evaluated in the brain, hearing takes place.

  • How Does It Cause Hearing Loss?

In otosclerosis patients, new bone formation often occurs in stapes. (stirrup) It settles at the base of the ossicle and prevents it from moving and makes a loss in sound transmission to the inner ear. Sometimes it settles on the inner ear wall. In both cases, the patient develops hearing loss.

  • What is the Cause?

The exact cause of otosclerosis is unknown. In some patients, familial (hereditary)there is a transition.

  • What are the symptoms?

In most patients, the complaint is unilateral or bilateral hearing loss that increases over the years. The loss develops slowly and the patient initially only makes faint sounds. (like whisper) He realizes that he can’t hear. Some of the patients state that they can hear conversations better in noisy environments. Ringing in the ear is another complaint. Rarely, there may be complaints of dizziness or mild instability. Complaints begin or increase after periods such as puberty and pregnancy. Initially unilateral hearing loss is tolerated as it progresses slowly. When the disease affects the inner ear, the complaints become disturbing or pronounced. It is more common in women than men.

  • How Is It Diagnosed?

In the examination of the patient by an otolaryngologist, the eardrums are usually normal.

An examination instrument called a tuning fork or hearing measurements made in sound-insulated cabinets with special devices called audiometry help to establish the diagnosis. audiogram It is also evaluated whether the disease has reached the stage that will be corrected by surgery, with the result of hearing measurement called. Tympanometry test is also helpful in diagnosis.

  • How is the treatment done?

If hearing loss has reached a certain level in otosclerosis, surgery becomes an effective treatment method. Surgery for the treatment of otosclerosis ‘stapedectomy’ It’s called surgery. Generally ‘teflon piston’ A prosthesis, known as a prosthesis, is placed in place of the immobilized stirrup. This surgery, which requires special skills, is sometimes performed with the help of laser, using advanced operating microscopes. The operation can be performed under general anesthesia or local conditions. According to the operator’s preference, it is a surgery that generally does not require stitches. In my own method, I perform the entire operation without the need for an incision in the ear canal. It is technically quite difficult, but it is a very successful operation in competent hands.

If the hearing loss is mild, the patient does not accept surgery or is not suitable for surgery for various reasons, non-surgical treatment will be considered. In this case, hearing aids that amplify the sound and transmit it to the ear canal may be useful. Drug treatment can be applied in patients who are followed up without surgery. This medication is thought to slow the progression of the disease. But it is not preferred often. In certain periods of the disease, only follow-up is sufficient.

  • What is the Post-Surgery Course?

It can go smoothly after the surgery. There may be dizziness. If there is, it may take up to 7-10 days, gradually decreasing. Sometimes nausea and vomiting also accompany the dizziness. Pain is rare and mild. In the first days, the patient may need support from relatives while walking, driving should generally be considered after the 2nd week and after the complete recovery of the dizziness caused by head movements.
Re-operations may be required when there are long-lasting dizziness and hearing problems.

Patients are advised not to do heavy physical work, not to lift heavy loads, not to strain, and not to travel by plane or land where they will be exposed to pressure changes for a period of 2 months.
After the tampon is removed, full recovery in hearing may take up to 2 months. With a successful surgery, there is a high probability that the hearing will be normal and close to normal. During this 2-month period, the patient may hear crackling-like sounds in the ear, and the sounds may be perceived as metallic as if they are coming from a broken speaker. Discomfort from loud noises is also a common complaint of patients in the first weeks.

Most patients can return to work after 7-10 days.

  • What Are the Risks of the Surgery?

Undesirable, negative results of a treatment method are called ‘complications’. Stapedectomy surgery also has some complications, albeit quite rare.

Taste changes in the tongue, non-improvement of hearing, perforation in the eardrum, worsening of hearing, and dizziness can be listed among these complications. Its incidence is between 0.3-6% and it is quite low.

As a result, the treatment of this disease, which occurs primarily with unilateral hearing loss as a result of microscopic calcification in the smallest middle ear ossicles of the body, is available with an incisional operation and satisfactory results can be obtained easily.
Healthy days…

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