Stapes Otosclerosis: Symptoms, Causes, and Treatment Options - Otolaryngology

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Otosclerosis


Hello Dr.
Hong: First of all, thank you very much for your response.
Regarding which small bone it is, I know it resembles the shape of "ㄈ", and there is a small white spot in the middle of the "ㄈ" shape.
(I may not be professional enough to confirm it's in the middle, but I am certain it is near the "ㄈ".) As for my symptoms, I believe they are acquired, because I remember being proud of being able to distinguish sounds coming from the right or left side when I was 7 or 8 years old, and it wasn't until I was 12 or 13 that I realized I had hearing loss, so I am sure the hearing loss has been present for about 10 years.
I had an examination back then, but I was too young to remember what the doctor said; however, my mother mentioned that the doctor said it could potentially affect the brain, which is why I am asking if surgery would impact cognitive function.
My family has said that if the side effects are minimal and it is a minor surgery, they would prefer to resolve it quickly.
(I have had other minor surgeries in the past that were optional and improved my condition, but I didn't ask about the consequences at the time, so I regret it a bit now.) If surgery is indeed necessary, I will consult my doctor again during my outpatient visit.
Thank you.
I also appreciate your suggestions, and I think I will continue to observe the situation for now, as at least one of my ears is functioning normally.
Additionally, my mother mentioned that she saw me get kicked in the right ear while practicing taekwondo (but the hardening sensation doesn’t seem to be due to external trauma?).
Could it be that I had a severe cold (like otitis media) in the past that led to this result? Thank you again for your explanation, doctor.

Xiao Wang, 20~29 year old female. Ask Date: 2008/04/07

Dr. Hong Guangliang reply Otolaryngology


Hello Xiao Wang, based on your description, it seems to be otosclerosis, which is more likely related than to otitis media.

Reply Date: 2008/04/07

More Info


Understanding Stapes Otosclerosis: Symptoms, Causes, and Treatment Options
Otosclerosis is a condition that affects the bones of the middle ear, particularly the stapes bone, which is the smallest bone in the human body. This condition can lead to hearing loss, which often begins in young adulthood and can progress over time. The stapes bone plays a crucial role in the auditory system by transmitting sound vibrations from the middle ear to the inner ear. When otosclerosis occurs, abnormal bone growth around the stapes can immobilize it, preventing it from vibrating properly and thus impairing hearing.


Symptoms of Otosclerosis
The primary symptom of otosclerosis is hearing loss, which can be conductive (related to problems in the outer or middle ear) or, in some cases, sensorineural (related to the inner ear or auditory nerve). Patients often report difficulty hearing in noisy environments, a sensation of fullness in the ear, and sometimes tinnitus (ringing in the ears). The hearing loss typically starts in one ear but can eventually affect both ears.
In your case, you mentioned that you have been experiencing hearing loss since the age of 12 or 13. This gradual onset is characteristic of otosclerosis, as the condition often develops slowly over many years. The fact that you were able to distinguish sounds clearly at a younger age suggests that your hearing was normal before the onset of this condition.


Causes of Otosclerosis
The exact cause of otosclerosis is not fully understood, but it is believed to have a genetic component, as it often runs in families. Some studies suggest that it may be related to hormonal changes, particularly in women, as the condition can worsen during pregnancy. Additionally, previous ear infections, such as otitis media, may contribute to the development of otosclerosis, although this connection is not definitively established.

You mentioned a history of trauma to your ear during martial arts practice, as well as possible past middle ear infections. While trauma can lead to various ear issues, otosclerosis is typically not caused by external injury. However, recurrent ear infections can lead to changes in the middle ear that might predispose someone to develop otosclerosis.


Treatment Options
Treatment for otosclerosis depends on the severity of the hearing loss and the patient's overall health. The main treatment options include:
1. Hearing Aids: For individuals with mild to moderate hearing loss, hearing aids can be an effective way to amplify sound and improve hearing.

2. Surgery: In cases of significant hearing loss, a surgical procedure called stapedectomy may be performed. This involves removing the immobilized stapes bone and replacing it with a prosthetic device. This surgery is generally safe and has a high success rate in restoring hearing. However, as with any surgical procedure, there are risks involved, including the potential for complications that could affect balance or lead to further hearing loss.

3. Observation: If the hearing loss is mild and not significantly impacting daily life, some patients may choose to monitor their condition without immediate intervention.


Conclusion
It is essential to discuss your concerns and treatment options with your healthcare provider, especially regarding the potential risks and benefits of surgery. Given your family history and the gradual nature of your hearing loss, it is wise to consider a thorough evaluation by an ear, nose, and throat (ENT) specialist. They can provide you with personalized advice based on your specific situation and help you make an informed decision about your treatment options.

In summary, otosclerosis is a manageable condition, and with the right approach, many patients can achieve significant improvements in their hearing. It is commendable that you are taking the initiative to understand your condition better and seek appropriate care.

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