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Otosclerosis is a disease of the middle and inner ear, in which parts of the ear harden and ossify. This affects the sound transmission from the middle to the inner ear. The ossification usually begins in the middle ear and can spread in the further course to the inner ear. In later stages, ossification causes increased hearing loss. Even a humming and hum in the ear (tinnitus) can occur. Most otosclerosis first occurs in one ear only and later in the second.
About ten percent of the population has a change in the bony structures in the middle and inner ear. Symptoms of otosclerosis, however, only show in about one percent of the population. Women are about twice as likely to be affected as men. Otosclerosis is more noticeable between the ages of 20 and 40 years. However, changes in the ear can persist as early as childhood without symptoms.
In otosclerosis there is an increasing deterioration of the hearing, usually only at one ear. In about 70 percent of those affected, otosclerosis later develops in the second ear. In women, the first symptoms of otosclerosis often appear during pregnancy. With increasing ossification, the mobility of the ossicles is increasingly limited. This can eventually lead to complete hearing loss (deafness).
If the otosclerosis is not treated, the ossification increases steadily. Physicians speak of a progressive (progressive) course. Medically, a deterioration can not be stopped. Over a period of time injections of cortisone-containing preparations may help reduce hearing loss. In the long run, however, they can not prevent a deterioration in hearing. The only long-term promising treatment option for otosclerosis is surgery. There are two different methods: stapedectomy and stapedotomy.
Doctors talk about an "ectomy" when something is removed. In stapedectomy, the stapes is removed accordingly - either with the help of surgical instruments or with a laser. Subsequently, an artificial replacement (prosthesis) is used, a so-called stapes plastic. It is like the stirrup itself connected at one end to the anvil and at the other end with the membrane of the oval window. The prosthesis thus completely fulfills the function of the stirrup, so that the sound transmission is ensured.
Stapedotomy is the second possible surgical procedure in otosclerosis. In the past, stapedectomy was usually used. Due to lower risks but the stapedotomy is preferred today. Stapedotomy does not remove the entire stirrup but only the long leg. The stirrup plate, which is attached to the membrane of the inner ear, remains in place. In the plate a small hole is drilled. The prosthesis is now attached to the anvil on one side as on the stapedectomy and on the stirrup plate on the other side.
The operation is done under local anesthesia. The anesthetic is injected into the external auditory canal. The eardrum is detached on one side and made the stirrup so accessible. As a rule, the surgery does not last longer than half an hour. After the operation, the eardrum is folded back. At least up to two weeks after surgery, a special ear bandage (ear tamponade) must be worn. However, the success of the operation is evident - if not during the operation - at the latest in these two weeks.
Total or partial hearing loss is what complicates communication considerably, and makes a person feel handicapped. One-side or bilateral otosclerosis is a common reason for loss of hearing, and though this disease is complicated, it can be treated by various means.
What is Otosclerosis?
As we know an ear consists of three parts: inner ear, middle ear, and external ear. Damage or defects of these parts make up for hearing impairment. Otosclerosis is hardening in the ear of the bones in the middle area. Sometimes hardening spreads to the inner ear and the stapes – combination of impairments is typical of this disease.
Types of Otosclerosis
- Cochlear (when it spreads to the inner ear and affects nerve function). It may become permanent, and if it affects balance canals, a person may be unsteady.
- Stapedial (spreads to stirrup or stapes and interferes with the motion of ear fluid). In this case, an otosclerosis ear can be treated with the help of surgery.
- Fenestral otosclerosis takes place when abnormal bones are entrapped on the stapes plate, and oval windows are involved, too.
First and foremost, a telltale sign of the disease is loss of hearing. Affected people may even be unaware about it, being notified only by friends and family who find it hard to communicate normally. A person suffering from otosclerosis conductive hearing loss may unwittingly start reading lips when talking to people – that helps to compensate loss of information. What else accompanies the disease?
- Noises in ear.
- Tinnitus – a more serious condition that manifests into hearing hissing sound, pulsation or some discreet tones. It can be eradicated with the help of surgery.
Methods of Otosclerosis Treatment
If only one ear is affected, a person may ignore the problem and just adapt to peculiarities of hearing. However, it does not seem to be a reasonable choice: hearing may be still disturbed by blockage of another ear with wax or water. Generally, there is no medication that can decrease the symptoms of disease or cure it. Sometimes, food supplements with fluoride are prescribed to slow down or stop the process of hearing loss. However, their intake has some side-effects, such as digestion disorders, allergy and skin itching, and pains in joints.
If a patient is not a subject to operation, or does not want to go through it, he or she may try hearing aids for otosclerosis. This is a good alternative that can make everyday communication simple again. It can also be installed together with temporal bone implant.
This is the most reliable and effective method for treatment of otosclerosis. It is recommended for people with one-side hearing impairment, and necessary for those who face bilateral hearing loss. There are two basic types of surgeries.
This procedure is preferable in many cases, and allows correcting early stages of otosclerosis. During such operation, sclerotic stape footstep is cut out and replaced with an implant, what brings improvement of hearing, at least temporary. Usually, it is made under local anesthesia, and it requires a short period of hospitalization. With this operation, sound transmission from eardrum to the inner ear becomes possible again. About 90% of operations bring permanent relief. However, people with conductive hearing loss are likely to experience recurrence.
This is a more advanced and modern variant of the mentioned operation. During this procedure, a small hole is drilled in the stapes footplate by a micro-laser, and a piston-like prosthesis is placed instead. The success of the procedure depends mostly on doctor’s skills, and it is preferred under normal conditions.
Recovery after surgery is minimal: a person may get back home the same or next day after operation. A person may get back to work in a week, travel by car soon after, and by air – in two weeks.
People who underwent operation may face various complications or side effects. First, further hearing impairment takes place in 2% of cases as the result of infection, scar, spasms of blood vessels, etc. Tinnitus, dizziness, face weakness and eardrum perforation are among the rest side effects.
Where to Seek for Medical Help?
German Medical Group offers extensive choice of clinic for patients from Europe. Why is it a reasonable choice?
- Europeans don’t need Visa to enter Germany.
- Trip within Europe will cost about $90-200, while flying to the USA is worth more than $500-1000.
- Otosclerosis surgery cost in Germany is about 20-40% less than in other developed countries, for instance, the USA.
- Patients don’t need entrepreneurs – many German doctors speak English well.
- Advanced German medicine uses the most effective and reliable methods of treatment.