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Posted on Wednesday, September 05, 2012

Treating Otosclerosis

Two doctors discuss otosclerosis treatments.

Otosclerosis is a mysterious condition in which the formation of bone, usually within the middle ear, impedes hearing and causes hearing loss. Although it is not known why this abnormal bone growth occurs, there are factors like pregnancy, virus, and genetics thought to contribute to its likelihood. Treatment and surgeries for otosclerosis varies and can depend on the severity of the condition and other underlying problems.

TREATMENT

Treatment for hearing loss resulting from otosclerosis is contingent, in part, upon the length and severity of the condition.

Medicine—sodium fluoride in conjunction with vitamin D is sometimes prescribed by a doctor to help slow the loss of hearing. There is some debate on the effectiveness of this treatment. Often a fluoride treatment will be given in conjunction with another treatment, a hearing aid or as after surgery care instructions.
Hormone Inhibition--A less known preventative treatment is to regulate female hormones thought to play a part in the worsening of this condition.
Hearing aids—Although hearing aids cannot cure otosclerosis, they can help treat the largest symptom--hearing loss. There are many options today for improving hearing with hearing aids. Technology can help correct hearing loss due to otosclerosis, and may even provide the least invasive and risky solution.

SURGERY

Surgical treatments for otosclerosis have been around for over a hundred years. Originally the limited knowledge of middle ear functions meant that often these surgeries developed complications or were not successful at all. A wealth of new information, advanced equipment, and medical techniques now mean that 9 out of 10 people who undergo surgery for otosclerosis obtain a successful return of hearing. Note: Not all patients are candidates for surgery. People with Meniere's disease or who still retain enough of an air-bone gap are not typically operated upon.

Without treatment otosclerosis does get worse. Complete deafness, nerve damage, and dizziness can result.

Total Stapedectomy--Total removal of the stapes bone and insertion of a micro prosthesis. Total stapedectomy surgery requires removal of all of the nonfunctioning stapes bones (small bone in the middle ear) and replacing it with a prosthetic device that allows sound to be transferred into the inner ear.

Partial Stapedectomy--This procedure removes only the inhibited portion of the footplate and reconstructs it or replaces it with a prosthesis. According to the Journal of the American Medical Association, "This technique has given excellent long-term results in a large number of patients. In over 90% of the cases reported the air-bone gap has closed to within 10 decibels, and in 65% of the cases, the air-bone gap was overclosed.

Stapedotomy— creating a small hole in the fixed stapes and inserting a min prosthesis. This surgery can be done on an out-patient basis and has a high success rate. Stapedectomy can deliver back a portion of hearing, but cannot be used for people who have sensorineural hearing loss.

In comparison of the three surgeries that are among top treatments for otosclerosis, the University Hospital of Sweden found, "Our results show that in the short-term perspective partial or total stapedectomy can still compete for better hearing results even at higher frequencies, but stapedotomy seems to yield more stable hearing results over time and should therefore be considered as the method of choice."

It should be noted by patients undergoing surgery that, as with any surgical treatments, there could be complications, such as dizziness or vertigo, and after care needs to be carefully followed. Also surgery in and of itself is not always the final answer. Treatments for otosclerosis can also be combined, as is the case with people who are given fluoride treatments after surgery and those who combine surgery with a hearing aid. If you have hearing loss, don't delay in seeking help. Not only can hearing loss can be a symptom of an underlying problem, but untreated hearing loss results in greater mental and physical health risks.

If you'd like to learn more, see your hearing health provider. If you need help finding a hearing health provider click HERE to be connected with the largest network of trusted hearing health professionals in the nation!

References
Persson P, Harder H, Magnuson B. Department of Otorhinolaryngology, Linköping University Hospital, Sweden. taken on, April 10, 2012 http://www.ncbi.nlm.nih.gov/pubmed/9039488

National Center for Biotechnology Information, PubMed Health, taken on April 7, 2012 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002031/

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