Otosclerosis

The Otosclerosis is a degenerative disease of the inner and middle ear. The transmission of sound from the eardrum to the inner ear is impeded by so-called bony changes in the temporal bone. The result is hearing loss, which can lead to deafness as the otosclerosis progresses.

What is otosclerosis?

As Otosclerosis is a bony change in the petrous bone. The three ossicles - hammer, anvil and stapes - are connected to the petrous bone via the inner ear. In front of this arrangement is the eardrum, which transmits the sound to the auditory nerve via the ossicles and the inner ear.

In a healthy inner and middle ear, the ossicles are flexibly connected to one another. In otosclerosis, inflammation-like and degenerative processes lead to ossification of the stapes. This restricts the mobility of the stapes, whereupon the sound is no longer or only partially transmitted.

There are hearing problems such as B. tinnitus. As the disease progresses, it leads to hearing loss and eventually deafness. Otosclerosis generally occurs in both ears at the same time and predominantly between the ages of 20 and 45.

causes

A Otosclerosis can have various causes, although a primary cause for the ossification has not yet been clearly assigned.

Since otosclerosis is often preceded by inflammatory diseases and viral infections, measles, rubella and mumps can be a possible trigger for the disease. Furthermore, so-called autoimmune processes can cause otosclerosis. The body's own immune system reacts allergically to its own body and fights it.

Hereditary components can also be considered in otosclerosis. The disease occurs more frequently in families in which other family members have already had it. The associated gene has not yet been deciphered, but studies show that children whose parents have otosclerosis are also very likely to develop it.

Another cause could be the hormonal balance. Since otosclerosis mainly affects women, hormonal influences could trigger the disease. Especially because pregnant women and women who take contraceptives (“birth control pills”) are more likely to develop otosclerosis.

Typical symptoms & signs

• Hearing loss
• Deafness (deafness)
• Symptoms similar to sudden hearing loss
• Tinnitus

Diagnosis & course

The Otosclerosis will be diagnosed by the ear, nose and throat doctor. However, diagnosis is difficult, especially in the early stages of the disease. When the disease begins it has no symptoms at all, so years can pass in which the otosclerosis goes undetected.

If otosclerosis is suspected, a hearing test is carried out at the beginning. Furthermore, the stapedius reflex - the function of the middle ear muscles - is checked. With this test pathological changes can be detected. There is also a hearing test with a tuning fork. These examinations determine how severe the hearing loss is already. Conductive hearing loss is usually diagnosed here.

A language test shows whether the person concerned already understands spoken words worse than a healthy person. Imaging methods such as X-rays, CT, MRT and scintigraphy are also used to confirm the diagnosis. With these examination methods, inflammation as well as bony changes can be recognized, so that the stage of otosclerosis can be determined.

The course of otosclerosis depends on several factors. The earlier otosclerosis is recognized and treated, the better the prognosis. If surgical treatment is carried out in good time, the hearing loss can be significantly improved. In the early stages of treatment, the hearing loss can be T. can even be completely eliminated. If otosclerosis is not treated in good time, hearing loss is the result, which can lead to complete deafness in the further course.

Complications

Because of otosclerosis, those affected primarily suffer from ear discomfort. Sudden hearing loss occurs for no particular reason. In the worst case scenario, the affected person can become completely deaf if no therapy is initiated. Especially in young people, hearing loss can lead to severe psychological complaints or depression and thus significantly reduce the quality of life.

Furthermore, it is not uncommon for tinnitus or other noises in the ears to occur, which significantly reduce the quality of life. This can also lead to sleep problems, which can lead to general irritability and dissatisfaction on the part of the person concerned. The further course of otosclerosis depends heavily on its severity and the time of diagnosis.

In many cases otosclerosis can be treated completely without any particular complications. Hearing aids can also be used to limit the symptoms of hearing loss. The treatment itself takes the form of a surgical procedure and does not lead to any further complaints. The life expectancy of the patient is also not influenced or reduced by the disease.

When should you go to the doctor?

Hearing impairment is worrying. A doctor's visit is necessary as soon as certain frequencies in the environment can no longer be heard or there is a general hearing impairment. If the person concerned realizes that he can no longer perceive noises as usual in everyday life or that he can hear less in direct comparison to other people, a doctor should be consulted. In principle, a check-up is recommended at regular intervals in the course of life in order to assess the hearing quality sufficiently and to be able to react immediately to changes. If one-sided hearing or noises in the ears develop, it is advisable to consult a doctor.

In the event of an increase in symptoms or numbness, medical care must be taken as soon as possible. Otherwise, there is a risk of lifelong deafness. Changes in behavior, an increased risk of accidents or injuries, and irritability also indicate an irregularity. A doctor's visit is advisable as soon as there is a withdrawal behavior or an aggressive demeanor. Whistling in the ear, ringing in the ears or insomnia and headache should be examined and treated. If the symptoms appear suddenly and without warning, a doctor should be consulted immediately. It is an acute, albeit not life-threatening, condition that requires medical help as soon as possible.

Treatment & Therapy

Drug treatment of the Otosclerosis does not exist at the moment. If an operation cannot be performed, a hearing aid can improve hearing. However, if the disease has progressed so far that deafness is present, hearing aids cannot help, or only to a limited extent.

Otosclerosis is treated with a surgical procedure. A distinction is made between two interventions, the stapedectomy and the stapedotomy. In a stapedectomy, the stapes and the adjacent part of the stapes footplate are removed. The auditory ossicle is then replaced by a stapesplasty (also called a prosthesis). The stapes plastic takes on the function of the stapes and transmits the vibrations of the sound. The stapedectomy is usually performed under local anesthesia (local anesthetic). The doctor can check whether there are any changes in hearing during the operation.

In a stapedotomy, not the entire stapes are removed, only the stapes legs. A small hole is drilled in the stapes footplate and a small prosthesis inserted, which is then attached to the anvil. This prosthesis (made of platinum Teflon) transmits the vibrations of the sound and thus improves the hearing ability of the person affected.

You can find your medication here

Outlook & forecast

The further course and the prospects for recovery of patients affected by otosclerosis depend primarily on the time and type of treatment. In general, there is a chance of at least partial regeneration of hearing skills. Initially, despite medical countermeasures, hearing continues to decline or stagnates at the level already diagnosed. Without adequate therapy, the risk of a considerably reduced acoustic perception is very high. The result is long-term hearing loss and, in severe cases, deafness.

Early surgery significantly increases the likelihood of recovery. About 90 percent of patients will experience a noticeable or complete relief in symptoms. After an operation, dizziness is a common complication. These impairments usually only last a few days. Sometimes dizziness can persist for a long time. The procedure is rarely unsuccessful and leads to a further deterioration in hearing.

Familial accumulations of otosclerosis can serve as warning signals. However, a preventive examination is also advisable if tinnitus occurs more frequently or if there are unexplained hearing impairments. An ear, nose and throat specialist recognizes changes in the ear canal at an early stage and thus increases the chance that the symptoms will be completely eliminated. Difficult gradients can be avoided through thorough checks.

prevention

There are currently no preventive measures to avoid one Otosclerosis to prevent. If there is a family disposition, an ENT doctor should be consulted regularly in order to have the sound transmission of the hearing examined.

If there are noises in the ears such as humming, humming, or the like, you should consult a doctor for a thorough examination. If tinnitus has already been diagnosed, regular check-ups should be carried out so that any otosclerosis can be recognized and treated in good time.

Aftercare

After surgery, pain and complications should be avoided. An initial hearing test will be carried out after the operation. In addition, wound care and wound healing are in the foreground. Antibiosis is given to prevent possible infection. As part of the follow-up treatment for the operation, the sutures and the tamponade are removed. Follow-up care is carried out by an ENT doctor.

Getting used to a hearing aid takes time. The use of the hearing aid not only amplifies voices, but also sounds and noise in the background. Spatial hearing is no longer possible. Whenever possible, the hearing aid should be inserted and used. Close contact persons are to be involved in helping people to help themselves.

The patient's social environment must be informed about this change in health. You are to be shown the best possible ways of communicating with the patient. Follow-up care is also provided by a hearing care professional. He checks the technical functionality and the fit.

If the patient suffers from the hearing impairment, accompanying psychotherapeutic treatment can alleviate the suffering and positively influence the acceptance of the impairment. In addition, patients can talk to other people with otosclerosis in a self-help group about coping with everyday life and discussing problems.

You can do that yourself

People suffering from otosclerosis can support medical therapy with various measures. First of all, it is important to check the symptoms regularly. The patient can keep a complaint diary and note in it, for example, the hearing ability or pain in the ear area. In addition, the follow-up checks suggested by the doctor should also be used, because otosclerosis can progress relatively quickly.

Hearing aids and other aids can improve hearing. If the hearing ability continues to deteriorate despite all measures, the doctor must be informed. Patients who have severe ostosclerosis are best to speak to a therapist. Although the condition is not life-threatening, numbness, dizziness and other symptoms can significantly affect the quality of life. This makes it all the more important to monitor symptoms closely and adjust the medication regularly.

Finally, possible triggers for inner ear disease must be found. Talking to the doctor can determine when the hearing problems first occurred and in which situations they became worse. Often it is then sufficient to adjust lifestyle habits or to correct the hormonal balance with medication.