Otosclerosis; It is a disease that occurs as a result of abnormal bone formation in the middle ear and inner ear. This new bone formation can sometimes prevent the transmission of sound to the inner ear, which is the main hearing organ, and cause hearing loss in the person. It is a related problem but mostly affects the stirrup (stapes) in the ear. The stirrup is a bone that plays a major role in hearing. Hearing occurs as a result of the vibration of this bone in the ear. In this disease, hearing loss can be seen as a result of abnormal growth of the bones, preventing the passage of sound, that is, vibrations, into the inner ear, which is the part of the ear responsible for hearing. In other words, the vibration of the stirrup is prevented as a result of the abnormal growth of the bones in the ear, thus preventing the ear from hearing. It is our organ located on both sides of our head. The clear transmission of sounds to the brain and their good perception indicate the quality of hearing, that is, the ears are working well. The ear has 3 main parts, namely the outer ear, middle ear and inner ear, and these 3 main parts have different functions from each other. It is responsible for transmitting it to the inner ear fluids by strengthening with mechanical pressure with the help of bones. The inner ear, on the other hand, undertakes the task of converting these pressure waves transmitted from the middle ear into messages that our brain can perceive.
What are the Types of Hearing Loss?
After examinations called audiometric tests, hearing loss is divided into 5 types. These are:
How Does Otosclerosis Cause Hearing Loss?
Otosclerosis New bone formation, which is abnormal in patients, is often observed in the stirrup (stapes) ossicle. This newly formed abnormal bone structure prevents the stirrup from moving, so there are problems in the transmission of sound waves, that is, sound vibrations taken from the outside and transmitted to the middle ear, to the fluids in the inner ear and hearing loss occurs. This type of hearing loss is called conductive hearing loss.
The new abnormal bone formation caused by this disease sometimes settles on the inner ear wall. By directly or indirectly affecting the cochlea in the inner ear, it can cause neural hearing loss originating from the middle ear as well as the inner ear. This type of hearing loss is also called sensorineural hearing loss. ir.
What are the Causes of Otosclerosis?
The cause of otosclerosis is still not clearly defined. However, there is a hereditary (familial) transmission characteristic of the disease. For example, in some cases such as the presence of measles virus and pregnancy, worsening of the course of otosclerosis may be observed. In some cases such as these, otosclerosis may have such links. It is recommended to get information from your doctor about these conditions.
If this disease is left untreated, hearing loss increases until late middle age. Therefore, otosclerosis is defined as a progressive disease.
Although the disease is mostly seen in middle-aged women, it can also be seen in men and children.
What are the Symptoms of Otosclerosis?
The two main symptoms of otosclerosis are hearing loss and tinnitus. Generally, hearing loss is observed in one ear or both ears in patients. Hearing loss develops slowly and the patient initially finds that he or she cannot hear only low-pitched, low-pitched sounds (such as whispers). Over time, this problem begins to worsen as the disease is a progressive disease. Although otosclerosis is not seen frequently, such as dizziness and balance problems, there are also symptoms that can be seen from time to time.
How is Otosclerosis Diagnosed?
Otosclerosis can be diagnosed by otosclerosis specialists by performing some examinations and tests, taking into account the symptoms of the patient. In the examinations performed by otolaryngologists, it is determined that the eardrums generally have a normal appearance. This hearing test is performed with an examination instrument called a tuning fork or a special device called an audiometer. These tests are carried out in soundproof cabins.
If otosclerosis is at a very early stage, sometimes surgery may not work in the treatment, but in some cases, the progression of otosclerosis can be prevented by surgery. For this reason, the otosclerosis disease level determined in the hearing tests performed by the physicians with special devices is t. important for the treatment.
What is Diaposon Audiogram (Otosclerosis Audiogram)?
In patients who have conductive hearing loss despite all diagnostic tests and tests performed before the patient is treated with surgery, a definitive diagnosis can only be made during surgery. . When the middle ear is checked during the surgery in some patients who are operated because of the diagnosis of otosclerosis, it can be understood that the cause of hearing loss is other than otosclerosis.
This is the reason why definitive diagnosis can be made during surgery in patients with conductive hearing loss. In these cases, it becomes more difficult to correct this hearing loss with surgery, and sometimes even it cannot be corrected depending on the cause of the hearing loss.
How Is Otosclerosis Treated? How Otosclerosis Surgery is Performed?
Otosclerosis level must have reached a certain level in order to be able to be treated surgically in otosclerosis. Otherwise, surgery is not an effective treatment for otosclerosis. This surgery for the treatment of otosclerosis is called "stapedectomy".
In otosclerosis surgery, the stapes ossicle, whose movement is restricted due to abnormal new bones formed due to the disease, is removed and replaced with a prosthesis. The stirrup is one of the smallest bones in the body. This operation, which is performed on the stirrup, which is approximately 3 mm in length, requires special skills due to the small size of the bone and is performed using advanced surgical devices, that is, advanced operating microscopes. In the first days, the patient may need help to walk, these effects gradually decrease over time. For 2 months after otosclerosis surgery, patients are asked not to lift heavy loads, not to travel by plane due to pressure difference, not to do activities that will create a pressure difference, such as diving, and not to strain. Complete recovery in hearing after surgery can only be achieved within 2-3 months.
If the hearing loss is not at the level to be operated and the patient does not want to have surgery, other treatment options may come to the fore if surgery cannot be performed. In such cases, turn the volume up to minimize hearing loss. The treatment method is tried with special devices that can be delivered to the ear canal. This method is not a method that slows down the progression of the disease.
The use of medication may also be preferred in the treatment of otosclerosis in order to prevent the disease from progressing, but the use of this treatment method is very limited.
There is another treatment method called sodium fluoride, which some physicians apply when surgery cannot be performed. Oral ingestion of sodium fluoride is thought to slow the progression of otosclerosis.
What are the Risks of Stapedectomy Surgery?
The side effects that can be caused by a drug, disease or treatment method are called complications. Complications are not uncommon in stapedectomy surgery.
Possible complications:
- Taste changes in the tongue,
- No improvement in hearing,
- Perforation in the eardrum,
- Worsening of hearing,
- Facial paralysis (almost always temporary),
- Inflammation of the middle ear,
- Inflammation of the meninges (meningitis).
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