It is a closed bone box inside the inner ear that protects the hearing and balance organ. The disease of this structure, which progresses with the loss of bone tissue and new irregular bone formation due to genetic or environmental factors, is called otosclerosis.
Sound waves pass through the external ear canal and vibrate the membrane. The eardrum separates the outer ear from the middle ear cavity like a tight curtain. The middle ear cavity is filled with air, and they are responsible for transmitting sound vibration between the hammer, anvil and stirrup ossicles and between the eardrum and the inner ear. The stirrup closes an opening to the inner ear called the oval window. From this opening, sound waves pass to the fluid-filled inner ear hearing organ.
Otosclerosis disease; This causes new irregular bone formation around the oval window and the stirrup, reducing the transmission of sound to the inner ear.
This disease is more common especially in young women aged 15-45. Apart from genetic features, measles infection and hormonal changes (such as pregnancy) cause the disease to progress and cause complaints.
The most common symptom is hearing loss, which we call a slowly progressive conductive type. It is typical that hearing is better in crowded noisy environments than in quiet environments. Apart from hearing loss, some patients may also complain of imbalance. In approximately 70% of patients, otosclerosis can present in both ears. The degree of hearing loss is usually fixed at a certain level. In very few patient groups, progressive otosclerosis covers the inner ear auditory organ and causes total hearing loss in that ear.
ENT examination, hearing tests and radiological imaging methods are used for diagnosis. On examination, it is typical that the eardrum is normal, sometimes with a red reflex behind the eardrum. The degree and type of hearing loss should be determined by audiological hearing test. Typical low ear pressure in ear pressure tests and negative acoustic reflex test are characteristic features. Computed ear tomography is an important diagnostic test to distinguish other causes of hearing loss behind the intact eardrum and to detect the otosclerosis focus.
A complete therapeutic method to eliminate otosclerosis disease. em has not yet been found. Treatment is planned to correct the hearing loss caused by it.
Types of treatment
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Follow-up
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Medication therapy
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Hearing aid
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Surgery
Follow-up is especially incipient and very It is an option for patients with mild hearing loss. This disease is a disease of the inner ear bone and occurs as a result of metabolic changes in the rate of bone destruction and production. Drug treatments used in bone resorption such as osteoporosis; It helps to stop the progression of hearing loss. However, it has no curative properties. Long-term use of sodium fluoride and bisphosphonate-derived drugs is required.
When the goal is to restore hearing, there are two alternatives: Hearing aid and surgery.
With surgery, the intact eardrum is opened and the middle ear cavity is entered. . Thus, other diseases that can cause hearing loss in the middle ear can be diagnosed. It is diagnostically important to see that the stirrup that is seen in otosclerosis does not vibrate and is fixed. In this case, part or all of the stirrup is removed. A new hole is made in the fixed oval window and the inner ear is entered. Afterwards, the Teflon piston prosthesis suitable for the patient's anatomy is placed between this hole and the anvil bone. Thus, the sound wave vibration is transmitted directly from the anvil to the inner ear with the help of the prosthesis.
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