Otosclerosis: Causes, Symptoms, Diagnosis, and Treatment


what isĀ  Otosclerosis?

Otosclerosis is an unexplained disease. It is pathologically due to the primarily limited bone resorption of a bone labyrinth and replaced by a spongy bone hyperplasia rich in blood vessels. It is called hardening.

When the egg garden window is infringed, it can cause the sacrum to be fixed and lose the function of sound transmission, so that the hearing is progressively reduced. The incidence of otosclerosis has a lot to do with race. The incidence of whites is high, and the incidence of blacks is the lowest. Yellow people are somewhere in between.

The age of onset is more young and middle-aged. Otosclerosis is a lesion of the bony ear sac and is the most common cause of progressive acoustic deafness in adults with a normal tympanic membrane. The clinical manifestations of hearing loss, tinnitus nature, monaural inhibition of binaural hearing loss, Weir’s misinterpretation and dizziness, ear-pore, earache, and pus. The otosclerosis is a progressive deafness that occurs in both ears.

Causes and Risk Factors

Its etiology is unknown, and the age of onset is mostly 20 to 40 years old. Foreign countries reported that there were more women than men, and domestic reports were slightly more than men. It is generally believed that the nutritional disorders, endocrine effects and genetic factors of the lost bone shell may be related factors of the occurrence of this disease.

Symptoms of otosclerosis

  • First, deafness. The first symptoms of otosclerosis are deafness, and progressive hearing loss in both ears or monaural ears is the most important symptom.
  • Second, tinnitus. About half of patients have tinnitus. Tinnitus in this condition is characterized by low frequency, intermittent, or persistent characteristics in the initial stage, and it may evolve into high-frequency tinnitus in the later stage.
  • Third, Webster misunderstood. Webster’s misinterpretation refers to the fact that patients have more severe hearing disorders and poor hearing in normal conditions, but they can improve hearing in noisy environments. This kind of otosclerosis symptoms is more common.
  • Fourth, dizziness. A small number of patients may experience vertigo in head movements, but they are mild and temporary.

Diagnosis of otosclerosis

According to medical history and examination, the diagnosis of typical cases is still easy, but should be noted with the congenital ossicular chain to identify: this type of patient is born with hearing impairment, does not increase with age; due to inflammation caused by the ossicular chain Tonic, adhesion, or disconnection, the tympanic membranes have many lesions.

Therapeutic principlesĀ 

1. The cause of the disease is unknown, the purpose of treatment is to restore hearing and cannot be cured.

  1. Surgical treatment is the most effective measure to improve hearing. The short-term curative effect of tibial condylar surgery is better, but the source of sclerosis cannot be controlled and the long-term curative effect is poor. Currently, it has been rarely used.

Inner ear fenestration can also improve hearing, but the long-term effect is poor and there may be a sensorineural hearing loss. Currently widely used is the partial or total resection of the sacrum, followed by the installation of the artificial sacrum. The operation is performed under a microscope and requires certain equipment conditions and technical levels.

  1. Can not be operated with hearing aids.

The treatment plan of otosclerosis

1. Surgical treatment, including inner ear fenestration, zygomatic iliac arthroplasty, and tibial extraction.
2. drug treatment, can be given vitamins, sodium fluoride and so on.
3. if the nasal cavity, nasopharyngeal cavity, tonsil lesions, should be treated.
4. Hearing aids may be provided for those who fail or are unfit for surgery.

Conservative treatment

Sodium fluoride may be tested for patients who are unsuitable for surgery or who are unwilling to undergo surgery. However, their efficacy is not yet certain and is rarely used in China. Hearing aids are an effective treatment option. For mental depression or irritability, the patient can be given symptomatic treatment.

Surgical treatment

Surgical methods are mainly zygomatic surgery and semi-standard fenestration. In zygomatic surgery, all or part of the affected humerus is removed and the ossicular chain is reconstructed with a suitable repair material to improve hearing.

All patients with otosclerosis were found to have a hearing loss of more than 30 dB through pure tone audiometry, a difference in the air-brain conduction of more than 15 dB, and a language discrimination ratio of more than 60. As long as there are no other surgical contraindications, they are all acceptable for tibial surgery.

The semi-regular fenestration is to open a small window on the bony semicircular canal so that the sound waves can be transmitted through this window to the inner ear without listening to the bone chain, which has a certain effect on improving hearing.

Precautionary measures of otosclerosis

1. Young people can’t play too much and listen to MP3s for too long. Excessive use of headphones can also cause chronic hearing loss. If you really need to keep using your headphones, take a break every half hour.

2. Aminoglycosides (ie, streptomycin, gentamicin, kanamycin, etc.) should be avoided in newborns and children.

3. Couples with a reproductive risk of deaf children should receive genetic guidance and prenatal counseling.

4. Ear injury and infection should be prevented.

5. Should prevent colds.

6. Care should be taken to avoid possible causes of deafness. For example, if you stay up late or feel physically and mentally exhausted, and have mental stress, you should pay attention to adjustments and rest.

7. Chronic otitis media should be treated as soon as possible to prevent deafness from continuing to develop.

If otosclerosis is not cured, it will gradually damage people’s hearing. In severe cases, it even leads to deafness, so we must put treatment first.

Currently, sacral surgery is a better method for the treatment of otosclerosis: the fixed sacrum is treated directly to improve hearing. To prevent the progression of the disease, it is applicable to 13 to 80-year-old patients with otosclerosis who have an aero-guided hearing loss of more than 30 dB and a gap between the air-bone conduction gap of 15 dB or more.

Surgical methods include zygomatic sacral traction, sacral augmentation, total sacral excision, partial sacral excision, CO laser partial sacral excision, and artificial sacral ostectomy. All or part of the affected tibial foot plate is removed, followed by autologous residual ossicles or other bones or cartilage pillars, polyethylene tubules, Teflon pistons, stainless steel fat plugs, silicone rubber or alumina ceramics, etc.

Artificial iliac bones made of inorganic materials are placed between the protuberances of the malleus or incus and the vestibular window. The vestibular window is covered with autologous venous sheets, bone or cartilaginous membranes, diaphragmatic fascia, connective tissue, gelatin sponge sheets, and the like.

Experts at the ENT clinic also explained that friends who do not want surgery can bring hearing aids to solve problems. However, if the hearing aid is used for a long time, the effect will be worse and worse, and it will bring inconvenience to the life of the patient. Therefore, it is recommended that it is not a special case or surgery.

Dietary care

Chinese medicine believes that the kidneys are open to the ear, and the kidneys are not ears. If the blood circulation is unfavorable, there is blood stasis in the ear, causing localized sclerosis.

In the usual diet, you can eat some foods with kidney and nourishing blood, such as walnut, longan meat, black sesame, red dates and so on. Introduce a “red jujube longan soup”: take 15 to 20 red dates, 7 longan meat; first red dates to slow fire for 15 minutes, then under the longan meat, boiling 5 minutes Serve, take hot soup, and eat longan Meat and jujube meat.

Once every night. Do not eat spicy, stimulate food, such as ginger, pepper, wine, lamb, pepper, etc., do not take hot tonic, such as ginseng, cinnamon, monkshood, pilose antler, bullwhip, Dabu cream and the like, eat more heat and inflammation Fresh vegetables, such as celery, loofah, eggplant, leeks, basil, cucumber, bitter melon and so on.


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