Animation of Otosclerosis Disease

Otospongiosis (Growth of Spongy Bone in The Middle Ear)

Definition of Otosclerosis

Otosclerosis is a medical condition that affects the small bones in the middle ear. It is characterized by the abnormal growth and remodeling of bone within the middle ear, specifically the stapes bone. The stapes bone plays a crucial role in transmitting sound vibrations from the middle ear to the inner ear.

In otosclerosis, the abnormal bone growth can immobilize the stapes bone, preventing it from effectively transmitting sound to the inner ear. This results in hearing loss. Otosclerosis can occur in one or both ears and often develops gradually over time. It is a relatively common cause of hearing impairment, especially in young to middle-aged adults.

The exact cause of otosclerosis is not fully understood, but it may have a genetic component, as it tends to run in families. It primarily affects the Caucasian population and is more common in women than in men.

The main symptom of otosclerosis is conductive hearing loss, which means sound is not efficiently conducted from the middle ear to the inner ear. Individuals with otosclerosis may also experience other symptoms, such as tinnitus (ringing in the ears) or dizziness.

Treatment of Otosclerosis

Otosclerosis can often be treated with surgical procedures, such as stapedectomy or stapedotomy, which involve the removal or modification of the affected stapes bone to restore hearing. In some cases, hearing aids may also be used to manage hearing loss associated with otosclerosis.

The treatment of otosclerosis, a condition characterized by abnormal bone growth in the middle ear that can lead to hearing loss, can vary depending on the severity of the condition and the specific needs of the patient. Treatment options may include the following:

Hearing Aids: For individuals with mild to moderate hearing loss due to otosclerosis, hearing aids can be an effective non-surgical option. Hearing aids are designed to amplify sound, making it easier for individuals to hear and communicate.


a. Stapedectomy: Stapedectomy is a surgical procedure in which the stapes bone, which has been affected by otosclerosis, is removed and replaced with a prosthesis. This procedure can often restore or significantly improve hearing.

Stapedectomy is a surgical procedure performed to treat otosclerosis, a condition characterized by abnormal bone growth in the middle ear that can lead to conductive hearing loss. The primary indication for stapedectomy is when a patient has significant hearing loss due to otosclerosis, typically in the presence of the following factors:

Moderate to Severe Conductive Hearing Loss: Stapedectomy is most commonly indicated when a patient experiences moderate to severe conductive hearing loss. This means that sound is not efficiently transmitted from the middle ear to the inner ear due to the fixation or immobilization of the stapes bone by otosclerosis.

Progressive Hearing Loss: When otosclerosis leads to progressive hearing loss that significantly impairs the patient's quality of life and ability to communicate effectively, stapedectomy may be recommended. Hearing loss may become more severe over time, making surgical intervention necessary.

Failure of Hearing Aids: In some cases, patients may have already tried hearing aids but have not achieved satisfactory results in improving their hearing. When hearing aids are not effective or no longer provide sufficient benefit, stapedectomy may be considered as a surgical alternative.

Absence of Other Ear Pathologies: Stapedectomy is typically recommended when otosclerosis is the primary cause of hearing loss, and there are no significant structural or pathological issues in the ear that would contraindicate surgery.

Patient Preference: The decision to undergo stapedectomy is ultimately based on the patient's preference, in consultation with an ear, nose, and throat specialist (otolaryngologist). Patients should be informed about the potential benefits, risks, and outcomes of the procedure.

It's important for individuals with otosclerosis to undergo a comprehensive evaluation by a qualified otolaryngologist to determine if stapedectomy is the most appropriate treatment option. Stapedectomy is a highly successful procedure for restoring or significantly improving hearing in patients with otosclerosis, but like any surgery, it carries risks, and the decision to proceed should be made after careful consideration and consultation with a healthcare provider.

b. Stapedotomy: Stapedotomy is a modification of the stapedectomy procedure, in which a small hole is made in the stapes bone instead of its complete removal. A prosthesis is then placed in the hole to improve sound transmission. Stapedotomy is considered less invasive than stapedectomy and has become a common surgical approach for otosclerosis.

Fenestration Surgery: In rare cases, when the stapes bone is extensively damaged or if other surgical procedures are not appropriate, a fenestration surgery may be considered. This procedure creates a small window in the inner ear to bypass the affected stapes bone, allowing sound vibrations to reach the inner ear.

Medications: In some cases, medications such as sodium fluoride may be prescribed to slow the progression of otosclerosis. However, these medications are generally not considered a primary treatment and are used infrequently.

The choice of treatment depends on several factors, including the degree of hearing loss, the patient's age, the presence of symptoms like tinnitus or dizziness, and the patient's overall health. It's important to consult with an ear, nose, and throat specialist (otolaryngologist) to determine the most appropriate treatment for your specific case.

In otosclerosis (or otospongiosis), a decrease in the sound transmission and hearing loss occurs due to the hardening (ossification) of the base of the stapes bone, which is innermost from the 3 ossicles in the middle ear, which is ideal for stapesectomy operations after the stiffening base has been removed are equipped with Teflon piston or intelligent metal technology (Titanium prosthesisis such as Nitibond®). Teflon piston is the most commonly used prosthesis in otosclerosis surgery. This disase is causing progressive conductive hearing loss due to over growth of spongy bone in the middle ear (abnormal formation of new bone in the middle).

Stapedectomy surgery is the most effective treatment for patients with a certain level of conductive - type hearing loss due to middle ear calcification.

Nitibond® Stapes Prosthesis

"Nitibond Stapes Prosthesis" was produced by Kurz Medikal, a German medical company, to be used for stapedectomy in patients with otosclerosis in the middle ear.

As shown in the figure above, it closes automatically and permanently with heat. During the procedure, instead of squeezing using a metal tool, the laser is used and the prosthesis heated by the laser beam is tightly wrapped around the incus ossicle and closed.

The only difference is that the prosthesis produced with this intelligent metase technology is not laser-tightened; The risk of necrosis in the ossicle decreases because it squeezes the bone from 3 different points, because this prosthesis is obtained from pure titanium, the patient can enter a 7-tes MRI, the product has a 20-year warranty, and it is argued that transmission of sound waves is more than other prostheses.

Indeed, ease of application and shortening of the operation time can be achieved.

The link group you can click to read the previously published articles about Otosclerosis on this website >>

You can find details at >> NITIBOND® STAPES PROSTHESIS

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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