Otosclerosis

Question 1

What is otosclerosis

Answer 1

Hardening + remodelling of the bones in the middle ear leading to conductive hearing loss. Normally affects stapes

Question 2

Causes of otosclerosis

Answer 2

Not entirely known but can be inherited autosomal dominant pattern.

Question 3

Otosclerosis presentation

Answer 3

Patient under 40 with gradual worsening unilateral/bilateral conductive hearing loss. May also experience tinnitus. Tends to affect hearing of lower-pitched sounds more (opposite of presbycusis)

Question 4

Otosclerosis examination

Answer 4

Rinne’s test - BC>AC
Weber’s test - normal if bilateral otosclerosis
- if unilateral, sound louder in affected ear.

Question 5

Otosclerosis differentials

Answer 5

Presbycusis, Labyrinthitis, Meniere’s disease

Question 6

Otosclerosis management

Answer 6

Conservative - use of hearing aids
Stapedectomy - remove stapes bone and replace with prosthetic.
Stapedotomy - Remove part of stapes (leave base) and prosthetic added