Otosclerosis and Stapes Surgery

Introdution to Otosclerosis

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This segment provides background information on conductive hearing loss, the pathophsyiology of otosclerosis, and treatment options.


  • Otosclerosis
  • Conductive heairng loss
  • Pathophyiology
  • Stapes
  • Preoperative considerations
  • Patient selection

About this video

Cameron C. Wick
First online
14 March 2019
Online ISBN
Springer, Cham
Copyright information
© The Author(s) 2019

Video Transcript

The term otosclerosis is derived from Greek and means hard ear. It describes a condition of abnormal bone growth at the otic capsule. This becomes clinically relevant when the diseased bone surrounds the stapes, which is the third and smallest bone in the middle ear space.

Hardening of the bone around the stapes prevents it from moving freely, which is called fixation. If the stapes bone is fixed, it cannot properly transmit sound energy, which results in a conductive hearing loss. In advanced cases, this can even lead to sensory neural or nerve hearing loss, but that scenario will not be the focus of this video.

Hearing loss associated with otosclerosis typically begins as a young adult and can affect both men and women. Some reports suggest a higher incidence of women, particularly with a rapid onset during pregnancy. The hereditary nature of otosclerosis is complex. Some genes are autosomal dominant, but have an incomplete penetrance.

The main options for treating otosclerosis are observation with repeat hearing tests, a hearing aid, or surgery. Observation is recommended only for mild hearing loss that is not bothersome to the patient. It is not clear if medicines, such as sodium fluoride or bisphosphonate supplements, can prevent otosclerosis from progressing.

Hearing aids can help overcome the stapes fixation by simply increasing the sound volume. Cost, style, hearing aid fit, and possible benefits of this option should be discussed with your otolaryngologist or audiologist.

The surgery for otosclerosis is called a stapedectomy or stapedotomy. These phrases are often used interchangeably and represent subtle variations on the surgical technique. In general, this is an outpatient procedure and the surgery is performed through the ear canal.