Inner Ear Diseases

Otosclerosis (Calcification of the Inner Ear)

Hearing occurs when sound waves reach the eardrum and cause it to vibrate. These vibrations are transmitted to the inner ear fluids by the movement of the hammer, anvil, and stirrup bones in the middle ear. In the inner ear, the vibrations are converted into electrical signals at the nerve endings and sent to the brain’s hearing center via the auditory nerve. Otosclerosis refers to the calcification of the wall areas of the stirrup bone (stapes) adjacent to the inner ear, restricting its movement. When the ossicle becomes immobile, it cannot transmit sound waves, resulting in hearing loss.

Initially, the inner ear remains unaffected, and only sound transmission is impaired. However, in advanced stages, calcification may extend to the inner ear wall, causing sensorineural hearing loss.

What are the causes of inner ear calcification?

The exact cause of otosclerosis is unknown. Factors believed to contribute to its development include race, family history, gender, and age. It is more common in Caucasians and women, particularly during or after pregnancy. The average onset age is 20–25 years, although it can rarely occur before puberty or after age 50.

Otosclerosis usually begins insidiously, making early detection difficult. It often presents as hearing loss and bothersome buzzing in one ear, typically following an infection during adolescence. As the hearing loss progresses, the other ear may also become affected. Some patients may also experience tinnitus, dizziness, and balance issues.

How is inner ear calcification diagnosed?

Physical examination findings are generally normal. Therefore, a hearing test is necessary. Imaging methods, such as tomography or MRI, do not directly reveal otosclerosis but may be performed to exclude other ear conditions.

If otosclerosis is in its early stages and does not significantly affect the patient clinically, it can be monitored through hearing tests. Depending on the degree of hearing loss, treatment options include surgery or hearing aids.

How is inner ear calcification treated?

The surgical treatment for otosclerosis is called stapedectomy. This procedure can be performed under local or general anesthesia, depending on the case. The success rate is high. Temporary dizziness may occur during the first week post-surgery, along with occasional nausea and vomiting.  Pain is rare and typically mild if present. Most patients can resume daily activities within 7–10 days. However, heavy lifting, diving, air travel, straining, and coughing should be avoided for approximately two months following the surgery. Full recovery may take 2–3 months. – Asia Europe ENT –