From the Research
The most effective treatment for otosclerosis is typically surgery, with stapedotomy being the preferred surgical procedure, as it offers favorable hearing outcomes with low complication rates, as shown in a recent study 1.
Treatment Options
Treatment options for otosclerosis include both surgical and non-surgical approaches.
- Surgical options:
- Stapedotomy: a procedure where a small hole is made in the stapes bone and a prosthesis is inserted to restore sound transmission.
- Stapedectomy: a procedure where all or part of the stapes bone is removed and replaced with a prosthesis.
- Non-surgical options:
- Hearing aids: amplify sounds to compensate for hearing loss.
- Medical management: sodium fluoride and bisphosphonates may help slow disease progression.
Evidence-Based Recommendations
A recent study published in 2025 1 compared the outcomes of stapedotomy and stapedectomy in patients with otosclerosis, and found that both techniques resulted in significant improvement in air-bone gap and speech recognition threshold, with no significant difference between them. Another study published in 2022 2 compared the outcomes of stapedotomy and hearing aids in patients with unilateral otosclerosis, and found that stapedotomy demonstrated increased quality of life and improved hearing outcomes compared to hearing aids.
Patient-Specific Considerations
The decision between treatment options should be individualized based on the patient's age, overall health, degree of hearing loss, and personal preferences.
- Patients with severe mixed hearing loss may benefit from cochlear implantation, as shown in a study published in 2011 3.
- Patients with far-advanced otosclerosis may require special consideration, as shown in a study published in 1993 4.
- Implantable hearing systems, such as the Carina active middle ear implant, may be an option for patients with severe conductive components and sensorineural hearing loss, as shown in a study published in 2021 5.