From the Research
The definitive treatment for otosclerosis is stapedotomy surgery, as it confers better hearing gain at high frequencies and lower complication rates compared to stapedectomy. This surgical procedure involves removing the fixed stapes bone partially and replacing it with a prosthesis to restore the mechanical connection between the middle ear and inner ear 1. The surgery is typically performed under local anesthesia as an outpatient procedure and takes about 60-90 minutes. Success rates are high, with approximately 90% of patients experiencing significant hearing improvement.
Key Considerations
- Alternative treatments include hearing aids for those who are not surgical candidates or who prefer non-surgical management.
- Fluoride therapy has been suggested to slow disease progression but is not curative.
- Surgery is considered definitive because otosclerosis involves abnormal bone growth around the stapes footplate that prevents normal sound transmission; only physical restoration of this mechanical pathway can truly correct the conductive hearing loss.
- Patients should expect some dizziness for a few days after surgery and should avoid heavy lifting, straining, flying, or water exposure in the ear canal for several weeks following the procedure.
Comparison of Surgical Techniques
- Stapedotomy has been shown to have better outcomes than stapedectomy in terms of hearing gain at high frequencies and complication rates 1, 2.
- However, the choice of surgical technique may depend on the individual patient's condition and the surgeon's preference.
- Some studies have suggested that stapedotomy with stapedius tendon preservation may be the preferred technique 3.
Post-Surgical Care
- Patients should follow post-surgical instructions carefully to minimize the risk of complications.
- Regular follow-up appointments with the surgeon are necessary to monitor hearing improvement and address any concerns or complications that may arise.