Otosclerosis: Pathophysiology, Hearing Loss Types & Treatment
Pathology
Abnormal bone remodeling fixes the stapes footplate to the oval window → conductive hearing loss.
May extend to cochlea → mixed or sensorineural loss (cochlear otosclerosis).
Presentation
- Gradual bilateral hearing loss (20s–40s)
- Tinnitus, sometimes vertigo
- Better hearing in noise (paracusis Willisii)
Management
- Hearing aids
- Stapedectomy / stapedotomy (prosthesis replacement)
- Sodium fluoride (controversial, slows progression)
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