Otosclerosis

Otosclerosis causes abnormal otic-capsule bone remodelling, usually fixing the stapes and producing progressive conductive hearing loss. Cochlear involvement or another inner-ear cause may add a sensorineural component. A normal drum with an air-bone gap suggests but does not confirm the diagnosis.

Discuss observation, hearing aids and stapes surgery according to disability, hearing reserve and patient preference. Small-fenestra stapedotomy is the usual operation; it improves sound transmission but does not prevent later hearing deterioration.

Sudden hearing deterioration, severe or persistent vertigo or severe pain after stapes surgery needs urgent review by the operating surgeon. ^{ENT UK}