Otosclerosis (another name for the disease is otospongiosis) is a lesion of the bone capsule in the inner ear. As a result of otosclerosis, the patient develops hearing loss, hearing aid dysfunction and stapes ankylosis. Along with hearing loss, the patient may experience pain in the ears, as well as dizziness. The disease usually affects one ear, but after some time without proper treatment it spreads to the second.

Statistics show that otospongiosis affects 1% of the population, mainly women, and most often its symptoms appear between the ages of 25 and 35 years. Treatment usually involves surgery.

Reasons

The occurrence of otosclerosis is associated with several reasons:

• factor of heredity. Most often, otospongiosis is a familial disease. Also, ear damage sometimes occurs in pregnant women (doctors attribute this to disorders of the thyroid gland and vascular diseases), which can contribute to the acquisition of the disease by future offspring;
• infection factor. Doctors have discovered that damage to the vessels of the inner ear can develop as a result of a disease, for example, but the patient must have a hereditary predisposition to the disease;
• factor of injuries and other disorders. It occurs if acoustic injuries occur, vascular damage occurs - the blood supply to the bone capsule of the labyrinth of the ear is disrupted, or tissue calcification develops.

Classification of the disease

Experts distinguish 3 types of otosclerosis depending on the type of ear dysfunction:

• conductive. In this form, only sound transmission is disrupted, but sound perception remains normal. This type of otosclerosis is, from the point of view of the prognosis for recovery, the most favorable, since it usually involves complete restoration of hearing. In some cases, along with medications, folk remedies are prescribed;
• mixed. With this form of the disease, sound perception and sound conduction are impaired. It is difficult to treat otospongiosis of this type. In some cases, doctors can only restore bone conduction of sound;
• cochlear. With the development of this form, the sound-perceiving function of the ear is significantly impaired (when conducting sound on an audiogram, the conduction threshold using bone-type conduction is no more than 40 dB). Even surgery is not able to eliminate all symptoms, and does not always lead to restoration of hearing and ear vessels sufficient for normal life.

Depending on the nature of the manifestation, otospongiosis is divided into:

• slow (observed in 2/3 of patients);
• spasmodic (observed in 20% of patients);
• fast (observed in approximately 10% of patients).

Signs of illness

Otospongiosis, as a rule, develops quite unnoticed. The stage when the patient does not feel any symptoms of the disease is called histological. It is worth noting that at this stage, changes in the ear are already beginning to occur - the structure of bone tissue in the ear labyrinth and the functioning of blood vessels change. It may take about 3 years from the onset of the disease to the appearance of the first noticeable signs. Diagnosis of otosclerosis at this stage is possible only with the help of audiometry. Starting from the second stage, the following main symptoms can be identified:

• the appearance of hearing loss. In the initial stages of the disease, the patient usually does not distinguish low tones (in particular, male voices), but perfectly hears high tones (children's and women's voices). There may also be transmission of extraneous sounds into the cochlea that pass through soft tissues (chewing food, the sound of steps). Further, this symptom can only worsen - its regression is impossible, but it does not reach complete deafness;
• noise in the ear. It is noted by more than 80% of patients with this disease. The degree of noise that a patient hears does not depend on the degree of hearing loss and vascular damage. Doctors suggest that this symptom has a direct connection with metabolic disorders or vascular problems;
• ear pain. Appears during periods of relapse of otosclerosis. Its localization is in the mastoid process. Usually, after the onset of pain, the patient begins to hear worse;
• dizziness. This rare symptom is usually mild in nature;
• neurasthenic syndrome. This symptom is directly related to the fact that patients cannot fully communicate with others, withdraw into themselves, become lethargic and drowsy.

Diagnosis of the disease

A doctor will diagnose a patient with otospongiosis if he or she comes to him with complaints of noise in the ear and hearing loss. The main task of the doctor is to distinguish otospongiosis from, for example, an ear tumor, otitis media, the presence of cerumen plugs or neuritis. To do this, he will prescribe the patient an otoscopy and also carefully examine his ears.

Using otoscopy, you can determine the absence of wax plugs, dryness, and changes in the skin of the ear canal. Also, if otospongiosis is suspected, the doctor will prescribe audiometry to the patient, which detects problems with the perception of quiet sounds (whispers). In some cases, the disease can be detected by performing a skull x-ray or CT scan.

Treatment of the disease

Treatment of otosclerosis involves the use of:

• surgical methods (operations);
• folk remedies.

Surgical treatment for otosclerosis (surgery) aims to improve the mechanism of sound transmission to the perilymph of the ear labyrinth. The operation is performed if the threshold for bone conduction of sounds does not exceed 25 dB, and for air conduction – 50 dB. If the patient's perception of sounds is above these limits or the active phase of treatment is being carried out, surgery is contraindicated. There are 3 types of operations to treat otosclerosis:

• stapedoplasty;
• creating an additional hole in the labyrinth;
• mobilization of the stapes.

Stapedoplasty carried out to free the stapes from the bony processes that immobilize it. Fenestration– the second type of treatment, however, like stapedoplasty, it is temporary (several years). It is worth noting that stapedoplasty is considered the most effective method, which provides an 80% successful cure for the disease. Treatment of otosclerosis allows you to restore blood vessels and the mechanism of sound transmission, but treatment must be combined with other methods - hearing aids, therapy.

Treatment of otosclerosis folk remedies can become an additional, but not the main method of treating blood vessels and ears. Among the many recipes, the following folk remedies are distinguished:

• potato juice. This folk remedy is recommended to be used daily for six months;
• olive or vegetable oil. It is recommended to drink it daily for several months to suppress the symptoms of the disease;
• a mixture of lemon juice, oil and honey. This folk remedy is also recommended to be taken every day on an empty stomach;
• dill seeds. This folk remedy is recommended for severe ear pain;
• Melissa. This folk remedy helps eliminate dizziness.

Otosclerosis is a dystrophic-degenerative lesion of the middle ear, during the development of which phases of destruction (destruction) of bone tissue and deposition of calcium salts alternate, which form new dense bone structures.

• At the same time, symptoms of otosclerosis may not always be present: “histological”, which does not affect the vestibulocochlear window, is found in 10% of the population,
• whereas clinical is detected in approximately 1%.
• Mostly women suffer; according to foreign data, they get sick 2 times more often; according to domestic data, they make up 70–80% of all patients.
• The disease most often affects people aged 15 to 45 years and manifests itself as bilateral hearing loss (hearing loss).

The nature of the hearing loss is usually conductive, that is, its decrease is caused by a violation of sound conduction. However, otosclerosis is also found in 1.5–2.3% of patients with sensorineural hearing loss. In this case, its so-called cochlear form is revealed: the process affects the cochlea and affects the internal structures of the labyrinth, but does not interfere with the mobility of the stapes.

Otosclerosis: causes of occurrence

Otosclerosis of the ear is a hereditary pathology, the genes of which are transmitted in an autosomal dominant manner (a dominant autosomal trait means that for the disease to manifest, it is enough to inherit a defective gene from one parent of either sex), but manifests itself in 20–40% of cases (this phenomenon is called incomplete penetrance) .

It is assumed that these genes are activated by the measles virus, the proteins and structural units of which are often found in foci of otosclerosis. Antibodies to the virus are found not only in the blood, but also in the perilymph: the fluid contained inside the cochlea. The theory is also supported by the fact that the incidence of otosclerosis decreased after the introduction of mandatory measles vaccination.

Another theory suggests that autoimmune mechanisms play a role in the development of the disease - antibodies to collagen types 2 and 9 are often found in the blood of patients. Subclinical (without pronounced manifestations) neuroendocrine disorders are also important. The first manifestations of the disease usually occur against the background of rapid hormonal changes: puberty, pregnancy, and the onset of menopause.

Classification

According to the forms of otosclerosis:

• tympanic form of otosclerosis - bone sound conduction is reduced by no more than 20 dB);
• mixed form I: by 20 – 30 dB;
• mixed form II: by 30 – 50 dB;
• cochlear form - bone conduction is more than 50 dB below normal.

According to the location of foci of otosclerosis:

• fenestral (changes in the boundaries of the vestibulocochlear window);
• cochlear (the cochlear capsule is affected);
• mixed.

By process stage:

• active (otospongious, fibrovascular foci): immature spongy bone permeated with vessels is formed at the site of otosclerosis;
• inactive (sclerotic) – sclerotic dense mature bone is formed.

By rate of progression:

• slow-onset forms: hearing loss until loss of the ability to communicate develops within 9–10 years;
• fulminant forms: almost complete deafness develops over several months due to the involvement of the structures of the inner ear in the process;
• protracted forms: the disease debuts in old age.

Clinical picture

Often the disease debuts in young women. Moreover, the earlier the disease begins, the more actively it develops. Pregnancy with otosclerosis can become both a trigger factor, causing the first symptoms, and worsen the condition, accelerating hearing loss.

The first complaint that patients make is “unreasonable” hearing loss, usually in both ears (unilateral hearing loss occurs in approximately 30% of cases). But even with bilateral hearing loss, patients can complain of unilateral hearing loss: the process proceeds asymmetrically, and the better hearing ear will be perceived as subjectively “normal”, even if we are no longer talking about the norm.

First, low frequencies “disappear”: it becomes more difficult to understand male speech. Then the hearing loss extends to high frequencies. But the process never reaches complete deafness: the patient hears his own speech even in the later stages of the disease. Characteristic signs of otosclerosis: in a noisy environment, speech perception improves, worsens with chewing and swallowing, intense attention, and several people talking at the same time.

Another common symptom: low- or mid-frequency tinnitus. Subjectively, it is described as the noise of falling water, the rustling of leaves, the rustle of the surf, the hum of wires. It is very difficult for patients to tolerate, often interferes with sleep, and even cases of suicide have been described for this reason. The noise intensity is usually constant, but can increase after drinking alcohol, physical exertion, stress, or overwork. Unfortunately, this is the most difficult symptom to eliminate, regardless of how otosclerosis is treated: in many patients, tinnitus persists after surgery.

In approximately a quarter of cases, these symptoms of otosclerosis are accompanied by dizziness and balance disorders caused by increased pressure inside the labyrinth. Typically, positional vertigo occurs when turning, tilting the head, or quickly changing body position.

Diagnostics

The main diagnostic criteria for otosclerosis:

• bilateral conductive hearing loss;
• normal patency of the auditory tubes;
• normal condition of the eardrums;
• family history.

An audiogram for tympanic and mixed forms of otosclerosis reveals conductive or mixed hearing loss. A “Carhart wave” often appears - in the range of 2–3 kHz, the bone curve indicators deteriorate by 5–15 dB. Speech audiometry shows 100% speech intelligibility.

In the cochlear form of otosclerosis, hearing loss is usually sensorineural or mixed with a predominance of sound perception disorders. Audiogram without air-bone interval. In this form, otosclerosis can be distinguished from other pathologies by:

• family history;
• symmetrical bilateral sensorineural hearing loss;
• good speech intelligibility, which is not typical for other forms of sensorineural hearing loss;
• onset of the disease at a relatively young age;
• progression of hearing loss for no apparent reason.
• changes on CT (demineralization of the labyrinth capsule).

With tympanometry (measuring the mobility of the eardrum), the results are within normal limits, regardless of the form of otosclerosis.

The only objective method of confirming the diagnosis is computed tomography of the temporal bones with a slice thickness of 0.5 - 0.6 mm. This is the only way to identify the localization and prevalence of foci, as well as the degree of activity of the process.

• decreased density of the cochlear capsule;
• stirrup thicker than 0.6 mm;
• the anterior part of the base of the stirrup is thickened (takes on a triangular shape).

In addition, CT can detect structural features of the temporal bones, which may be important when planning treatment.

Conservative therapy

Treatment of otosclerosis without surgery is indicated for patients with an active form or its cochlear form. Therapy is aimed at slowing down the activity of the process and preventing sensorineural hearing loss. Drugs used:

• bisphosphonates: drugs that inhibit the activity of osteoclasts (cells that destroy bone tissue) - Xidofon, Fossamax, Fosavance;
• sodium fluoride – fluoride ions reduce bone resorption;
• calcium preparations;
• alfaclcidol is a precursor of vitamin D 3, which regulates mineral metabolism and stimulates the synthesis of bone matrix proteins - the protein frame of the bone.

Drug therapy is carried out in courses of three months with a three-month break. Initially, at least two courses are planned. Conservative therapy is rarely used as an independent treatment for otosclerosis. It does not restore hearing, but helps prevent its loss by stopping the growth of foci of otosclerosis, which is especially important in its active phase, when surgery is not recommended due to the possibility of reossification (re-ossification).

Surgical treatment

Surgery for otosclerosis is called stapedoplasty. This is a microsurgical intervention that restores sound transmission along the chain of auditory ossicles. Usually, the footplate of the stapes is either completely removed and replaced with a prosthesis, or (if it is firmly fixed in the sclerotic bone) a hole is drilled in it, into which a piston connected to a chain of auditory ossicles is inserted. The intervention is carried out both under general anesthesia and local anesthesia; the choice of pain relief is up to the doctor.

Indications for surgery:

• complaints of hearing loss and tinnitus;
• conductive or mixed hearing loss, the air-bone interval on the audiogram is at least 30 dB;
• the eardrum is not perforated;
• otosclerosis in the inactive phase.

Relative contraindications:

• active phase of the otosclerotic process;
• The ear on which surgery is planned is the only hearing one.

The general condition of the patient (cardiovascular insufficiency and similar pathologies) may also be a contraindication to surgery for otosclerosis of the ear. If stapedoplasty cannot be performed due to contraindications, possible correction is limited to a hearing aid.

There are several options for stapedoplasty, but none of them guarantee 100% hearing restoration: 10% develop postoperative conductive hearing loss, 3.5–5.9% develop sensorineural hearing loss, and 0.9–2% develop deafness.

If the operation is not performed under anesthesia, the patient feels an improvement in hearing already on the operating table. After this, a tampon is placed in the ear canal, and subjectively, hearing returns to its previous level - but only because the ear is “plugged.”

• The first day after stapedoplasty, the patient should lie on the non-operated side, stand up, and cannot turn his head. You can get out of bed for the first time no earlier than one day after the end of the operation.
• On the second day after surgery, you can sit and walk carefully. There is a high probability of dizziness, so it is better to move along the walls and supports.
• On the fourth day, the bandage is changed.
• After a week, the tampon is removed.
• They are usually discharged from the hospital after 7–10 days.

For a month after surgery, be sure to sleep on the “healthy” side. All this time you cannot:

• do not allow water to get into the ear (when washing your head, the ear canal should be covered with oiled cotton wool);
• shake your head, bend your head down;
• suffer from acute respiratory viral infections and the flu, but if you fail to protect yourself, do not blow your nose under any circumstances;
• In general, any vibrations and shocks are contraindicated;

You cannot ride the subway for 2 months after surgery.

3 months after surgery you cannot:

• lift weights (more than 10 kg);
• run and jump;
• fly on an airplane;
• skydive;

During this time, be sure to avoid loud noises. If it is noisy at work, the operated ear should be protected with earplugs or special anti-noise headphones. Earplugs are also useful on holidays (fireworks, pyrotechnics, loud music).

Diving is prohibited for life. Hearing stabilizes on average 3 months after surgery, so there is no point in relying on an audiogram that will be taken upon discharge. Audiograms taken 3 and 6 months after surgery will be more revealing.

At first, all sounds will seem very loud and strong. Then the world around you will become less loud - but this does not mean deterioration, it is a sign that the hearing aid has adapted after the operation.

Otosclerosis is a pathology of the human sound-conducting apparatus, in which the hearing organ begins to intensively lose its basic functions. The most common manifestations of the pathology are noises in the sink, migraines and dizziness, as well as a stable deterioration in hearing. This is explained by disturbances in the functioning of the tympanic ossicles of the middle ear.

Mature people, aged 30 to 45 years, are more susceptible to otosclerosis. However, otosclerosis is often observed in children during adolescence. It should be noted that this pathology affects women 3 times more often than men. In order to recognize otosclerosis in time and begin treatment, you need to know about its distinctive symptoms, methods of diagnosis and therapy, as well as basic preventive measures.

Main forms of pathology

Despite the fact that the etiology of the disease is not fully understood, most otolaryngologists agree that ear otosclerosis is hereditary. It is diseases that are inherited that are the most difficult in terms of diagnosis and treatment.

The following forms of otosclerosis are distinguished:

Conductive form

This form of the disease is characterized by a violation of the exclusively sound-conducting function of the ear. It is quite easy to identify with the help of an audiogram, which will show an increased threshold for the conduction of air masses. The bone tissue will remain within its normal state.

A tympanogram will help quickly identify this form of pathology. This is the mildest and most favorable form of otosclerosis, responding well to drug treatment.

Surgical intervention provides an 80% guarantee that hearing will be completely restored.

Cochlear

This form of the disease is distinguished by the fact that the sound-conducting function of the hearing aid is disrupted to a much greater extent than in the conductive course of the disease. In this case, otosclerosis of the ears in a person becomes a serious obstacle to communication with the outside world and live communication.

The audiogram records not only a disturbance in the passage of signals through the auricle, but also a critically low threshold for sound transmission through bone tissue. The latter indicators, as a rule, do not rise above 40 dB.

Mixed

The mixed group of otosclerosis is the most unfavorable in terms of further prognosis. The patient has a conduction disorder of both air and bone types.

Undoubtedly, these deviations negatively affect a person’s auditory perception of the surrounding world. Unfortunately, even surgery is not able to restore hearing to the level of air conduction.

How does otosclerosis manifest?

As a rule, otosclerosis has genetic causes. The initial diagnosis of otosclerosis can be done independently. Symptoms characteristic of otosclerosis manifest themselves as follows.

In most cases, this ear pathology implies a barely noticeable but regular hearing loss. At the very beginning of the disease, the patient still perceives high tones well, but has problems perceiving lower tones.

It is noteworthy that patients begin to distinguish the timbre of a man’s voice worse, but they can hear women’s speech well for quite a long time after the onset of the disease.

Extraneous sounds in the ears

This symptom is present in the vast majority of patients who have been diagnosed with otosclerosis. It should be noted that tinnitus is in no way related to the degree of hearing loss. The sounds that the patient hears resemble radio interference, the rustling of leaves or the sound of a primus stove.

People also call these sounds white noise. Presumably, this sign of otosclerosis manifests itself due to circulatory disorders or failure of metabolic processes in the auricle.

Painful sensations in the ear

Painful sensations in the ear are characterized by the tympanic form of the disease, in which the patient begins to rapidly lose hearing.

As a rule, the pain increases quite quickly, and its peak impact occurs in the mastoid process of the ear. Pain can indicate both the onset of the disease and the period of its exacerbation.

Migraines and dizziness

These symptoms are not often seen in patients with otosclerosis, but they also occur. As a rule, dizziness is of a background nature and is not particularly intense.

If the patient is bothered by severe headaches, dizziness and fainting, it is necessary to seek medical help to clarify the diagnosis. The patient may be prescribed a tympanogram to ensure the mobility of the ear bones.

Neurological signs of illness

Hearing loss is one of the most unpleasant consequences of otosclerosis. Impaired sound perception leads to the patient losing the ability to fully communicate with society.

Due to hearing problems, people often withdraw into themselves and stop striving to communicate with others. The patient begins to show signs of apathy, disruption of sleep and wakefulness, drowsiness and lethargy.

Treatment

In order to have an idea of ​​the state of your body during treatment, you need to know what otosclerosis is and how it occurs.

If the disease is detected at its inception stage, then the patient has a good chance to avoid hearing loss without resorting to surgical intervention.

Conservative therapy

Treatment of otosclerosis without surgery, i.e. Conservative treatment includes prescribing a number of effective medications to the patient for a period not exceeding 6 weeks. However, therapy is repeated every 3 months to avoid relapse of the disease.

Before starting treatment, the patient is required to undergo such types of examinations as audiometry and tympanogram. Depending on why otosclerosis occurs, symptoms and treatment may vary. Broad-spectrum drugs prescribed for this pathology include the following:

• Phytin (1 tablet 3 times a day);
• Potassium iodide (4 times a day after meals);
• Sodium bromide (100 mg 3 times a day);
• Sodium solution (1 injection each);
• Fosamax (1 tablet per day);
• Xidifon (one tablespoon three times a day).

In addition to the above medications, the otolaryngologist may prescribe a course of calcium tablets and vitamin D.

It is necessary to continue taking vitamin complexes for six months. Once a month, the patient must undergo control audiometry to record the level of hearing at a particular stage of treatment.

Surgical intervention

Due to the fact that otosclerosis is usually detected in the patient quite a long time after the onset of the disease, surgery is indicated in most cases.

The main goal of otosclerosis surgery is the maximum possible restoration of the sound-conducting function of the ear. Surgical treatment is advisable even if the patient has to use a hearing aid.

The most common operation for this problem is called stapedotomy or stapedoplasty. The main work is carried out on the auditory ossicles, during which one of them (the stapes) is partially or completely replaced with a prosthesis.

Only one ear can be operated on at a time. If the otosclerosis is bilateral, then surgery on the second ear is possible in no less than 6 months.

In order for postoperative recovery to be successful, the patient should not lie down on the operated ear for 2-3 days after the intervention. You are allowed to sleep only on your back or healthy side.

In addition, the patient is entitled to a special form of care on the first day after surgery. The patient is also not recommended to fly or expose the body to physical activity for 4-6 weeks after surgery. As a rule, hearing improves already on the 7th to 10th day of surgical treatment.

Traditional methods

If you are lucky enough to notice the first manifestations of otosclerosis (otospongiosis) in time, then treatment will be simpler and faster than in the later stages of the disease.

As a rule, doctors first try to achieve maximum results from conservative treatment and folk remedies.

Only if they are ineffective is surgery indicated for the patient. To get better results from drug therapy, it can be combined with folk remedies.

1. A decoction of angelica roots is excellent in the fight against otosclerosis. For 500 ml of boiled water you need to take 10 g of dry plant. The product needs to sit for about 2-3 hours. The decoction is taken shortly before meals, 25 ml at a time.
2. Chinese lemongrass or ginseng will help relieve pain and relieve congestion in the affected ear. These tinctures are sold in pharmacies in ready-made form. A few drops of the product are mixed with 50-70 grams of water. You need to take the medicine up to 3 times a day before meals.
3. You can eliminate disturbing extraneous noise in the ears by preparing a decoction of ordinary dill seeds. To do this you will need 1 liter of boiling water and 20 g of seeds. The broth is infused in a dark place for about a day. The patient needs to drink at least 150 ml of the product per day.

In addition to treatment with folk remedies for oral administration, there are recipes aimed at local effects on the sore ear. Traditional healers believe that this can significantly improve the patient’s condition.

• A solution for the use of ear turundas for otosclerosis can be prepared as follows: 100 g of lemon balm, pour 500 ml of alcohol. The mixture is left for 3-5 days in the cellar or pantry. Then the resulting product is diluted by half with boiled water. Every evening you need to soak a cotton pad in the solution and place it in your ear for a period of up to 6-8 hours.
• An excellent help in getting rid of ear diseases are homemade blackberry drops. To do this, you need to collect a small amount (about 200 g) of fresh berries and leaves. They are boiled in a liter of water until the amount of liquid is reduced by half. The finished product is instilled into the ear canal, 2-3 drops daily.

Important information! You can resort to using any of the methods of alternative medicine with the permission of your attending physician.

Remember that traditional recipes are only an addition to the main treatment - they cannot replace drug therapy or surgery, or become an alternative to traditional treatment.

Despite the fact that otosclerosis is inherited as a dominant autosomal trait, one should not complain only about genetics. Even in a person who has certain genetic disorders, the disease may never manifest itself. Protecting your body from infection is quite difficult, but it is still possible.

The likelihood of developing otosclerosis increases in situations where a person has a weakened immune system.

You should take special care of yourself during pregnancy and lactation, after traumatic situations, during exacerbation of chronic pathologies, and also promptly treat emerging acute diseases. Of course, everyone needs to know how to diagnose and how to treat otosclerosis.

Hearing is one of the ways to perceive the world around us. The ability to hear is often perceived as a natural human ability, but in the meantime the health of the ears may be at risk. It is important to pay attention to alarming symptoms in a timely manner and not put off visiting a doctor.

The importance of hearing health

Determining the importance of the hearing organs for a person is simple: just think about how much information a person receives using their ears. This is the first thing that comes to mind when it comes to ears.

There is another side to the issue: the correct functioning of the auditory organs allows the body to control the vestibular apparatus. Without the coordinated work of all systems, it will be impossible to maintain balance and even navigate in space.

It is believed that the ears are not particularly vulnerable organs, but they should not be left without proper control. Deterioration or loss of hearing can be a problem or a real tragedy for anyone.

What is otosclerosis of the ear?

Despite their own protective mechanisms, the ears can be susceptible to the development of various pathologies. It is important to carefully monitor the condition of the hearing organs; this will preserve their health and the acuity of perception of the surrounding world for a long time.

Otosclerosis of the ear is a disease that is characterized by the proliferation of bone structures in the soft tissue areas of the middle and inner ear. Medical statistics show that women are more susceptible to this pathology than the stronger sex. The disease is characterized by a long-term development. In most cases, it begins in adolescence, reaching its peak at age 30. Cases of the disease among young children also occur, but much less frequently.

The disease of otosclerosis of the ear requires careful and competent medical intervention, which should be aimed at preserving the patient’s hearing. Due to the loss of elasticity of soft tissues (especially in the area of ​​the cochlea of ​​the inner ear), the full transmission of vibrational movements to the necessary receptors ceases, that is, the sound wave does not reach its target and does not form sound sensations. This development of otosclerosis of the ear leads to serious hearing loss up to complete deafness.

Causes of the disease

Scientists have not yet come to a consensus on what provokes the development of pathology in humans. Factors that influence the hearing organs continue to be studied, which will further expand knowledge about the disease. But today there is reason to believe that otosclerosis of the ear is largely a genetic disease. A similar conclusion was made based on clinical observations that showed a high percentage of heredity of this problem.

Other factors that cause hearing loss:

1. Anomalies of the auditory organs (congenital and acquired).
2. Chronic pathologies of the middle ear.
3. Noise overload (long stay in an area of ​​increased noise exposure).
4. Severe emotional overload combined with physical stress.

Types of disease

In medicine, it is customary to classify a disease according to several criteria. Depending on the type, structure and location of ear tumors, the following are distinguished:

1. Fenestral otosclerosis. The source of the disease is located in the vestibule of the cochlea of ​​the inner ear. The perception of sound data is impaired.
2. Cochlear otosclerosis, which directly affects the capsule of the cochlea. The ear loses the ability to fully conduct sound waves.
3. Mixed type of pathology. This type disrupts not only the perception, but also the conduction of sound, which leads to hearing loss in the patient.

According to the nature of the course of the disease, active and sclerotic otosclerosis of the ear are divided. Pathology rarely appears in any one form; the stages of the course alternately replace each other.

Based on the speed of development, the disease is also usually divided into several stages, which are recorded as part of clinical observations:

1. Fleeting disease (about 10% of known cases).
2. Slow development of the disease (the most common nature of the disease, about 70% of cases).
3. Mixed type of flow or spasmodic (20% of cases).

Symptoms of the disease

There are several main factors that a person should pay attention to in order to detect the development of pathology in time.

Symptoms:

1. Tinnitus. Otosclerosis is provoked by the constant presence of noise interference, which can be perceived as wind, rustling leaves or other natural background. It is possible to pay attention to such a symptom at a time when the quality of hearing is greatly reduced, but the noise remains.
2. Attacks of dizziness, accompanied by nausea and vomiting. Such a symptom does not always occur, but can exist either independently or in combination with other signs of the disease. Its manifestation is typical at the moment of making sudden movements or rocking in transport.
3. Pain syndrome. The appearance of a feeling of constant pain in the area behind the ear should alert a person. This symptom has an increasing effect, most often leading to a decrease in the quality of hearing.
4. Hearing loss which is preceded by a feeling of constant ear fullness. It appears in one ear, but does not always spread to the second auditory organ.
5. Insomnia, apathy, decreased attention. These symptoms are a consequence of other manifestations of the disease.

Complications of otosclerosis

From the above we can conclude that the disease leads to serious and dangerous complications. Complete hearing loss is considered the main danger in the development of otosclerosis without proper medical intervention.

Diagnostic methods

How to treat otosclerosis of the ear? It all starts with a vigilant attitude towards your own health and correct diagnosis of the disease.

First of all, a person must make an appointment with an otolaryngologist (ENT), who will conduct further diagnostics and prescribe treatment. Based on the main symptoms, the doctor will conclude that the patient has problems with the health of the middle or inner ear. A more detailed diagnosis allows us to establish a number of measures:

1. Otoscopy of the ear, which allows you to detect the presence of changes in tissues characteristic of otosclerosis.
2. Carrying out audiometry.
3. Diagnostics of the vestibular apparatus.
4. Setting the level of sensitivity to ultrasound.
5. Examination of hearing aid mobility.
6. Prescription of x-rays and MRI.

The most important thing is the correct separation of otosclerosis from other possible pathologies of the middle and inner ear. For this reason, the recommendations of a specialist should not be neglected.

Treatment options

Symptoms and treatment of otosclerosis of the ear are the main aspects that the ENT should take into account when interacting with the patient. In choosing the right treatment therapy, great importance is given to the stage at which the disease is detected, as well as the correct classification of the disease.

Not all types of otosclerosis can be treated with medication; you often have to seek help from a surgeon. How to treat tinnitus with otosclerosis? The attending physician will be able to determine the necessary course based on the diagnostic results and the patient’s condition.

Conservative tactics

If the patient has been diagnosed with otosclerosis in cochlear or mixed forms, then the doctor may limit himself to drug therapy in combination with physiotherapeutic methods, without resorting to surgical intervention.

Conservative tactics include the following activities:

1. Taking medications rich in iodine, phosphorus and bromine. Such complexes of multivitamins and minerals play a key role in metabolic processes. Their action is aimed at preventing the appearance of excess calcium in soft tissues.
2. Electrophoresis is widely used as a method of physiotherapeutic treatment of the mastoid process.
3. Adjusting the diet, adding foods that are rich in vitamins and minerals necessary for the smooth functioning of the body. This stage duplicates the intake of vitamin complexes, but is of a natural nature.

Doctors separately draw the attention of patients that they should limit their exposure to the sun and reduce the amount of vitamin D.

Surgical intervention

Surgery for otosclerosis of the ear is performed if the patient is diagnosed with the fenestral form of the disease, or conservative therapy has not brought results within three to five months. Surgical treatment of the cochlear form of the disease is under study and development; currently no such operations are being performed.

Until recently, two main approaches were used:

1. Surgical impact on the ear stapes, its loosening.
2. Fenestration of the base of the ear stapes, which implied the creation of a through hole in the organ. In this way, improved perception and sound transmission was achieved.

Modern medicine tends to abandon such methods of ear surgery. Such an intervention brings only a short-term improvement in the patient’s condition and does not justify the risks of the operation.

Stapedoplasty is an operation that has gained popularity in the treatment of otosclerosis. The essence of this intervention is to remove the damaged stapes and install a prosthesis in its place. This is an operation for otosclerosis of the ear, reviews of which are captivating with their positivity. Research and patient opinions show that about 80% of operations performed gave the desired result.

Repeated surgery to install the prosthesis is allowed after six months (performed on the other ear if necessary). Modern developments in the field of ear microsurgery make it possible to improve results and return people to health.

The price of surgery for otosclerosis of the ear depends on the place where it is performed; in the Moscow region it can reach 100 thousand rubles. Moreover, such intervention is taken into account within the framework of the compulsory health insurance policy.

Known prevention measures

Returning to the fact that scientists have not yet figured out the true causes of the development of pathology, it is necessary to understand that it is difficult to protect yourself from it. It is important to take precautions and carefully monitor your health.

You definitely need to undergo regular examination by an ENT specialist, which will allow you to see deviations at an early stage. If you experience tinnitus or other hearing problems, it is important to seek help in time and not risk your own health.

If the disease is diagnosed, then careful adherence to the doctor’s recommendations will allow you to maintain your hearing at the proper level for a long time.

Otosclerosis is a pathology, the basis of which is damage to the bone capsule of the ear labyrinth. In this process, normal bone tissue is replaced by cancellous or porous bone. Cochlear otosclerosis is characterized by the participation in the pathological process of the sound-perceiving system: the cochlea, the vestibule and semicircular canals, the cochlear window and the internal auditory canal.

The disease is hereditary and is transmitted in an autosomal dominant manner. Females are most susceptible to it during puberty, when the disease manifests itself. However, hearing loss due to otosclerosis occurs around age 30. The progression of the disease can be stimulated by pregnancy and childbirth. Acoustic noise and vibration contribute to the development of pathology. The disease develops slowly. Otosclerosis usually affects both ears.

Symptoms of cochlear otosclerosis

• steadily decreasing hearing acuity;
• the appearance of tinnitus;
• ear pain;
• dizziness with sudden movements of the head;
• vestibular dysfunction;
• headaches;
• memory impairment;
• insomnia.

Diagnostics

Possible taking into account anamnestic data, results of audiometric tests and X-ray examination, including CT. In cochlear otosclerosis, a CT scan of the temporal bones reveals a defect in the sound-conducting apparatus due to fixation of the base of the stapes in the oval window. Cochlear otosclerosis is characterized by a steady loss of hearing for high and low tones of a tuning fork against the background of shortening of bone conduction. Pure-tone audiometry records a descending type curve.

Treatment of cochlear otosclerosis

Once the diagnosis is established, treatment must begin immediately. First of all, preventive measures are taken: they recommend a quiet lifestyle, exclude the possibility of being in a noisy environment, and limit the presence of vitamin D in the diet. Pregnancy is not recommended. Conservative measures are aimed at improving metabolism in bone tissue. For this purpose, calcium, phosphorus, bromine and sodium fluoride preparations have been taken for a number of years. During the menopausal period, hormonal drugs are used. Vitamin therapy and physical therapy are recommended. However, the most highly effective treatment for otosclerosis is surgery, which in most cases allows one to restore hearing. If surgical treatment is not possible, hearing correction is performed using digital hearing aids.

Essential drugs

There are contraindications. Specialist consultation is required.

• (an agent that regulates calcium metabolism). Dosage regimen: orally, adults and children over 10 years old - 1 tbsp. spoon 2-3 times a day.
• (corrector of bone and cartilage tissue metabolism). Dosage regimen: orally, at a dose of 70 mg once a week.
• (a remedy that replenishes calcium and vitamin D3 deficiency). Dosage regimen: orally, adults and children over 12 years of age - 1 tablet 2 times a day with meals.