Otosclerosis (Otospongiosis)

Jeffrey D. Wolfrey, MD and Kellie D. Wheeler, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A primary bone dyscrasia involving the otic capsule

  • This is the leading cause of conductive hearing loss in adults.

  • There are two forms:

    • Histologic otosclerosis: asymptomatic form in wh...

DIAGNOSIS

HISTORY

  • Progressive conductive hearing loss, usually with well-preserved speech discrimination

  • Patients often are soft-spoken and aware that they seem to hear better in noisy environments.

PHYSICAL EXAM

TREATMENT

MEDICATION

No specific drug therapy, but sodium fluoride, bisphosphonates, vitamin D, and calcium gluconate have been tried, especially in cases of predominantly sensorineural hearing loss. 

SURGERY/OTHER PROCEDURES

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • No restrictions on activity

  • Monitor health-related quality-of-life measures.

Patient Monitoring

Interval audiometric testing 

PATIENT EDUCATION

  • Because speech discrimi...

REFERENCES

Meyer TA, Lambert PR. Primary and revision stapedectomy in elderly patients. Curr Opin Otolaryngol Head Neck Surg.  2004;12(5):387–392.  [View Abstract]
Lailach S, Schenke T, Baumann ...

ADDITIONAL READING

  • Batson L, Rizzolo D. Otosclerosis: an update on diagnosis and treatment. JAAPA.  2017;30(2):17–22.

  • Derks W, De Groot JA, Raymakers JA, et al. Fluoride therapy for cochlear otosc...

SEE ALSO

Hearing Loss 

CODES

ICD10

  • H80.90 Unspecified otosclerosis, unspecified ear

  • H80.20 Cochlear otosclerosis, unspecified ear

  • H80.00 Otosclerosis w oval window, nonobliterative, unsp ear

  • H80.10 Otosclerosis involving oval w...

CLINICAL PEARLS

  • The audiometric signature of otosclerosis is a dip in conductive hearing at 2,000 Hz.

  • Hearing aids are helpful in patients with preserved speech discrimination.

  • Bilateral involvement and...

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