Nanda Books

Otosclerosis is a disease of the bone surrounding the inner ear. It can cause hearing loss when abnormal bone forms around the stapes, reducing the sound that reaches the inner ear. This is called conductive hearing loss. Less frequently, otosclerosis can interfere with the inner ear nerve cells and affect the production of the nerve signal. This is called sensorineural hearing loss.

Causes of Otosclerosis

There is a specific gene, which if present in the patient’s genetic make up, can result in the development of otosclerosis. Some medical studies have implicated the measles virus as a factor in causing otosclerosis. In some women with otosclerosis, pregnancy can accelerate the process.

Symptoms of Otosclerosis

Otosclerosis tends to target one ear at first, but both ears are eventually affected. The condition doesn’t cause total deafness. The symptoms of otosclerosis include:

• Gradual but progressive loss of hearing
• Hearing may improve in noisy conditions
• Sensations of ringing in the ears (tinnitus)
• Dizziness.

Treatment of Otosclerosis

There is no known cure for otosclerosis. The individual with otosclerosis has several options: do nothing, be fitted with hearing aids, or surgery. No treatment is needed if the hearing impairment is mild. 
Hearing aids amplify sounds so that the user can hear better. The advantage of hearing aids is that they carry no risk to the patient. An audiologist can discuss the various types of hearing aids available and make a recommendation based on the specific needs of an individual.

As hearing aids work well and are completely safe, many patients with otosclerosis decide not to undergo surgery. However, surgery does offer the chance of returning the hearing to normal so that a hearing aid is not required. Surgery can also have a stabilising effect on the otosclerotic process and can offer some degree of protection against otosclerosis advancing to the inner ear.

Postoperative Care of Otosclerosis

1. Do not blow your nose for three weeks following surgery. If you sneeze or cough keep your mouth open.
2. Avoid any heavy lifting (over 4 kg), straining or bending for three weeks following surgery
3. Keep your head elevated as much as possible. Sleep and rest on 2-3 pillows if possible.
4. Do not get water in your ear. If showering/washing your hair, place a cotton wool ball coated in Vaseline in the car canal to seal it. If there is a separate incision keep this dry until your first post-operative visits.
5. If you wear glasses either remove the arm on the operated side, or make certain that it does not rest on the incision behind your ear for one week.
6. Replace the cotton wool ball daily until your first post-operative visit.
7. Take your oral antibiotic as prescribed.
8. You may use Panadol, Panadeine or Panadeine Forte for pain. Do NOT use Aspirin or other analgesics.
9. If there is a separate incision a small amount of drainage may occur from this area also. If the drainage is profuse or develops a foul odour contact us.
10. Popping sounds, a plugged sensation, ringing or fluctuating hearing may be occur during healing.
11. Avoid travel by air for three weeks following surgery.
12. If you should notice any swelling, redness or excessive pain, contact us.
13. Some dizziness may occur after surgery. If severe or is associated with nausea or vomiting, contact us.
14. Please contact our office to make an appointment to be seen 7-10 days after the time of your surgery unless stated otherwise by your physician.

Reference : http://www.ent.com.au/Otosclerosis%20and%20Stapedectomy.htm