Causes
Otosclerosis symptoms
Diagnostics
Otosclerosis treatment
Otosclerosis is a pathology of the middle and inner ear associated with the appearance of bone tissue in the area of attachment of the stapes (the third, innermost auditory ossicle) to the oval window of the vestibule (border of the middle and inner ear), as well as with the growth of the bony plates of the auricular cochlea and semicircular canals. Otosclerosis occurs most often in women of childbearing age.
Otosclerosis in the area of junction of the streamer with the oval window leads to disruption of the sequential transmission of sound waves to the cochlea - this is how the pathology of sound transmission develops. Bony growths in the cochlea interfere with the normal perception of sounds by the nerve endings of the auditory nerve - this is a pathology of sound perception or sensorineural hearing loss. When the semicircular canals are damaged by otosclerosis, vestibular disorders develop (dizziness, nausea, unsteady gait, difficulty maintaining balance with a sharp change in body position).
Causes
Unfortunately, to date, no specific cause of otosclerosis has been established. At the same time, there are several different theories that, to a certain extent, explain the development of this pathology.
The hereditary theory is considered the most widespread. According to her, a person has a special gene responsible for the growth of bone tissue in the cavity of the middle and inner ear. However, under what conditions and where exactly this gene is located is not yet known.
The infectious theory says that otosclerosis appears after an inflammation in the ear (acute otitis media, chronic purulent otitis media). In most cases this is true, but sometimes otosclerosis develops against the background of complete well-being.
The theory of external influences explains the pathological influence of constant vibrations, chronic noise and ultrasonic waves on the sound-conducting system of the ear, triggering sclerotic processes in it.
The cause of otosclerosis can also be impaired metabolism (cholesterol, calcium, glucose), endocrinological pathology (thyroid, pancreas), liver disease.
Otosclerosis symptoms
Otosclerosis develops slowly, and therefore a person does not notice any symptoms for a long time. As the process progresses, hearing decreases, usually on both sides. Later, noise, a feeling of pressure in the ear, dull headaches begin to disturb.
If otosclerosis affects the vestibule and semicircular canals (the organ of balance), then dizziness, periodic nausea, difficulties in maintaining the balance of the body, especially with sudden movements, occur.
There are several specific signs for otosclerosis:
- Hearing impairment while chewing;
- The symptom of Willis is an improvement in hearing in a noisy environment compared to silence;
- Toynbee's symptom is difficulty with the perception of speech when several people are talking at the same time.
Diagnostics
Diagnosis of otosclerosis in K + 31 begins with a study of the patient's complaints, the duration of the onset of symptoms, previous diseases and occupational hazards. The presence of otosclerosis in close relatives is being clarified.
An objective examination of the pathology from the external auditory canal, tympanic membrane and middle ear is not observed. High-resolution studies: computed tomography and magnetic resonance imaging allow to detect areas of sclerosis and growth of bone tissue.
We focus on the health of our patients and perform auditory tests to investigate the function of the ear.
Audiometry - determination of hearing acuity and sensitivity of the ear to sounds of different intensities. Based on the results of the study, a graphical image of the function of the auditory analyzer is compiled - an audiogram, the analysis of which makes it possible to establish a violation of the conduction of sounds through the auditory ossicles. This conclusion plays an important role in the diagnosis of otosclerosis.
Tuning-fork tests - also allow you to find a problem in the sound-conducting system.
Tympanometry - performed to exclude pathology in the tympanic membrane.
Otosclerosis treatment
Unfortunately, the process of otosclerosis is irreversible, so conservative therapy is ineffective. Medication can be prescribed only to relieve certain symptoms (headache, dizziness, nausea) and correct metabolic disorders.
In the case of otosclerosis, the only radical treatment may be surgery to restore your hearing and keep you healthy in the future . The most common type of surgery is stapedotomy - removal of the affected part of the stapes and replacing it with a special prosthesis. If the entire stapes are affected, it is removed and completely prosthetic (stapedectomy).
Surgical interventions on the middle and inner ear, despite their inaccessibility and complexity, are performed under local anesthesia through the external auditory canal using miniature instrumentation under a special microscope. Thanks to this technique, the patient can feel the effect of the treatment right during the operation and hear the first sounds fully.
If there are contraindications to surgical treatment or its ineffectiveness, hearing aids are performed.
