Otosclerosis affects the bone surrounding the inner ear, called the otic capsule. Abnormal remodelling near the stapes, the smallest hearing bone, can immobilise it and reduce sound transmission, causing progressive conductive hearing loss.
A subject of Dr Dehgani-Mobaraki’s research
Otosclerosis was the subject of his experimental medical-degree thesis, “Stapedotomia per otosclerosi: 10 anni di esperienza” (Stapedotomy for otosclerosis: 10 years of experience). He has studied the condition since his training, including its surgical aspects, and now manages audiological diagnosis, treatment-pathway selection and postoperative follow-up.
Who is affected and symptoms
The condition usually begins in young adulthood and often runs in families. Hearing gradually worsens over months or years in one or both ears, sometimes with tinnitus or a sense of hearing better in noisy surroundings. Inner-ear involvement may add a sensorineural component.
Diagnosis
Endoscopic examination usually shows a normal eardrum, distinguishing otosclerosis from middle-ear fluid or perforation. Audiometry and tympanometry, available at all venues, establish the type and degree of hearing loss and signs of stapes fixation. High-resolution temporal-bone CT is used in selected cases.
Treatment options
Choice depends on the severity of hearing loss, individual needs and inner-ear involvement. Options include observation with periodic audiometry for mild loss; effective, non-invasive hearing aids; or stapes surgery (stapedotomy or stapedectomy), using a small prosthesis to replace the function of the fixed stapes. When surgery is indicated, Dr Dehgani-Mobaraki refers patients to specialist centres and follows their care before and after the procedure.
Frequently asked questions
Does otosclerosis lead to complete deafness?
Its course varies. Inner-ear involvement can cause an additional sensorineural component. Periodic audiometry monitors progression.
Is a hearing aid or surgery better?
Both are valid options. The decision is made together after investigations and discussion of the person’s expectations.
Is it hereditary?
There is often a family history, but not every relative develops the condition.
Author: Dr Puya Dehgani-Mobaraki, specialist in Otorhinolaryngology and Head and Neck Surgery. Clinical review: October 2026. This information is educational and does not replace medical diagnosis or a prescription.