Clinical Presentation, Diagnostic Approaches, and Therapeutic Management of Otosclerosis

Otosclerosis is a progressive disorder affecting the bones in the middle ear, leading to hearing loss. It primarily affects the stapes bone, causing fixation and impairing sound transmission.

Clinical Presentation

Patients often present with progressive hearing loss, tinnitus, and sometimes vertigo. Conductive hearing loss is the hallmark symptom, typically observed in young adulthood.

Diagnostic Approaches

• Otoscopy: May reveal a reddish hue over the promontory (Schwartz's sign).
• Audiometry: Demonstrates conductive hearing loss with Carhart's notch.
• Imaging: High-resolution CT scans confirm involvement of the cochlear otic capsule.

Therapeutic Management

Treatment options include:

• Hearing Aids: Effective in mild cases.
• Medical Therapy: Fluoride therapy can help stabilize progression.
• Surgical Intervention: Stapedectomy or stapedotomy restores hearing by replacing the stapes bone with a prosthesis.

Post-Treatment Rehabilitation and Prognosis

Rehabilitation includes audiologic follow-ups and speech therapy in severe cases. The prognosis is generally favorable, with significant hearing improvement post-surgery.