Otosclerosis disease can be defined as an impairment in mobility of stapes ossicle, due to a calcification at the level of oval window. Depending on the degree of this calcification, hearing loss occurs. This hearing loss is progressive, usually conductive, but to a lesser extent sensorineural or mixed hearing loss might also be encountered. In addition to hearing loss, tinnitus and dizziness may be present. The cause of this condition is not known exactly, but it has been shown that it can be genetically transmitted. There is a family history of this disease in approximately 60% of cases. It has been revealed that measles virus infections may trigger the disease. It has been reported that some hormonal factors may play a role, and the disease may progress in pregnancy. Women are two times more affected compared to men. The average age is between 15-45. Onset before age ten and after age 45 is rare.

The diagnosis of the disease is made by ear examination and some hearing test findings. Calcification can be revealed with Computed Tomography (CT). The definitive diagnosis is made by controlling the movement of the ossicular chain during the operation.

There are three main treatments for this disease. These are rehabilitation with hearing aids, medical therapy and surgical treatment. Hearing aids can be used in patients who deny surgery or whose hearing loss is not suitable for surgery. These patients can benefit from the hearing aid very efficiently. Medical therapy can be used mostly to reduce the rate of progression of the disease. The most commonly used drug here is sodium fluoride. In addition, vitamin D and calcium carbonate can also be used. Surgical treatment consist of an operation called 'stapedotomy'. Although this surgery can be performed with local anaesthesia, my preference is to perform the surgery under general anaesthesia as most of my colleagues. The procedure may be performed endoscopically. The stapes mobility is checked and, if immobile, it is removed and replaced by a prosthesis. Thus, the integrity and mobility of the ossicular chain is ensured, and the sounds are transmitted to the inner ear properly. Some precautions are taken after the operation. The patient is advised to lay down with his head slightly elevated, antihistamines might be administered in order to prevent sneezing, and anti-constipation medications are given if he or she has constipation. These measures are taken to prevent any displacement of the prosthesis with pressure during the recovery process. The patient is followed-up, and the eardrum is checked.

Some complications may occur during surgery, immediately after surgery, or in the long term. These include perforation of the eardrum, bleeding, temporary taste impairment, perilymph fistula, incus dislocation, sensorineural hearing loss, otitis media, temporary or permanent facial paralysis, and dislocation of the prosthesis. It should be noted that the complication rates in question are quite low. One of the most feared complication is the risk of complete deafness. The risk in question varies between 0.6% and 3% in different series.

As you can realize, the stapes surgery is definitely not a "minor" surgery! It is a microsurgery that requires extreme delicacy and experience. If the surgery is successful, very satisfactory results can be obtained in terms of hearing.