Your hearing health

Otosclerosis: symptoms, causes & treatments

Last update on Mar, 20, 2025

Otosclerosis is a condition that affects the middle ear, contributing to hearing loss and other symptoms such as dizziness and tinnitus. Some people may be more at risk of developing this condition than others. While there is no known way of preventing otosclerosis, there are ways to manage it.

Dr. Thomas Tedeschi, Au.D.

Chief Audiology Officer, Miracle-Ear

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Key takeaways

Otosclerosis is a condition caused by abnormal bone growth in the ear.
The exact cause of otosclerosis is unknown, but genetics and biological sex may play a role.
Hearing loss is the most common symptom of otosclerosis.
A doctor may diagnose otosclerosis with an audiogram, a tympanogram or a CT scan.
There are two types of otosclerosis: fenestral and cochlear.
Otosclerosis is often treated with hearing aids, cochlear implants or surgery.

What is otosclerosis?

Otosclerosis is a condition that involves abnormal bone growth inside the ear, which can lead to hearing loss. It affects more than 3 million people in the United States, and Caucasian women tend to be affected most. When it comes to having an ear disease, otosclerosis is not dangerous and rarely leads to complete deafness.¹ While there is no cure, there are treatments and procedures that can help offset its effects.

What causes otosclerosis?

Otosclerosis is caused when a tiny bone inside the middle ear, called the stapes, fuses with other parts of the ear and becomes stuck. This blocks sound from travelling effectively between the ear canal and auditory nerve, which is why otosclerosis causes hearing loss. It’s not completely clear what causes otosclerosis, but there are a few factors that may contribute to it.

Many people wonder “is otosclerosis genetic?”

Otosclerosis may be linked to genetics and passed down by family members. According to the American Hearing Research Foundation, if a person has one parent with osteosclerosis, they have a 25% chance of developing it themselves and a 50% chance if both of their parents have it.²

Autoimmune disorders or stress fractures to the bony tissue surrounding the inner ear could both play a role in a person’s risk of developing otosclerosis. Some studies have also found that there may be a connection between the measles virus and otosclerosis.³

Another possible factor is hormones, specifically estrogen in women. Women are twice as likely as men to develop otosclerosis, and they are more likely to develop it during pregnancy or as hormones change with age.⁴ This connection is still being studied.

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What are symptoms of otosclerosis?

Otosclerosis symptoms include hearing loss, tinnitus, and dizziness or balance issues. Here are a few specifics to be aware of with each of these symptoms.

The most common symptom of otosclerosis is hearing loss. Otosclerosis-associated hearing changes happen gradually, often over several years. Many times, low-pitched or soft sounds are the first ones to go. It usually affects one ear first and then both ears over time.⁵While hearing loss is common, it’s worth noting that otosclerosis deafness is rare.

Otosclerosis and tinnitus often go hand in hand. Tinnitus refers to ringing in one or both ears, and can be related to a variety of conditions, including otosclerosis.

Otosclerosis and pulsatile tinnitus, which is a whooshing or thumping sound in the ear, can also occur together. There is still research being done to determine why tinnitus happens with otosclerosis, but it may be due to increased blood flow in the growing bone.⁶

Otosclerosis and dizziness can also occur together. This often happens when the bone growth extends into the inner ear.⁷

Otosclerosis and vertigo may also happen due to fluid buildup inside the ear.⁸

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Otosclerosis diagnosis and tests

Getting an otosclerosis diagnosis can be done by visiting an ENT, audiologist or otologist. They may run a diagnostic test for otosclerosis which will likely include one of the following:

As they apply to otosclerosis, audiograms are hearing tests that show how well you hear the frequency (pitch) and intensity (loudness) of sounds. This test is usually done by pressing a button or raising your hand when you hear a sound.

To help diagnose otosclerosis, tympanograms are tests used to measure how your eardrum conducts sound. A tool called a tympanometer is inserted into your ear, sending in a rush of air and a low tone. The tympanometer measures how your ear drum reacts to the air and noise.

A CT scan is another way of determining whether or not you have otosclerosis. Radiology, or imaging, can be helpful because it allows doctors to see if there’s abnormal bone growth happening inside your ear.

Types of otosclerosis

There are two different otosclerosis types: fenestral otosclerosis and cochlear otosclerosis.

Fenestral otosclerosis, also called stapedial otosclerosis, is the more common of the two. It involves the base of the stapes bone attaching to the oval window, which is a small opening in the middle ear. Hearing loss is common due to the positioning of the stapes.⁹

Cochlear otosclerosis is the less common type, and is a loss of density in the bone that surrounds and protects the cochlea. This can lead to sensorineural hearing loss, which is hearing loss that results from damage to the inner ear or to nerve pathways from the inner ear to the brain.¹⁰

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What is the best treatment for otosclerosis?

When it comes to otosclerosis treatment, there is no cure, but there are options available to help manage the symptoms. Hearing aids and cochlear implants can help to improve people's hearing. There are times, however, when a stapedectomy surgery may be recommended.

A good solution for those who struggle with mild otosclerosis, hearing aids work to amplify the sounds around you. They are often the first choice when it comes to treating otosclerosis with a non-invasive option.

While they cannot prevent worsening hearing loss due to otosclerosis over time, hearing aids can be adapted to treat increasing levels of hearing loss. Your hearing care professional can help you determine both the best hearing aid for otosclerosis and for your needs.

Another option is a cochlear implant. Otosclerosis and hearing loss can be improved with a cochlear implant by creating a new pathway for sounds to travel to your brain.

Although they are more invasive than hearing aids and require a surgical procedure to be placed, cochlear implants are an effective treatment to help with otosclerosis.

Otosclerosis surgery is another method for treating otosclerosis and can help reduce its long-term effects. An otosclerosis operation, called a stapedectomy, involves the stapes bone being removed and replaced with a prosthetic device that allows sound waves to travel to your inner ear.

Treating hearing loss is important for your overall health as well as your quality of life. If otosclerosis runs in your family, be sure to stay on top of your hearing health. And if you’ve noticed changes in your hearing, visit a Miracle-Ear location near you for a free hearing test.

Sources

^¹ “Otosclerosis.” American Hearing Foundation. https://www.american-hearing.org/disease/otosclerosis/.

^² Ibid.

^³ Sagar, Prem Raj et al. “Otosclerosis and Measles: Do Measles Have a Role in Otosclerosis? A Review Article.” Cureus vol. 12,8 e9908. 21 Aug. 2020, doi:10.7759/cureus.9908. https://pmc.ncbi.nlm.nih.gov/articles/PMC7505640/.

^⁴ Ricci, Giampietro et al. “The effect of female hormone in otosclerosis. A comparative study and speculation about their effect on the ossicular chain based on the clinical results.” European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery vol. 279,10 (2022): 4831-4838. doi:10.1007/s00405-022-07295-w. https://pmc.ncbi.nlm.nih.gov/articles/PMC9474451/.

^⁵ “Otosclerosis.” National Institute on Deafness and Other Communication Disorders. March 16, 2022. https://www.nidcd.nih.gov/health/otosclerosis.

^⁶ Skarzynski, Piotr Henryk et al. “Prevalence and Severity of Tinnitus in Otosclerosis: Preliminary Findings from Validated Questionnaires.” The journal of international advanced otology vol. 15,2 (2019): 277-282. doi:10.5152/iao.2019.5512. https://pmc.ncbi.nlm.nih.gov/articles/PMC6750799/.

^⁷ “Otosclerosis.” Balance & Dizziness Canada. https://balanceanddizziness.org/disorders/vestibular-disorders/otosclerosis/.

^⁸ Necula, Violeta et al. “Vertigo Associated with Otosclerosis and Stapes Surgery-A Narrative Review.” Medicina (Kaunas, Lithuania) vol. 59,8 1485. 18 Aug. 2023, doi:10.3390/medicina59081485. https://pmc.ncbi.nlm.nih.gov/articles/PMC10456756/.

⁹Duong D, Weerakkody Y, Sharma R, et al. Otospongiosis. Last revised July 25, 2024. https://radiopaedia.org/articles/otospongiosis-1?lang=us

¹⁰Ibid