Hearing management

Updated 07 December 2017


Otosclerosis refers to abnormal bone growth in the middle ear, leading to hearing loss.


It's a relatively common cause of loss of hearing. Otosclerosis tends to run in families: if both parents have otosclerosis, the risk is 50 percent to the children. It most typically affects white women of middle age though it can manifest as early as the age of 15. Though it generally starts in one ear, it usually eventually affects both ears and may get worse during pregnancy.

It is believed that the composer Beethoven suffered from otosclerosis, as did the eccentric Howard Hughes, and the pop singer Frankie Valli. In the popular TV series CSI, the character Gil Grissom suffered from this condition, and had a successful stapedectomy.

Alternative names
Chronic conductive hearing loss; otospongiosis.

What causes it
The mechanism of hearing is this:

  • Sound waves cause the ear drum to vibrate,

  • Three tiny bones in the middle ear transmit these vibrations to the fluid of the inner ear, and

  • There, movement of hair cells causes the nerve impulses we experience as sound.

In otosclerosis, abnormal growth of bone within the inner ear interferes with the movement of the bones, especially ones called the stapes, and thus with the transmission of the sound waves. Around 1 in 10 of people with typical bone changes actually develops significant hearing loss.

Gradual onset of hearing loss, often first noticed with whispers or low-pitched sounds. This loss is progressive, but variable There can also be dizziness, balance problems, or tinnitus – a ringing, hissing, or other abnormal noise heard in the ears or head.


Generally, an ear, nose & throat (ENT) specialist would examine you and rule out other possible causes of similar symptoms. An audiologist might carry out various tests to assess your hearing and balance.

Where the condition is mild, a hearing aid alone may be sufficient help.

A stapedectomy may be performed to bypass the bones which have been affected, usually inserting a tiny prosthesis to replace some of the sclerotic ( scarred ) bone. This is usually done on the worst affected ear, with the other ear being treated three to 12 months later when it is clear that the first operation was successful. The operation has a high success rate. Discuss the risks and benefits with the surgeon, as, rarely, the operation may fail to improve the hearing.

Some have used sodium fluoride which may slow the bony changes.

The problem tends to be progressive, but good surgical results may last for decades.

When to call your doctor
It is advisable to consult your doctor if you experience any persistent loss of hearing.

(MA Simpson, Health24, February 2008)


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Ask the Expert

Hearing Expert

Dr Kara Hoffman graduated from UCT in 2004, thereafter she completed her year of community service in Durban. In 2010 she completed her Masters Degree in Paediatric Aural Rehabilitation from UKZN. In 2016, she became a Doctor of Audiology through the University of Arizona (ATSU). Dr Hoffman and her partner Lauren Thompson opened a fully diagnostic audiology practice called Thompson & Hoffman Audiology Inc. In 2011 with world-class technology and equipment to be able to offer the broad public all hearing-related services including hearing testing for adults and babies, vestibular (balance) assessments and rehabilitation, industrial audiology, hearing devices, central auditory processing assessments for school-aged children, school screening, neonatal hearing screening programmes at Alberlito and Parklands Hospital, cochlear implants and other implantable devices, medicolegal assessments and advanced electroacoustic assessments of hearing. Thompson and Hoffman Audiology Inc. are based at Alberlito Hospital in Ballito, St Augustines Hospital in Durban and at 345 Essenwood Road, Musgrave. The practices are all wheelchair friendly. There are three audiologists that practice from Thompson & Hoffman – including Dr Kara Hoffman, Lauren Thompson & Minette Lister. The practice boasts professional, highly qualified, and extensive diagnostic services where all your hearing healthcare needs can be met. The additional licensing in vestibular assessment and rehabilitation, paediatric rehabilitation and cochlear implantation places this practice in one of the top specialist audiological positions in South Africa, with a wealth of experience in all clinical areas of audiology and is a very well respected and sought-after practice.

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