Otosclerosis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Otosclerosis?
An otolaryngologist, also called an ENT doctor, who treats diseases of the ears, nose, throat, and neck, usually diagnoses and treats otosclerosis. An otologist, a doctor who specializes in diseases of the ear, may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is otosclerosis?
Otosclerosis is a condition caused by abnormal bone remodeling in the middle ear. Bone remodeling is a lifelong process in which bone tissue renews itself by replacing old tissue with new. In otosclerosis, this process goes wrong. Sound then has trouble traveling from the middle ear to the inner ear.
It most often happens when the stapes, one of the three tiny bones in the middle ear, gets stuck in place. When this bone cannot vibrate, sound cannot pass through the ear, and hearing suffers. It usually causes conductive hearing loss, which means there is a problem with how the ear transmits sound vibrations.
Symptoms
Hearing loss is the symptom people report most often. It usually starts in one ear and then moves to the other, and it may appear very gradually. Other signs can include:
- Trouble hearing low-pitched sounds or a whisper.
- Tinnitus, a ringing, roaring, buzzing, or hissing in the ears or head.
- Dizziness or balance problems.
Causes and who gets it
Why otosclerosis happens is still unclear. Scientists think it could be linked to a past measles infection, stress fractures to the bony tissue around the inner ear, or immune disorders. It also tends to run in families. About 60 percent of otosclerosis has an underlying genetic cause. Not everyone who has the gene will develop the condition.
It can affect women and men, but it is more common in women and has been linked to rapid onset during pregnancy. Hearing loss often begins in young adults, those in their twenties or thirties. Otosclerosis affects both ears about 70 percent of the time. The amount of hearing loss may not be the same in each ear.
How doctors diagnose it
Many other ear problems can cause the same symptoms, so an ENT specialist examines you first. The first step is to rule out other diseases or health problems that can cause the same symptoms. Next come hearing tests. An audiogram measures how well you hear. A tympanogram measures how well sound moves through the middle ear. Sometimes imaging tests, such as a CT scan, are also used.
Treatment
The main options are watching with repeated hearing tests, hearing aids, or surgery. Watching is recommended only for mild hearing loss. Hearing aids can help overcome a fixed stapes by increasing the sound volume.
Surgery is called a stapedectomy or stapedotomy. The surgeon removes part (stapedotomy) or all (stapedectomy) of the stuck stapes bone. The surgeon replaces it with a prosthetic device, or implant. The implant lets the bones of the middle ear move again. Some hearing loss may persist after stapedectomy, and in rare cases, surgery can actually worsen hearing loss.
There is currently no effective drug treatment for otosclerosis. Some medicines, such as sodium fluoride or bisphosphonate supplements, have been reported to limit worsening. But there is no definitive evidence that they stop it from progressing.
When to see a doctor
See a doctor if you notice hearing loss, trouble hearing whispers, or ringing in your ears. Other conditions can cause the same symptoms. After ear surgery, tell your ENT specialist right away about sudden hearing loss, intense pain, facial weakness, or prolonged or intense dizziness, especially a room-spinning feeling.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can check your symptoms, arrange a referral, and coordinate care with an ear specialist.
Common questions
Can otosclerosis be cured with medicine?
No, there is currently no effective drug treatment for otosclerosis. Hearing aids or surgery are the main options.
Does otosclerosis run in families?
Yes, it often does. About 60 percent of otosclerosis has an underlying genetic cause. Not everyone who has the gene will develop the condition.
Does otosclerosis affect both ears?
Yes, it often does, about 70 percent of the time. The amount of hearing loss may not be the same in each ear.
Is stapes surgery risky?
Yes, it carries some risk, but injuring the ear drum or causing more hearing loss is rare. Some hearing loss may persist after stapedectomy, and in rare cases, surgery can actually worsen hearing loss.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
