Medical Treatment of Otosclerosis: Stabilizing Hearing and Relieving Tinnitus
Otosclerosis affects the ear through disrupted bone metabolism, involving stapedial fixation and, in some cases, the cochlea. Medical management targets this process to preserve the sensorineural hearing component and relieve associated symptoms including tinnitus and vertigo.
Clinical Situation
This protocol applies to otosclerosis presenting with stapedial fixation and/or cochlear involvement. Cases range from enzymatically less-active stapedial disease to those with an active cochlear component — including progressive cochlear involvement and pure cochlear otospongiosis — each requiring a differentiated medical approach.
Treatment Approach
Medical management centres on inhibitors of bone metabolism — either sodium fluoride or a bisphosphonate. The appropriate agent and the structure of the treatment course are guided by the extent and activity of the otosclerotic process. Complete agent selection, dosing, and treatment duration are specified in the full protocol.
Clinical Goals
- Preservation and stabilisation of hearing thresholds (sensorineural component)
- Stabilisation of hearing loss progression
- Improvement of tinnitus and vertigo
- In some cases, improvement of 10 to 15 dB at annual audiometric follow-up
References
DOI: 10.1016/j.otc.2017.11.006
- Options for the medical treatment of otosclerosis include sodium fluoride and bisphosphonates.
- The use of inhibitors of bone metabolism aims to preserve hearing thresholds (sensorineural component) and improve symptoms such as tinnitus and vertigo.
- Double-blind controlled clinical trials using sodium fluoride have shown stabilization of hearing thresholds.
- In some cases even an improvement of 10 to 15 dB can be observed in the annual posttreatment audiometric follow-up.