ABSTRACT
Otosclerosis is a condition affecting the bone of the otic capsule. In the disease process, the normal dense bone surrounding the labyrinth is replaced by a more cellular woven bone. In advanced end stage otosclerosis, where there is insufficient cochlear reserve to consider stapes surgery, cochlear implantation can be considered. There are two issues in this regard: firstly, there is a risk of cochlear duct obliteration by the disease process and so a magnetic resonance imaging scan should always be obtained. Secondly, the loss of mineralised bone around the cochlear can result in spread of symptoms of non-auditory stimulation such as pain and facial twitching. The otoscopic appearance of the eardrum is classically completely normal. Tuning fork tests will show a conductive hearing loss. There is a quite a marked racial variation with European Caucasians being much more frequently affected than Afro-Caribbeans.
