Otosclerosis: What It Is, How It Affects Hearing, and What Treatments Exist

When the tiny bone in your inner ear — the stapes, a small bone that transmits sound vibrations from the middle ear to the inner ear. Also known as stirrup bone, it becomes fused or fixed due to abnormal bone remodeling, it stops moving properly. This condition is called otosclerosis, a disorder where bone grows abnormally around the stapes, blocking sound transmission. It’s one of the most common causes of conductive hearing loss in adults, especially women between 20 and 45. Unlike age-related hearing loss, otosclerosis doesn’t damage the nerve — it just stops sound from reaching it.

Otosclerosis often starts with trouble hearing low voices or background noise, and people might notice their own voice sounds louder than usual. It usually affects both ears over time, though one ear may be worse. The exact cause isn’t clear, but genetics play a big role — if a parent has it, your risk doubles. Some studies also link it to past measles infections or hormonal changes, which might explain why it’s more common in women, especially during pregnancy. It’s not caused by loud noise or ear infections, so it’s easy to miss until it starts getting in the way of daily life.

There are two main ways to treat it. The first is stapes surgery, a procedure where the fixed stapes is replaced with a small prosthetic to restore movement. This is called a stapedectomy or stapedotomy, and it works for most people — many regain most of their hearing within weeks. The second option is hearing aids, devices that amplify sound when surgery isn’t right for you. For advanced cases where the inner ear is also affected, a cochlear implant, a device that bypasses damaged parts of the ear and directly stimulates the auditory nerve might be needed. Medications like sodium fluoride are sometimes used to slow bone growth, but they don’t reverse damage.

If you’ve noticed your hearing slipping slowly — especially if you’re a woman in your 30s or 40s — don’t wait. A simple hearing test can show if it’s otosclerosis or something else. Most people who get treated early do very well. What you’ll find below are real stories and facts from people who’ve lived with this, from the first signs they ignored to the treatments that changed their lives. No fluff. Just what works, what doesn’t, and what to ask your doctor next.