Clinical features
The main features of otosclerosis include:
- onset usually 20 - 40 years
- family history in two thirds of cases
- two thirds of patients are female, with the condition precipitated or promoted by pregnancy
- commonly bilateral and symmetrical; may be unilateral
- patient may hear better in noisy surroundings
- tinnitus may be present
On examination:
- absent stapedial reflex
- normal tympanic membranes
- Rinne's test negative; Weber's test - hearing best in the deafer ear
- audiometry - air conduction is impaired
A normal ear drum, in the presence of conductive hearing loss suggests otosclerosis.
If the cochlea is affected, there may be signs of sensori-neural deafness - Rinne's positive; Weber's - sound heard loudest in the normal ear.
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