clinical features

Last reviewed 10/2021

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.