• Salah Mansour
  • Jacques Magnan
  • Karen Nicolas
  • Hassan Haidar


Otosclerosis is the most common cause of conductive hearing loss in adults with normal appearing tympanic membrane. This chapter discusses the advanced biology of the otic capsule and the major related molecular aspects of the disease and its main genetic implications that help to better understand the etiological factors behind the disease. The different forms of otosclerosis and the typical clinical manifestations are presented. Nowadays the diagnosis of otosclerosis have greatly improved especially through specialized audiometric evaluations serving the positive and differential diagnosis. A special emphasis is done on the imaging of otosclerosis that have a great impact on the preoperative workup, patient’s counseling, postoperative events and follow up of the disease. The primary stapes surgery procedures are well demonstrated. Several intraoperative challenges and their management are exposed. Difficult anatomical and pathological presentations are discussed. The positive outcome of stapes surgery on hearing and tinnitus is presented. The complications of stapes surgery and the different causes of its failure are treated in depth. Revision stapes surgery techniques relative to the underlying failure are explained. Alternative treatments of otosclerosis are described. Special attention has been accorded to juvenile otosclerosis: its differential diagnosis and its management are discussed. Far advanced otosclerosis is reviewed along with its recent care centered on the impact of acoustic rehabilitation with stapedotomy prior or not to cochlear implants in different forms of advanced disease with profound deafness.


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