What are the current management options for a patient with otosclerosis who is experiencing significant hearing impairment?

Management options for a patient with otosclerosis experiencing significant hearing impairment include:

• Hearing aids: Conventional air conduction hearing aids are often the first-line management to improve hearing in otosclerosis by amplifying sound.
• Surgical intervention: Stapedectomy or stapedotomy surgery can be considered to improve conductive hearing loss by replacing or bypassing the fixed stapes bone in the middle ear.
• Implantable devices: For patients with severe or refractory hearing loss, implantable devices such as bone-anchored hearing aids or middle ear implants may be options. Cochlear implants are generally reserved for moderate to profound sensorineural hearing loss but may be considered if otosclerosis leads to mixed or sensorineural components.
• Referral to specialist ENT and audiology services: Patients with significant hearing impairment due to otosclerosis should be referred for specialist assessment and management planning.

These management options aim to improve hearing function and quality of life, tailored to the severity and type of hearing loss present in otosclerosis.

References: Hearing loss in adults: assessment and management (NICE, 2023) ¹; British Academy of Audiology referral guidance (2023) ¹; RNID guidance (2022) ¹.