Ear Calcification
A small intervention, a great freedom to hear
The condition referred to as ear calcification is a general term describing calcifications occurring in the middle or inner ear. With ear calcification, we actually refer to two distinct diseases that are not directly related to each other: otosclerosis and tympanosclerosis. These two conditions should not be confused. Their causes, locations, and pathological mechanisms are entirely different. Otosclerosis is a structural calcification disease affecting the otic capsule, which is the bone of the inner ear. In this condition, calcification occurs in localized areas.
This disorder is characterized by bone destruction and regeneration. In simple terms, due to genetic and other triggering factors, calcification occurs in the parts of the inner ear bone adjacent to the stapes, leading to fixation of the stapes to the inner ear. Tympanosclerosis, on the other hand, is a reactive calcification disorder. It affects subepithelial tissues and presents with widespread calcification. It develops due to hyaline deposition followed by calcification. It often occurs after middle ear infections or surgical interventions such as ear tube insertion.
What is the Process of Calcification?
Otosclerosis develops in two stages: otospongiosis and otosclerosis. These stages take years and occur sequentially. The first stage involves bone resorption (osteoclastic activity), forming spongy bone structures. Increased blood flow leads to the Schwartze sign (reddening of the inner ear bone). The second stage involves bone formation (osteoblastic activity), resulting in dense, hardened bone. Blood flow decreases and imaging differences become less distinct.
Symptoms of Otosclerosis
Otosclerosis presents with symptoms influenced by genetic, viral, and hormonal factors. Hearing loss is the main symptom, usually without prior ear problems. It can affect one or both ears. Tinnitus is common. Women are affected twice as often as men, and pregnancy can accelerate the condition.
Diagnosis is mainly made through hearing tests. Tympanometry and acoustic reflex tests are also important. Special findings such as Carhart’s notch may be observed.
Surgical Process of Otosclerosis
The main surgical procedures are stapedotomy and stapedectomy. These aim to restore sound transmission to the inner ear using a microprosthesis. Surgery can be performed on one or both ears depending on the case.
Surgical Stages
In stapedotomy, part of the stapes is removed and a small hole is created. A microprosthesis is inserted to transmit sound. In stapedectomy, the stapes base is completely removed and replaced with tissue and a prosthesis.
Postoperative Process
Patients usually stay in the hospital for one night. Mild dizziness may occur for a few days. Stitches are removed after one week. Patients should avoid pressure changes such as flying or blowing their nose for two weeks.
Hearing improvement begins after healing. Final hearing levels are determined after three months. Tinnitus may decrease or disappear. The prosthesis is permanent and usually does not require replacement.
After recovery, patients can return to normal activities except those involving sudden pressure changes such as diving. The surgery significantly improves hearing and quality of life.
