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Otosclerosis (Otospongiosis)

Otosclerosis (Otospongiosis) is a topic covered in the 5-Minute Clinical Consult.

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  • A primary bone dyscrasia involving the otic capsule
  • This is the leading cause of conductive hearing loss in adults.
  • There are two forms:
    • Histologic otosclerosis: asymptomatic form in which abnormal bone spares vital structures of the ear
    • Clinical otosclerosis: Abnormal spongy bone involves ossicular chain or other structures, leading to altered physiology.
  • System(s) affected: sensory, hearing


  • Predominant age
    • Clinical onset usually in early 20s
    • Peak incidence 3rd to 5th decade
  • Predominant gender: female > male (2:1)
Pregnancy Considerations
  • Progression may accelerate during pregnancy.
  • Some women first notice hearing loss at this time.

  • Histologic form: 4–8% among U.S. Caucasian population; 1% among African Americans
  • Histologic form: U.S. Caucasian population: 5,000/100,000; African Americans: 1,000/100,000
  • Clinical form: 0.3–0.4%

Etiology and Pathophysiology

  • Unknown; possible association with measles virus infection, hormonal factors, cytokine-related inflammation, fluoride metabolism, and oxidative stress

  • 50–60% of those affected give positive family history.
  • Appears to be transmitted by autosomal dominant gene with variable expressivity

Risk Factors

Unknown, possibly measles virus infection

Commonly Associated Conditions

  • Van der Hoeve syndrome (rare triad of osteogenesis imperfecta, blue sclera, and otospongiosis)
  • Tinnitus, usually low frequency

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Stephens, Mark B., et al., editors. "Otosclerosis (Otospongiosis)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816029/all/Otosclerosis__Otospongiosis_.
Otosclerosis (Otospongiosis). In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816029/all/Otosclerosis__Otospongiosis_. Accessed April 21, 2019.
Otosclerosis (Otospongiosis). (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816029/all/Otosclerosis__Otospongiosis_
Otosclerosis (Otospongiosis) [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 21]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816029/all/Otosclerosis__Otospongiosis_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Otosclerosis (Otospongiosis) ID - 816029 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816029/all/Otosclerosis__Otospongiosis_ PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -