[Practical considerations of surgical treatment of otosclerosis]

The ENT-specialist after determine the diagnosis, the deafness degree and the requirements of each otosclerotic individual must consider the therapeutic possibilities and the end results, also the complications, the indications and the contraindications. These considerations are fundamental under the forensic medicine viewpoint and a good medical practice and even in order to avoid failures provided preestablished prospectives and the outcomes fails to adhere to the proposed schedule. Surgical option is promising in cases of severe deafness when our aim is to improve the enlargement and recognition of environmental sounds when an acoustic prosthesis is not employed. In these cases possibly recruitment is present at the initial stages, which requires and adaptation period. Also must be analyzed the influence for surgery of environment factors and life-style (pressure changes, ambient noise, etc.), the existence of tinnitus, equilibrium disorders, hard of hearing features and the age. Results procured with surgery in unilateral otosclerosis are lesser compared with bilateral, which in association with the fact that in the majority od unilateral the degree of impairment (percent of binaural deficit) is minimal, compel us to be very cautions in counseling these patients.