[Current concepts in the surgical management of otosclerosis]

Otosclerosis can be of viral origin and in 25-50% of cases a familiar accumulation can be seen. Typically patients develop a progressive middle ear hearing loss which starts in young adulthood and which can affect one as well as both ears in up to 80% of cases. The surgical procedures of choice are stapedotomy and stapedectomy. Complications of surgery are persistent vertigo, secondary facial nerve palsy and the most severe complication is deafness in up to 1% of the cases. Even if the operation risks are low, the alternative use of a hearing aid must be offered in the initial consultation. A new technique of stapes surgery is laser-assisted stapedotomy. Necrosis of the incus process with dislocation of the prosthesis is the most common finding which necessitates stapes revision surgery. The aim of this article is to present the current scientific concept, diagnostics and therapy of otosclerosis with an emphasis on surgical treatment options.