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Updated: Jun 26, 2026

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Management Options and Their outcomes in Bilateral Advanced Otosclerosis.

Swathi Ramasamy1, A Senthil Vadivu2, S Raghu Nandhan1

  • 1Otorhinolaryngology Department, Madras ENT Research Foundation, Chennai, Tamil Nadu.

The Journal of International Advanced Otology
|June 25, 2026
PubMed
Summary

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Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery·2026
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Complication profile in a cochlear implantation- surgical audit in a large study population of low socio-economic status in a developing country.

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A Case of Langerhan's Cell Histiocytosis of Temporal Bone.

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Systematic review of cochlear implantation in adults with asymmetrical hearing loss.

Cochlear implants international·2021

For progressive hearing loss in otosclerosis, cochlear implantation (CI) offers superior speech outcomes and symptom relief compared to stapedotomy with hearing aids. Both interventions improve hearing, but CI provides greater benefits for speech and associated symptoms.

Area of Science:

  • Otolaryngology
  • Audiology
  • Neurosurgery

Background:

  • Otosclerosis is a hereditary condition causing progressive hearing loss in adults.
  • Multimodal treatment is often necessary due to the progressive nature of otosclerosis.
  • Management decisions incorporate audiological, radiological evaluation, and the Merkus algorithm.

Purpose of the Study:

  • To compare audiological and speech outcomes of cochlear implantation (CI) versus stapedotomy with hearing aid use.
  • To evaluate the effectiveness of different interventions for bilateral advanced otosclerosis.
  • To assess symptom relief (vertigo, tinnitus) in patients with otosclerosis.

Main Methods:

  • A cohort study involving 38 patients with bilateral advanced otosclerosis.
  • Group A: 15 patients underwent cochlear implantation (CI).
Keywords:
Advanced otosclerosisMerkus algorithmTinnitus Handicap InventoryVertigo Handicap Indexcochlear implantationfacial nerve stimulationprogressive hearing lossstapedotomy

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  • Group B: 23 patients underwent stapedotomy followed by hearing aid use. Outcomes were compared using paired t-tests.

    • Main Results:

    • Both CI and stapedotomy with hearing aids significantly improved hearing and speech outcomes.
    • Speech-related outcomes were statistically superior in the CI group (Group A).
    • Hearing outcomes were comparable between groups; CI group showed greater improvement in vertigo and tinnitus.

    Conclusions:

    • Early intervention is crucial for preserving residual hearing in progressive hearing loss.
    • Cochlear implantation effectively enhances audiological and speech outcomes while alleviating tinnitus and vertigo.
    • Stapedotomy with hearing aid use is a cost-effective option with comparable audiological results.