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Otosclerosis: Vestibular Symptoms and Sensorineural Hearing Loss

Of 546 patients with otosclerosis, 500 who had not had ear surgery were divided into four groups according to the relative and absolute amounts of sensorineural hearing loss in the hearing-impaired ears. The first three groups of patients had progressively less of a conductive component and progressively more of a sensorineural component to their hearing losses. The fourth group of patients had pure sensorineural hearing impairments. The remaining 46 patients were placed in group V. They had bilateral hearing losses and had had a prior unilateral stapedectomy for otosclerosis and they had received medical therapy for otosclerosis. The following conclusions were reached: 1 Further clinical evidence was obtained supporting the existence of the entity “pure labyrinthine otosclerosis.” However, there can be difficulties in the diagnosis of this condition. 2 The incidence of vestibular symptoms in patients with otosclerosis increased as the relative and absolute amounts of sensorineural hearing loss increased and was much higher than one would expect in the normal population. In addition, with increasing sensorineural hearing loss, the severity of vestibular symptoms increased along with the incidence of depression in vestibular function determined by the bithermal caloric test in patients with vestibular Symptoms. 3 A preliminary study on the administration of a combination of calcium gluconate, sodium fluoride, and vitamin D to patients with otosclerosis who had vestibular symptoms indicated that the therapy controlled vestibular symptoms in a high percentage of these patients. 4 A preliminary study on the administration of calcium gluconate, sodium fluoride, and vitamin D to patients with otosclerosis indicated that in a high percentage of patients the deterioration in hearing was stopped. A small but significant number of patients had reversal of their hearing loss. 5 Side effects of treatment with a combination of calcium gluconate, sodium fluoride, and vitamin D were not serious and were reversible, and there appears to be no contraindication to this therapy for healthy adults.