Otosclerosis: gradual hearing loss in younger adults
Otosclerosis is abnormal bone growth in the middle ear that stops one of the tiny hearing bones moving freely. It usually starts between the ages of 20 and 40, often runs in families, and is very treatable, with hearing aids or surgery.
A tiny bone that stops moving.
Sound passes through the middle ear along three tiny bones. The last of these, the stapes or stirrup, sits in a small opening into the inner ear and moves like a piston to pass vibrations on. In otosclerosis, spongy new bone grows around the stapes and gradually fixes it in place, so less sound gets through.
The result is a conductive hearing loss that comes on slowly over months or years, in one or both ears. Tinnitus is common. Occasionally the bone changes also affect the inner ear, adding a sensorineural element to the loss.
It is more common in women, and hearing can sometimes worsen during pregnancy.
Some people find it easier to hear conversations in noisy places, because others raise their voices.
Signs of otosclerosis.
A hearing test shows the conductive pattern typical of otosclerosis. If we see it, we write to your GP, who can refer you to ENT to confirm the diagnosis and discuss treatment.
Diagnosis support, and hearing aids if you choose them.
We test both air and bone conduction, which shows the conductive pattern typical of otosclerosis.
If we see that pattern, we write to your GP, who can refer you to ENT.
If you prefer not to have surgery, or are waiting for it, hearing aids can restore much of what you are missing.
Regular tests track any changes, before and after treatment.
Treatment options.
Both work well. The choice depends on your hearing, your ears and your preference.
If the loss is mild and not troubling you, regular hearing tests may be all you need for now.
Very effective for conductive loss, because the inner ear is often working well. No surgery needed.
An ENT surgeon replaces part of the stapes with a tiny prosthesis, restoring the sound pathway. Usually done one ear at a time.
Some people have surgery on one ear and use a hearing aid on the other.
Frequently asked questions.
It often runs in families, though not everyone with a family history gets it.
Stapes surgery can restore hearing very effectively for many people. Hearing aids are an excellent alternative. Neither stops the bone process entirely, so hearing is usually monitored over time.
It causes hearing loss that can become significant, but complete deafness is rare. Treatment usually restores useful hearing.
Some women notice their hearing gets worse during pregnancy. Mention it to your GP or midwife if this happens.
Usually very well, because the inner ear is often working normally. The hearing aid simply makes sound strong enough to overcome the stiff bone.
Find out what is behind the change.
A free 60 minute hearing test, with results explained the same day.
Conductive hearing lossLow-frequency hearing lossHearing loss in one earHearing aidsHearing tests
Written and clinically reviewed by our HCPC registered audiologists. Last reviewed: 15 October 2026. This page is general information, not a diagnosis. If you are worried about your hearing or your ears, book an appointment or speak to your GP.