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Otosclerosis - Symptoms
Last reviewed: 06.07.2025
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Symptoms of otosclerosis include hearing loss and tinnitus that progress at varying rates. Periods of stabilization alternate with periods of significant hearing loss, but hearing loss, like deafness, never regresses. Rapid development of the disease, characteristic of the so-called juvenile form, in which severe hearing loss develops over a short period of time, is rarely observed. According to some authors, 70-80% of cases of the first manifestation of otosclerosis occur between the ages of 20 and 40. Hearing loss in otosclerosis is usually bilateral, and several months to years may pass between its appearance on one side and the other. A characteristic sign of otosclerosis is a relatively better perception of speech in noise conditions than in silence - paracusis willisii (Willis symptom, Willis phenomenon, paracusia). The symptom is detected in half of patients with otosclerosis on average, it is more typical for pronounced fixation of the stapes, provided that the level of bone conduction is preserved. With the development of a mixed form of hearing loss, the frequency of detection of paracusia decreases. Another symptom characteristic of otosclerosis was described by J. Toynbee (Toynbee symptom) and consists of unclear speech perception, especially when several people are talking at the same time.
Tinnitus is another constant symptom of the disease, occurring in 67-98% of patients. Its localization varies - it is one or both ears, less often the head. At the onset of the disease, the noise is noted only in silence, with an increase in the level of hearing loss, its intensity increases. Low-frequency noise is more characteristic, the presence of high-frequency noise may indicate concomitant diseases of vascular genesis. Up to a quarter of patients with otosclerosis complain of heaviness, a feeling of pressure in the ear.
Symptoms of vestibular apparatus damage are less typical for patients with otosclerosis. The frequency of their detection ranges from 25 to 28%, however, a number of studies have not revealed vestibular symptoms in patients with otosclerosis.
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