Clinically Oriented Basic Science ReviewPathophysiology of OtosclerosisChole, Richard A.*; McKenna, Michael†Author Information *Departments of Otolaryngology and Molecular Pharmacology, Washington University School of Medicine, St. Louis, Missouri, and †Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A. Supported by a grant from the National Institutes of Health #R01-DC00263-11. Address correspondence to Richard A. Chole, M.D., Department of Otolaryngology, Washington University School of Medicine, Campus Box 8115, 660 South Euclid Avenue, St. Louis, MO 63110, U.S.A. Otology & Neurotology: March 2001 - Volume 22 - Issue 2 - p 249-257 Buy Abstract Objective To review current knowledge of the pathophysiology of otosclerosis and to review hypotheses for the amelioration of this disease. Data Sources Review of the literature and experimental observations by the authors. Conclusions Otosclerosis is a localized disease of bone remodeling within the otic capsule of the human temporal bone. Unlike other similar bone diseases, it does not occur outside of the temporal bone. These lesions seem to begin by resorption of stable otic capsule bone in adults, followed by a reparative phase with bone deposition. There are clearly genetic factors that lead to this disease, but measles virus infection and autoimmunity also may play contributing roles. Surgical correction of the conductive hearing loss is highly effective, but nonsurgical intervention has not yet been shown to prevent or slow the disease. Of the factors that may inhibit this process, fluorides, cytokine inhibitors, and bisphosphonates, third-generation bisphosphonates appear to hold the most promise. © 2001 Lippincott Williams & Wilkins, Inc.