A patient with otosclerosis is not a candidate for surgery. Which of the following is the MOST appropriate hearing rehabilitation device, and why is a BAHA (Bone-Anchored Hearing Aid) NOT preferred over conventional amplification?

• A BAHA is preferred over air conduction aids because bone conduction bypasses the stapes fixation entirely
• B Conventional air conduction hearing aid; BAHA is reserved for mixed or sensorineural loss or chronic ear discharge — in pure conductive otosclerosis, amplifying air conduction is effective because cochlear function is preserved ✓
• C Cochlear implant is required if otosclerosis extends to the cochlea with mixed hearing loss
• D No hearing aid is effective; surgery is the only treatment for otosclerosis

Explanation

In pure conductive otosclerosis without significant cochlear (sensorineural) component, cochlear function is preserved. Conventional air conduction hearing aids effectively amplify sound to overcome the conductive component and are first-choice non-surgical rehabilitation. BAHA is preferred when: (1) chronic suppurative ear discharge precludes an occluding ear mold, (2) atresia/meatal stenosis prevents insertion of a conventional aid, or (3) mixed hearing loss where cochlear reserve is poor. In otosclerosis with mixed loss ('cochlear otosclerosis'), cochlear implantation may ultimately be needed if cochlear function deteriorates below implant candidacy thresholds.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.