A 30-year-old woman with bilateral conductive hearing loss is diagnosed with otosclerosis. She is pregnant (12 weeks) and asks about treatment. Which of the following is MOST accurate regarding management during pregnancy?
- A Sodium fluoride therapy should be started immediately to arrest progression during pregnancy
- B Stapedectomy should be performed in the second trimester for optimal outcomes
- C Hearing aids are the preferred management during pregnancy; surgery should be deferred post-partum ✓
- D Pregnancy has no effect on otosclerosis progression; manage as usual
Correct answer: C. Hearing aids are the preferred management during pregnancy; surgery should be deferred post-partum
Explanation
Otosclerosis is known to be accelerated by hormonal changes of pregnancy (high oestrogen and progesterone levels promote active otospongiosis), potentially causing rapid progression of hearing loss. Surgery (stapedectomy) is generally deferred until after delivery due to anaesthetic risks and the potential for further progression during pregnancy. Hearing aids provide safe and effective amplification during this period. Sodium fluoride, which may stabilise the active vascular otospongiotic foci, is not safe in pregnancy.
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.