A 30-year-old woman is diagnosed with clinical otosclerosis. She declines surgery and requests medical management. Which agent is used to slow the progression of the sensorineural component (cochlear otosclerosis)?

• A Bisphosphonates (alendronate)
• B Calcitonin intranasal spray
• C Sodium fluoride ✓
• D Vitamin D analogues

Explanation

Sodium fluoride is the only medical therapy with evidence for slowing the progression of otosclerosis, particularly the cochlear (sensorineural) component. It acts by replacing the hydroxyl group in hydroxyapatite to form fluorapatite, which is more resistant to osteoclastic resorption, thereby stabilizing the ongoing endochondral bone remodeling. It does not reverse the conductive component (fixed stapes). It is given with calcium and vitamin D to prevent fluoride-related side effects. Surgical stapedectomy/stapedotomy remains the definitive treatment for the conductive hearing loss.

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.