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October 1961

The Pathogenesis of Otosclerosis

Arch Otolaryngol. 1961;74(4):362-372. doi:10.1001/archotol.1961.00740030371002

Clinical observations show that auditory thresholds in otosclerotic patients fluctuate much more widely than do those in normal-hearing persons. Such decided variations in auditory acuity among patients with otosclerosis suggest the presence of psychological factors. Patients themselves claim that the slightest emotional change is immediately reflected in their hearing, and that they hear more poorly when they are worried or upset.

Unpleasantness in family life or on the job, and the strain of concealing their hearing loss from their associates are situations recognized as depressing auditory acuity. The otologist knows from experience how sharply a patient's hearing seems to fall off, after he has made a mistake in answering questions during a hearing test with whispered or conversational speech. Believing that his hearing has become worse since his last test, he almost stops listening.

The otologist is obliged to reassure his patient by telling him that the test is not

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