Fenestral otosclerosis

A 57-year-old female presented with a longstanding history of left-sided hearing loss that progressively worsened over the previous year with intermittent otalgia and superimposed subjective non-pulsatile tinnitus. Audiologic evaluation was notable for mixed conductive and sensorineural hearing loss on the left. Temporal bone CT imaging demonstrated resorptive changes along the margins of the oval window and cochlear promontory on the left with capsular sparing on the right compatible with clinically suspected fenestral otosclerosis. Due to the low-level gap in air/bone conduction at diagnosis, the patient was not deemed a surgical candidate for stapes replacement and referral was made for fitting of external audiological aid