Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.


The middle ear has 3 tiny hearing bones called ossicles, which transfer vibratory energy from the eardrum to the inner ear. Otosclerosis, a bone-remodeling disorder of the temporal bone, is common and frequently causes abnormal fixation of the third hearing bone (stapes). This results in a progressive, conductive hearing loss. Other symptoms may include tinnitus, sensorineural hearing loss due to otosclerotic inner ear syndrome, and balance dysfunction (imbalance without true vertigo). Hearing loss typically begins between ages 15-45, and about 60% of all otosclerosis patients have a family member with similar hearing loss.

The diagnosis of otosclerosis is based on clinical history and results of comprehensive audiometric (hearing) tests. The final diagnosis, however, can only be confirmed at surgery after manual palpation of each ossicle. Treatment options for otosclerosis include non-intervention, use of conventional or bone anchored hearing aids, and middle ear exploration with stapedotomy/stapedectomy. During stapes surgery, a portion of the non-functioning stapes bone is removed and replaced with a prosthesis. This prosthesis allows the ossicular chain to move freely so that sound energy can properly transmit to the inner ear. In >90% of cases, hearing can be dramatically improved. There is a 0.5% to 1% chance of profound hearing loss from stapes surgery; therefore, the decision must be carefully considered.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist in Tucson.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure. He has an international reputation as an expert for treating ear diseases.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped him to optimize delivery of personalized ear and lateral skull base care.
  • Dr. Jacob is an expert in surgery for otosclerosis and performs the most stapedectomy procedures in Tucson. Depending on the clinical situation, he offers both the total stapedectomy technique and the small fenestration, laser stapedotomy method for hearing restoration. Most operations are done through the ear canal, using the microscope or ear endoscope. For those who wish to avoid surgery, a full selection of hearing aids and bone anchored hearing implants is also offered.