Etiology Many theories have been proposed such as hereditary, 54% of patients present with family history endocrine, women with pregnancy worse her hearing metabolic, enzyme abnormal was pathogen infectious, virus was identified in the lesion a vascular autoimmune J none have be proven, Hormonal factors have been suggested to play a role in otosclerosis based on the observation that pregnancy sometimes accelerates the progression of the diseaseEtiology ◼ Many theories have been proposed such as ◼ hereditary, 54% of patients present with family history ◼ endocrine, women with pregnancy worse her hearing ◼ metabolic, enzyme abnormal was pathogen ◼ infectious, virus was identified in the lesion ◼ vascular, ◼ autoimmune, ◼ none have be proven. Hormonal factors have been suggested to play a role in otosclerosis based on the observation that pregnancy sometimes accelerates the progression of the disease