Otosclerosis (inner ear calcification) is diagnosed by an Ear, Nose, and Throat (ENT) specialist. The diagnostic process begins with a detailed patient history. During the physical examination, the eardrum and external ear are typically normal; however, a reddish hue behind the eardrum, known as Schwartze's sign, may occasionally be observed, suggesting early-stage disease activity.

To accurately diagnose otosclerosis and rule out conditions with similar symptoms, a comprehensive evaluation of the ear is conducted. This includes a series of audiological tests to determine the type and extent of hearing loss:

* Audiometry: This test measures the lowest sound levels a patient can hear across various frequencies and pitches, providing crucial information about hearing thresholds.
* Tympanometry: By assessing the mobility of the eardrum, this test helps determine if there is stiffness or calcification within the ossicular chain, which is characteristic of otosclerosis.
* Acoustic Reflex Test: This test specifically evaluates the impact of the calcification on the stapes bone, further aiding in the diagnosis.

In certain cases, a Computed Tomography (CT) scan may be requested. This imaging provides detailed visualization of the intricate bone and tissue structures of the inner ear, allowing for a more definitive diagnosis and assessment of the extent of the condition.