Common Ear Conditions
Our ears are very important sense organs and often undervalued. They can help us sense danger from unidentified sounds as well as provide pleasure when we listen to soothing music. Symptoms affecting our ears include: Otalgia or ear pain, otorrhoea or ear discharge, hearing loss, ringing sounds and giddiness. It is important not to ignore such symptoms as most ear conditions can be easily diagnosed and hearing can be improved or restored after treatment. If left untreated, permanent hearing loss or even deafness may be the end-result. Some of the common conditions affecting our ears are listed below.
Earwax (also known as cerumen) is produced by special glands in the outer part of our ear canal and is designed to trap dust and dirt particles keeping them from reaching the eardrum. Usually the wax accumulates, dries, and then falls out of the ear on its own. The ear is therefore self-cleaning. One of the most common and easily treatable causes of hearing loss is impacted or accumulated earwax. Many people use cotton swabs or other small objects to remove earwax as a daily habit. This not recommended the earwax is pushed deeper into the ear, increasing buildup and affecting hearing. Excessive earwax can be treated by ear syringing. However wax which is very hard and impacted may need the use of instruments or ear suctioning to be removed safely and painlessly.
This occurs when there is an infection of the outer ear structures. Otitis externa is caused when water gets trapped in the ear canal leading to a collection of trapped bacteria. In this warm, moist environment, bacteria multiply causing irritation and infection of the ear canal. Although it typically occurs in swimmers, bathing or showering can also contribute to this common infection. In severe cases, the ear canal may swell shut leading to temporary hearing loss and making administration of medications difficult. Microscopic removal of infected material is important to enable the infection to resolve quickly.
The most common cause of hearing loss in children is otitis media, which is a middle ear infection or inflammation of the middle ear. This condition can occur in one or both ears and primarily affects children due to the shape of the young Eustachian tube. When left undiagnosed and untreated, otitis media can lead to infection of the mastoid bone behind the ear, a ruptured ear drum, and hearing loss. If treated appropriately, hearing loss related to otitis media can be improved.
A perforated eardrum is a hole or rupture in the eardrum, a thin membrane that separates the ear canal and the middle ear. A perforated eardrum is often accompanied by decreased hearing and occasional discharge with possible pain. The amount of hearing loss experienced depends on the degree and location of perforation. Sometimes a perforated eardrum will heal spontaneously, other times surgery to repair the hole is necessary. Serious problems can occur if water or bacteria enter the middle ear through the hole. Surgery to repair the eardrum has a high rate of success and is quick and safe.
A cholesteatoma is a skin growth that occurs in the middle ear behind the eardrum. This condition usually results from poor eustachian tube function concurrent with middle ear infection (otitis media), but can also be present at birth. The condition is treatable, but can only be diagnosed by medical examination. Over time, untreated cholesteatoma can lead to bone erosion and spread of the ear infection to localized areas such as the inner ear and brain. If untreated, deafness, brain abscess, meningitis, and death can occur. Surgery in the form of a mastoidectomy is needed for complete and safe removal of a cholesteatoma.
Tinnitus is the medical name indicating “ringing in the ears,” which includes noises ranging from loud roaring to clicking, humming, or buzzing. Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear. The health of these nerve endings is important for acute hearing, and injury to them brings on hearing loss and often tinnitus. Hearing nerve impairment and tinnitus can also be a natural accompaniment of advancing age. Exposure to loud noise is probably the leading cause of tinnitus damage to hearing in younger people. Medical treatments with drugs and assistive hearing devices are often helpful to those with this condition.
Autoimmune Inner Ear Disease
Autoimmune inner ear disease (AIED) is an inflammatory condition of the inner ear. It occurs when the body’s immune system attacks cells in the inner ear that are mistaken for a virus or bacteria. Prompt medical diagnosis is essential to ensure the most favorable prognosis. Therefore, recognizing the symptoms of AIED is important: sudden hearing loss in one ear progressing rapidly to the second and continued loss of hearing over weeks or months, a feeling of ear fullness, vertigo, and tinnitus. Treatments primarily include medications but hearing aids and cochlear implants are helpful to some.
Adapted from American Academy of Otolaryngology-Head & Neck Surgery
By Dr Andrew Loy Heng Chian
Consultant ENT-Head & Neck Surgeon
Adjunct Assistant Professor, Duke ¨C NUS Graduate Medical School
Visiting Consultant, Tan Tock Seng Hospital
Fellow, American Head & Neck Society