MIDDLE EAR INFECTION

The middle ear contains the eardrum, the middle ear chamber and the Eustachian tube. The Eustachian tube connects the middle ear to the part of the nose located behind the roof of the mouth. Not only can air move between the middle ear and the nose, but bacteria can also move between the two. When bacteria moves from the nose to the middle ear, a middle ear infection can occur.
Middle ear infections are common in children but are less likely to develop in adults. Adults and children’s Eustachian tubes are shaped differently, the reason adults do not develop these infections. Children’s Eustachian tubes are shorter than adults, allowing for bacteria to move easier. However, adults’ Eustachian tubes are sloped permitting easier drainage, reducing the likelihood of middle ear infections.

OUTER EAR INFECTION

An outer ear infection affects the outer ear canal, which begins at the outside opening of the ear and leads to the eardrum. The ear canal may look red and swollen, or it may not show any signs of infection. Your child may complain of his/ her ear(s) hurting, itching or feeling ticklish. Other signs that your child may have an outer ear infection are when he/she pushes on the outer skin of the ear to make the itching or tickling feeling dissipate or when your child’s ear hurts when chewing.

Outer ear infections occur when bacteria grows in the ear canal. This infection can occur if the ear frequently gets wet and stays damp for hours. This is why the outer ear infection is called “swimmer’s ear.” Not only do children develop this infection, but teenagers and adults can also develop an outer ear infection.

It can also occur if you use cotton swabs on your child’s ear for cleaning or drying. The cotton swabs can push water and dirt back toward the eardrum; this allows for bacteria to grow and live.

TINNITUS

Tinnitus is usually a symptom of some underlying medical problem such as Meniere’s Disease, hearing loss with age, inner ear infections and other conditions affecting the ear. Ringing sounds, along with other noises, seemingly originating from the ear or head, are common when experiencing tinnitus.

For an accurate diagnosis the doctor will ask about your medical history, require a
description of your symptoms and perform a thorough ENT exam. Some diagnostic tests may be performed during the ENT exam such as hearing and balance tests, CT scan or MRI.

Treatment of tinnitus varies depending on a person’s specific underlying cause. Tinnitus is treated easily in many cases. However, if the underlying problem cannot be treated, your doctor can offer ideas on how to make living with tinnitus easier.

MENIERES

Meniere’s Disease is a medical condition affecting the inner ear, the part of the body that controls sound waves sent to the brain, as well as balance. There are two different canals in the inner ear: one for balance and one for filtering sound information; both are filled with a fluid called endolymph. In the hearing canal, endolymph acts as a filter for sound, and when in the balance canal, the fluid creates messages about the position and movement of the body. In someone who has Meniere’s Disease, too much endolymph in the inner ear causes pressure and swelling in the canals, causing unpleasant symptoms.

Symptoms of Meniere’s Disease

• Problems with hearing
• Vertigo – sudden onset of a whirling or spinning motion
• Tinnitus – buzzing, whistling, roaring, or ringing in the ear
• Pressure in the inner ear

For the doctor to correctly diagnose your condition, you will be asked about your symptoms and medical history, take a physical exam, test your balance and hearing and possibly take a diagnostic test. Your physical exam may include examination of your ear, hearing and coordination tests, and checking nerve functions in your face. To test balance, the doctor may administer an electronystagram (ENG) during which your ears are filled with either warm or cool air or water and a series of movements are carried out to assess how well your balance canal is functioning. Two other tests that may be performed to eliminate the possibility of a brain tumor are auditory brain stem response and magnetic resonance imaging.

Ways to Reduce Discomfort of Meniere’s Disease

• Reduce salt intake to about 2000 mg per day
• Avoid adding salt to food
• Use salt-free mouthwash, toothpaste, antacids, and medications
• Avoid caffeine and smoking because they reduce blood flow to the ear
• Avoid alcohol because it alters balance
• Reduce stress
• Exercise

There is no cure for Meniere’s Disease, but doctors may prescribe medications to reduce the amount of fluid in your body, which could reduce the amount of fluid in your inner ear and alleviate some of your symptoms. Other medications help with symptoms such as dizziness, nausea and vertigo.

There are three types of surgery that can help people with Meniere’s Disease: endolymphatic sac decompression, vestibular neurectomy and labyrinthectomy. Endolymphatic sac decompression is performed in the inner ear to help relieve pressure.

In a vestibular neurectomy, the balance nerve of the effected ear is cut, eliminating vertigo. The third surgery,labyrinthectomy, removes the whole balance portion of the ear, eliminating vertigo but also hearing in that ear.

TYMPANTOMY

Tympanotomy is a same day surgery in which a small incision is made in the eardrum, fluid is drained from the ear and small tubes are placed in the ear to prevent more fluid build up.

Tympanotomy may be performed when Serous fluid collects in the ear, which often impairs hearing. Common causes of build-up in children are recurrent infections and allergies. In adults, fluid build-up in the ear is mainly caused by allergies or fluid retention following an upper respiratory infection. The surgery can be done under general (usually for children) or local (usually for adults) anesthesia. If a tube was inserted during surgery to prevent further collection of fluid in the ear, it need not be removed; it will fall out by itself within a year.