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Common Ear Problems
Ears are our organs of hearing. They are also part of the mechanism that controls our balance. This leaflet describes some of the problems that affect ears and may lead to deafness or dizziness. It also describes a condition called tinnitus - ringing or other noises in your ears or head.

If you look at the diagram on pages 4-5, you will see that an ear can be divided into three sections: - The outer ear. - The middle ear. - The inner ear.

Sound goes into the outer ear, passes through the middle ear and is processed by the inner ear before being sent to your brain. If you are deaf or hard of hearing, it is because part of this system does not work.

If you suffer from dizziness, this may sometimes be caused by problems in the inner ear.

Different kinds of deafness There are two main kinds of deafness:

  • Conductive deafness, where sound cannot pass through the outer or middle ear.
  • Sensorineural deafness, where the cause of the deafness is in the cochlea or in the hearing nerve. Deafness which is the result of a problem in the cochlea is also called sensory, cochlear or inner ear deafness. Deafness caused by a problem in the hearing nerve - or auditory nerve - may also be called neural deafness.

The two kinds of deafness may have different causes. This leaflet will look at some of these causes and at what you can do to help yourself.

If you have any worries, your doctor will examine your ears

Ear conditions and what to do about them

In the outer ear
Blockages in the external ear canal may affect your hearing. They are usually caused by wax. The wax is made by the ear to clean itself and normally falls out of the ear on its own, but occasionally you may need to visit your doctor to have it removed. Do not attempt to remove wax from your ears yourself. Never push cotton buds, fingers or anything else into your ears. You will push any wax there is onto your eardrum. This could cause pain, infection and deafness. Some ear drops which are sold for removing wax may make your ears itch. It is best to ask your doctor to check your ears.

Otitis externa is where the skin of the ear canal has become inflamed. This may happen if you have scratched your ear or if you have a skin condition such as eczema. The result can be pain and a watery discharge. There is usually little or no hearing loss. Do not scratch your ear. See your doctor to get ear drops and keep your ear dry.

In the middle ear Glue ear (otitis media with effusion) is most common in children. It happens when the eustachian tube gets blocked and air cannot get into the middle ear. Instead, the middle ear fills up with fluid which becomes thick like glue, the eardrum cannot move, and hearing is reduced. Most children with glue ear get better without treatment and their hearing goes back to normal. If glue ear persists, an operation called a myringotomy may be advised, where a tiny ventilation tube called a grommet is inserted temporarily into the eardrum. If a child's parents stop smoking, this may help; so may treatment of any allergies. Other treatment with medicines is not very effective.

Chronic middle ear infection is now rare because of treatment with antibiotics, but some people have an abnormal eardrum as a result of chronic infection, behind which dead skin collects. Your ear, nose and throat (ENT) specialist may suggest a mastoid operation for this. If the dead skin is not removed, it can become infected and damage your hearing.

Otosclerosis affects more women than men, often starts around the age of 30, and can run in families. It is caused by a bony overgrowth of the stapes, one of the chain of bones (ossicles) which stretches across the middle ear. The link in the chain becomes rigid and sound vibrations cannot pass through it. People with otosclerosis gradually become more deaf. Hearing aids are very useful to someone with this condition. Most people can have an operation - a stapedectomy or stapedotomy - where the stapes is replaced by a tiny piston so that sound can travel to the inner ear. The operation has a high success rate.

Damaged ossicles - the tiny bones in the middle ear - can be repaired or replaced during operations called ossiculoplasties.

Perforated eardrums can be treated by an operation called a myringoplasty, where a tissue graft is used to seal up the hole. In the inner ear Sensorineural deafness is most often the result of damage to tiny hair cells in your cochlea. These hair cells cannot be replaced.

This damage may happen:

  • Before a baby is born, for example if the mother has rubella (German measles) while she is pregnant.
  • If a baby is born prematurely or if the mother has a difficult labour.
  • If you have a disease such as mumps or meningitis.
  • If you take certain drugs - in particular aspirin, or antibiotics called streptomycin and gentamicin.
  • If you are exposed to loud noise for a long time. By law, if you work somewhere very noisy you must wear ear plugs or muffs to protect your hearing.
  • If you have a serious head injury with a skull fracture.
  • Naturally, as you grow older.
Sensorineural deafness from birth may also be genetic although this is rare. It is common, however, for people in one family to have the same pattern of hearing loss as they get older. People with sensorineural deafness usually find hearing aids very helpful. A cochlear implant (see page 13) may be an option for people who have become completely deaf through sensorineural deafness.

Presbyacusis is the natural hearing loss many people experience in old age. Everyone loses hair cells in the cochlea throughout their life and gradually their hearing becomes less acute. You probably find you can hear speech but cannot understand it. This is often because only the high frequency sounds are affected. Other people seem to 'mumble'. Hearing aids will be helpful if they are properly fitted; good advice and support, if possible from a hearing therapist, are even more important. See page 14 for some suggestions.

Vertigo (dizziness) and balance problems may be caused by damage to your semicircular canals, or by a problem with the balance centres at the base of your brain. This damage could be the result of a virus or poor blood supply. In some cases, it is hard to be sure of the cause. Usually, your balance will recover on its own, given time, but you may need to take drugs for a few days. A physiotherapist can teach you helpful balance exercises.
See a doctor if you have vertigo or balance problems.

Tinnitus - noises in your ears or head - is experienced by about one in seven people at some point. The noises may be quiet or loud, and can be hissing, rushing or other sounds.

Research suggests that tinnitus is not just an ear disorder, but that parts of the brain that interpret sound patterns can cause small tinnitus signals to be amplified. You may get tinnitus if you develop a hearing loss, after listening to loud sounds, or for no clear reason at all. There are various therapies for tinnitus; one of the newest is retraining therapy.

For information call the RNID Tinnitus Helpline, tel: 0808 808 6666; textphone: 0808 808 0007.

Menière's Disease is caused by increased pressure in the fluid which fills your inner ear. It consists of sensorineural deafness, tinnitus and vertigo (dizziness). The vertigo may make it difficult for you to walk or stand, and you may vomit.

Attacks happen at intervals - there may be weeks or even years between them. The levels of deafness and tinnitus may go up and down. Your hearing may go back to normal on its own.

Your ear specialist may advise you to follow a special low-sodium diet and to avoid stress.

Drugs can help if the Menière's Disease is mild. If it is severe, your specialist may suggest you have an operation.

Cochlear implants If you were born hearing but have lost all your hearing through sensorineural deafness, and hearing aids do not help, a cochlear implant may be an option for you.

A cochlear implant is a small electronic device, a part of which is implanted in the cochlea of a deaf person so that it bypasses missing hair cells. It does not give you perfect hearing, but many people who have cochlear implants can understand speech and recognise different sounds around them. Some can even use the telephone.

Children who are born deaf can also sometimes have cochlear implants if this is done while they are still very young, but implants are not suitable for adults who were born deaf.

There is continuing debate on ethical issues surrounding the use of cochlear implants. Their effectiveness in the long term is still being evaluated.

What next?
One in seven people have a hearing loss, so you are not alone. There are many things you can do to help yourself, apart from seeing a doctor or an ENT specialist:

  • Make sure your family, friends and colleagues know about your hearing loss so that they can give you support.
  • If you get a hearing aid and it does not help you at first, do not give up. Ask for help.
  • Ask your ENT consultant if there is a hearing therapist at the hospital you go to for treatment. Hearing therapists can give you advice about dealing with deafness and using hearing aids.
  • Talk to the Social Worker with Deaf People at your social services department about special equipment.
  • If you are in work or looking for work and feel your hearing loss is a disadvantage, ask the Disability Employment Adviser at your Jobcentre for advice.
  • Send in the coupon in the centre of the leaflet for more information.
  • Join RNID to keep in touch with our work and take advantage of our services.
  • Ask your local council about lipreading classes.
  • Join a club for deaf or hard of hearing people.

Source: RNID Factsheet
Date Published @ DS: 30/10/2000 



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