Ear & Hearing :
Sinusitis is the most common chronic medical condition in the country. This disorder of the upper airway affects 37 million Americans and leads to debilitating pain and a decline in quality-of-life.
2.Earwax... and what to do about it
What Is Otitis Media?:
Otitis media means inflammation of the middle ear. The inflammation
occurs as a result of a middle ear infection. It can occur in one
or both ears. Otitis media is the most frequent diagnosis recorded
for children who visit physicians for illness. It is also the most
common cause of hearing loss in children.
Although otitis media is most common in young children, it also affects adults occasionally. It occurs most commonly in the winter and early spring months.
Yes, it is serious because of the severe earache and hearing loss it can create. Hearing loss, especially in children, may impair learning capacity and even delay speech development. However, if it is treated promptly and effectively, hearing can almost always be restored to normal.
Otitis media is also serious because the infection can spread to nearby structures in the head, especially the mastoid. Thus, it is very important to recognize the symptoms (see list) of otitis media and to get immediate attention from your doctor.
How Does the Ear Work?
The outer ear collects sounds. The middle ear is a pea sized, air-filled
cavity separated from the outer ear by the paper-thin eardrum. Attached
to the eardrum are three tiny ear bones. When sound waves strike the
eardrum, it vibrates and sets the bones in motion that transmit to
the inner ear. The inner ear converts vibrations to electrical signals
and sends these signals to the brain. It also helps maintain balance.
A healthy middle ear contains air at the same atmospheric pressure
as outside of the ear, allowing free vibration. Air enters the middle
ear through the narrow eustachian tube that connects the back of the
nose to the ear.
When you yawn and hear a pop, your eustachian tube has just sent a tiny air bubble to your middle ear to equalize the air pressure.
What
Causes Otitis Media?
Blockage of the eustachian tube during a cold, allergy, or upper
respiratory infection and the presence of bacteria or viruses lead
to the accumulation of fluid (a build-up of pus and mucus) behind
the eardrum. This is the infection called acute otitis media. The
build up of pressurized pus in the middle ear causes earache, swelling,
and redness. Since the eardrum cannot vibrate properly, you or your
child may have hearing problems.
Sometimes the eardrum ruptures, and pus drains out of the ear. But more commonly, the pus and mucus remain in the middle ear due to the swollen and inflamed eustachian tube. This is called middle ear effusion or serous otitis media. Often after the acute infection has passed, the effusion remains and becomes chronic, lasting for weeks, months, or even years. This condition makes one subject to frequent recurrences of the acute infection and may cause difficulty in hearing.
What
Are the Symptoms?
In infants and toddlers look for:
pulling or scratching at the ear, especially if accompanied by the following...
- hearing problems
- crying, irritability
- fever
- vomiting
- ear drainage
In young children, adolescents, and adults look for:
- earache
- feeling of fullness or pressure
- hearing problems
- dizziness, loss of balance
- nausea, vomiting
- ear drainage
- fever
Remember, without proper treatment, damage from an ear infection
can cause chronic or permanent hearing loss.
What Will Happen at the Doctor’s Office?
During an examination, the doctor will use an instrument called an otoscope to assess the ear’s condition. With it, the doctor will perform an examination to check for redness in the ear and/or fluid behind the eardrum. With the gentle use of air pressure, the doctor can also see if the eardrum moves. If the eardrum doesn’t move and/or is red, an ear infection is probably present.
Two other tests may be performed for more information.
An audiogram tests if hearing loss has occurred by presenting tones at various pitches.
A tympanogram measures the air pressure in the middle ear to see how well the eustachian tube is working and how well the eardrum can move.
The
Importance of Medication
The doctor may prescribe one or more medications. It is important
that all the medication(s) be taken as directed and that any follow-up
visits be kept. Often, antibiotics to fight the infection will make
the earache go away rapidly, but the infection may need more time
to clear up. So, be sure that the medication is taken for the full
time your doctor has indicated. Other medications that your doctor
may prescribe include an antihistamine (for allergies), a decongestant
(especially with a cold), or both.
Sometimes the doctor may recommend a medication to reduce fever and/or pain. Analgesic ear drops can ease the pain of an earache. Call your doctor if you have any questions about you or your child’s medication or if symptoms do not clear.
What
Other Treatment May Be Necessary?
Most of the time, otitis media clears up with proper medication
and home treatment. In many cases, however, further treatment may
be recommended by your physician. An operation, called a myringotomy
may be recommended. This involves a small surgical incision (opening)
into the eardrum to promote drainage of fluid and to relieve pain.
The incision heals within a few days with practically no scarring
or injury to the eardrum. In fact, the surgical opening can heal
so fast that it often closes before the infection and the fluid
are gone. A ventilation tube can be placed in the incision, preventing
fluid accumulation and thus improving hearing.
The surgeon selects a ventilation tube for your child that will remain in place for as long as required for the middle ear infection to improve and for the eustachian tube to return to normal. This may require several weeks or months. During this time, you must keep water out of the ears because it could start an infection. Otherwise, the tube causes no trouble, and you will probably notice a remarkable improvement in hearing and a decrease in the frequency of ear infections.
Otitis media may recur as a result of chronically infected adenoids and tonsils. If this becomes a problem, your doctor may recommend removal of one or both. This can be done at the same time as ventilation tubes are inserted.
Allergies may also require treatment.
So,
Remember . . .
Otitis media is generally not serious if it is promptly and properly
treated. With the help of your physician, you and/or your child
can feel and hear better very soon.
Be sure to follow the treatment plan, and see your physician until he/she tells you that the condition is fully cured.
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Earwax...and what to do about it :
Earwax
Never put anything smaller than your elbow in your ear! Cotton swabs are for cleaning bellybuttons, not ears. You have probably heard these admonitions from relatives and doctors since childhood…read on to find out what they meant.
The
Outer Ear and Canal
The outer ear is the funnel-like part of the ear you can see on
the side of the head, plus the ear canal (the hole which leads down
to the eardrum).
The ear canal is shaped somewhat like an hourglass-narrowing part way down. The skin of the outer part of the canal has special glands that produce earwax. This wax is supposed to trap dust and dirt particles to keep them from reaching the eardrum. Usually the wax accumulates a bit, dries out and then comes tumbling out of the ear, carrying dirt and dust with it. Or it may slowly migrate to the outside where it can be wiped off. The ear canal may be blocked by wax when attempts to clean the ear push wax deeper into the ear canal and cause a blockage. Wax blockage is one of the most common causes of hearing loss.
Should You Clean Your Ears?
Wax is not formed in the deep part of the ear canal near the eardrum,
but only in the outer part of the canal. So when a patient has wax
blocked up against the eardrum, it is often because he has been
probing his ear with such things as cotton-tipped applicators, bobby
pins, or twisted napkin corners. These objects only push the wax
in deeper. Also, the skin of the ear canal and the eardrum is very
thin and fragile and is easily injured.
Earwax is healthy in normal amounts and serves to coat the skin of the ear canal where it acts as a temporary water repellent. The absence of earwax may result in dry, itchy ears.
Most of the time the ear canals are self-cleaning; that is, there is a slow and orderly migration of ear canal skin from the eardrum to the ear opening. Old earwax is constantly being transported from the ear canal to the ear opening where it usually dries, flakes, and falls out.
Under ideal circumstances, you should never have to clean your ear canals. However, we all know that this isn't always so. If you want to clean your ears, you can wash the external ear with a cloth over a finger, but do not insert anything into the ear canal.
What Are the Symptoms of Wax Buildup?
- partial hearing loss, may be progressive
- tinnitus, noises in the ear
- earache
- fullness
in the ear or a sensation the ear is plugged
Self
Treatment
Most cases of ear wax blockage respond to home treatments used to
soften wax if there is no hole in the eardrum. Patients can try
placing a few drops of mineral oil, baby oil, glycerin, or commercial
drops, such as Debrox®, or Murine® Ear Drops in the ear.
These remedies are not as strong as the prescription wax softeners
but are effective for many patients. Rarely, people have allergic
reactions to commercial preparations. Detergent drops such as hydrogen
peroxide or carbamide peroxide may also aid in the removal of wax.
Patients should know that rinsing the ear canal with hydrogen peroxide
(H2O2) results in oxygen bubbling off and water being left behind-wet,
warm ear canals make good incubators for growth of bacteria. Flushing
the ear canal with rubbing alcohol displaces the water and dries
the canal skin. If alcohol causes severe pain, it suggests the presence
of an eardrum perforation.
When Should I See My Doctor?
If you are uncertain whether you have a hole (perforation or puncture)
in your eardrum, consult your physician prior to trying any over-the-counter
remedies. Putting eardrops or other products in your ear in the
presence of an eardrum perforation may cause an infection. Certainly,
washing water through such a hole could start an infection. In the
event that the home treatments discussed in this leaflet are not
satisfactory, or if wax has accumulated so much that it blocks the
ear canal (and hearing), your physician may prescribe eardrops designed
to soften wax, or he may wash or vacuum it out. Occasionally, an
otolaryngologist (ENT specialist) may need to remove the wax using
microscopic visualization.
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