Ear Infections

An ear infection can occur in any part of the ear.  The most common type of ear infection occurs when the space behind the ear drum becomes infected.  This type of infection is called a middle ear infection and is more common in children, but can occur at any age.  Middle ear infections are most commonly caused by a bacteria, but viruses can also be involved.  The outer ear and ear canal can also become infected.  In this type of infection, the outer ear is often red, swollen and tender to the touch.  A middle ear infection is often painful, but does not usually cause tenderness to the touch or redness of the outer ear.

How are ear infections treated?  They are most often treated with oral or topical antibiotics.  Occasionally, IV antibiotics are required.  Tympanostomy tubes may also be required to effectively treat an ear infection, especially a recurrent or persistent ear infection.  


Cholesteatoma

What is a cholesteatoma?  A cholesteatoma is a skin-lined cyst that is trapped behind the ear drum.  These often begin as a retraction of the ear drum into the middle ear.  The pocket that forms from this retraction collects wax and dead skin and forms a cyst in the ear that becomes locally destructive.  This pocket will frequently become infected and usually causes hearing loss and infected drainage from the affected ear. 


What are the common symptoms associated with cholesteatoma?  Common symptoms of a cholesteatoma include hearing loss, an infected appearing discharge from the ear, recurrent ear infections, fullness of the ear, dizziness, or ear pain among other symptoms. 


Is this a serious condition?  Left untreated, a cholesteatoma can eventually cause brain infections and facial weakness because they are near the brain and the nerve that animates your face. 


How is a cholesteatoma treated?  Cholesteatomas can be managed in a variety of ways depending on the extent of the cholesteatoma, and the general health of the patient.  Initial treatment may involve cleaning of the ear and topical or oral antibiotics.  Significant cholesteatomas are most commonly treated with surgery of the ear to remove the cyst from the ear and protect the important structures near the ear.  Surgery for cholesteatoma will often be preceded by a CAT scan to help determine the extent of surgery and a hearing test to determine its impact on the function of the ear. 


Ear Aches

Ear aches/pain in the ear can occur in all age groups.  Ear pain can be caused by diseases of the ear itself, or it can be pain that is referred to the ear from a problem in the structures remote from the ear.  

Ear aches can be caused from diseases of the ear itself.  Examples include middle and outer ear infections, tumors of the ear, or trauma to the ear.  


Ear aches can be caused by medical conditions that are remote from the ear.  Examples include dental infections or cavities, throat cancer, brain cancer, and arthritis of the joints of the neck.  


Is this a serious condition?  While earaches are usually caused by non-life threatening conditions, they can also be caused by serious infections in or around the ear, as well as other types of potentially life threatening as mentioned above.  


Hearing Loss

There are two general types of hearing loss.  Sensorineural hearing loss occurs when there is damage to the inner ear or hearing nerve that prevents transmission of sound to the brain.  Conductive hearing loss occurs when something interferes or prevents transmission of sound to the inner ear.  

There are many causes of sensorineural hearing loss in adults, but it is commonly caused by exposure to loud noise, aging, head trauma and viral infections.


Sensorineural hearing loss often has different causes in children.  The most common causes of sensorineural hearing loss in children include genetic abnormalities, viral infections, or birth defects that result in inner ear abnormalities.  


Conductive hearing loss can be caused by a variety of conditions ranging from obstruction of the outer ear canal with wax, to cholesteatoma and otosclerosis.  The exact condition is diagnosed by a careful physical exam, a hearing test, and sometimes with a CAT scan or MRI scan.  Treatment is based on the diagnosis identified through this process and can arrange from observation with no treatment, hearing aids, and a surgical procedure to correct the cause of the conductive hearing loss.  


How is hearing loss treated?  All treatment starts with a hearing test and a correct diagnosis.  Hearing loss can be treated by observation and follow-up hearing tests, treatment with steroids for some types of hearing loss, hearing aids, and in some cases hearing loss can be treated with surgery.  Consultation with an ear, nose & throat specialist is important in finding the best treatment for your hearing loss. 


Sensorineural hearing loss or ringing in the ears that occurs on one side only is a special concern because it is sometimes caused by a non-cancerous tumor of the hearing/balance nerve.  This type of tumor is an unusual, but important cause of one-sided hearing loss and ringing.  This type of tumor is called an acoustic or vestibular schwannoma and can be observed without treatment, or treated with surgery or radiation depending on the size of the tumor, and the health of the patient.  


Dizziness

There are many causes of dizziness, and the ears are often involved in this troubling symptom.  Common causes of dizziness include benign paroxysmal positional vertigo or BPPV, Meniere's disease, and labyrinthitis.  Dizziness may begin as a spinning sensation, or may occur as a sensation of imbalance without a spinning sensation.  Dizziness is an important symptom to have evaluated because of the potential for injury from a fall.  Also, dizziness may be a harbinger of a more serious condition.  

Facial Nerve Paralysis

Ramsay-Hunt syndrome, or herpes zoster oticus is a rare form of the shingles that can cause facial nerve paralysis.  The shingles is a form of recurrent chicken pox.  If the shingles breaks out on the ear, it can affect both the hearing and the function and control of the facial muscles.  

What symptoms are associated with Ramsay-Hunt syndrome?  Ramsay-Hunt syndrome usually has a painful blistering rash of the outer ear with associated weakness or paralysis of the face on the same side as the ear rash.  Patients can have associated hearing loss, dizziness, taste changes, and dry mouth and eyes.  


Bell's palsy can also cause facial nerve paralysis, but does not have an associated rash or hearing loss.  Bell's palsy is thought to be the result of a viral infection of the nerve that controls the facial muscles, and will most often resolve.  The facial paralysis associated with Ramsay-Hunt syndrome is less likely to fully resolve than with Bell's palsy.  


Facial paralysis can also be caused by a stroke, as well as by tumors of the brain, facial nerve, the parotid gland, as well as the base of skull.  


Foreign Bodies

One of the most common ear conditions seen in an ENT office is a foreign object lodged in the ear canal.  Objects commonly found in the ear canal include plastic toy pieces, insects and ticks, ball bearings, earring parts, cotton from Q-tips, hearing aid parts and pieces, and slag from welding accidents.  Foreign body insertion is much more common in children, but can also occur in adults.  Serious injuries can occur from insertion of foreign bodies into the ear canals, and this practice is best avoided.  

There are many other conditions of the ear that can adversely affect your health and well being.  We are prepared to help with all of your hearing and ear health needs.