Ear Disorders
Swimmer's Ear - Perforated Ear Drum - Cholesteatoma - Tinnitus or Ear Ringing
Swimmer’s ear is an infection of the outer ear structures that happens when water gets trapped in the ear canal. It is usually an infection of swimmer’s but may occur from bathing, showering, or trauma to the ear canal and/or from over-the-counter ear solutions for wax removal. Swimmer’s ear may also be called an outer ear infection or otitis externa. Bacteria that are normally inside the ear canal are allowed to multiply un-checked and cause irritation and infection of the canal and outer ear tissues.
Symptoms of swimmer’s ear vary from mild to moderate in severity and may include any of the following:
- Outer ear pain and/or itching
- A blocked or full sensation in the ear, even decreased hearing
- Ear drainage
- Fever
Assessment and Treatment- Treatment of swimmer’s ear can include several different methods decided upon by your physician or ENT doctor. Careful cleaning with specialized equipment, ear drops and placement of an ear wick may all be treatments discussed with you by your otolaryngologist.
Prevention- A dry ear is not likely to become infected. Ear plugs can be worn before swimming to keep moisture out of the ear. Solutions with vinegar and/or alcohol can be used if recommended by your ENT to keep the ears clean and dry. People with flaky, scaly and itchy ears or with extensive ear wax are more likely to develop outer ear infections and may need to have their ears cleaned periodically by an otolaryngologist.
A perforated eardrum is a rupture or hole that occurs in the eardrum or tympanic membrane. The eardrum is a thin membrane of skin that separates the ear canal from the middle ear and helps to transmit sounds to the hearing nerve. When a hole occurs in the tympanic membrane decreased hearing, pain and occasional ear drainage may occur.
Causes of a Perforated Eardrum- Perforation of an eardrum usually results trauma or infection and may occur from any of the following:
- An object (cotton swab, stick…etc) is pushed too far into the ear canal
- After a sudden explosion or loud noise
- After a skull fracture
- If the ear is struck squarely with an open hand
- A middle ear infection remains untreated or progresses too rapidly before treatment can be administered.
Most eardrum perforations will heal on their own within days or weeks after rupturing, some may even take several months. On rare occasions a small perforation may persist in the tympanic membrane after an ear tube, placed by an ENT physician, comes out spontaneously or is removed by the physician. During the healing of a perforation it is advisable that the ear be protected from water. Eardrum perforations that do not heal spontaneously may benefit from surgical correction.
Treatment- Benefits of surgically fixing a perforated eardrum include; preventing chronic infections caused by recurrent water exposure, improved hearing, and diminished ear ringing. Surgical correction can be as simple as a patch of paper laid over the perforation in the office or a more intensive surgery in the operating room, usually done.
Cholesteatoma
A cholesteatoma is a skin cyst that occurs in the middle ear behind the eardrum. If this continues to grow unchecked it can increase in size, pressing and eventually destroying the surrounding delicate ear bones of the middle ear cavity.
Causes- Formation of a cholesteatoma usually occurs because of poor Eustachian tube function and less commonly from recurrent middle ear infections. When the Eustachian tube does not function properly a vacuum or negative pressure is created within the middle ear space. This negative pressure pulls or sucks the eardrum backwards over the ear bones and middle ear cavity creating a pouch. The pouch takes the form of a skin cyst that sheds layers of old skin that build up inside the middle ear.
Symptoms- The patient may experience recurrent ear drainage, decreased hearing and a sensation of fullness or pressure in the ear. Symptoms can progress if left untreated to worsening hearing loss, dizziness, and even facial muscle paralysis. Medical attention should be sought sooner than later if a person experiences any of these.
Treatment- Initial evaluation by an otolaryngologist-head and neck surgeon may involve careful cleaning and ear drops. Further assessment to evaluate the extent of the cholesteatoma growth may be done by x-rays or CAT scans of the middle ear cavity. Hearing and balance testing may also be recommended. If it is determined that surgery is necessary to preserve the ear and remaining hearing, your ENT will talk with you about the procedure. The surgery is performed usually as an outpatient and removal of the cyst is attempted to achieve a safe, dry, infection-free ear.
*Go to our Procedures page and view Mastoidectomy
Tinnitus is the medical term for ear ringing or any noise that is heard inside the head. Tinnitus may come and go or may be a continuous sound. It can encompass any number of forms; some patients note frank ringing, others hear a roaring like a sea-shell being held up to their ear. Other persons have reported bells ringing, water dripping, and motors running to describe their tinnitus.
Causes- The overall cause of tinnitus remains one of the medical mysteries. It is thought however, that most tinnitus is from damage to the microscopic nerve endings of the hearing nerve in the middle ear. This is usually represented by some form of hearing loss but not always. If you are older, advancing age may be accompanied by a certain degree of hearing nerve impairment creating some form of tinnitus. In young patients loud noise exposure is the leading cause of tinnitus as this has often damaged the delicate nerve endings along the hearing nerve.
There are several possible “other causes” of subjective tinnitus (sounds only you can hear):
- Allergies
- Ear wax
- High or low blood pressure
- Diabetes
- Thyroid disease
- Medications
