Ear Diseases

Watch the video

Summary

The ear is composed of three primary parts: the outer ear, middle ear, and inner ear. The outer ear collects sounds from the environment, while the middle ear translates these sounds into vibrations. Once they reach the inner ear, these vibrations are converted into signals and sent to the brain for processing.

When someone’s ears have a problem or disease, their hearing might deteriorate. Additionally, the patient may experience symptoms such as ear pain, dizziness, nausea or vomiting, difficulty in maintaining balance, ringing in the ears, fluid discharge from the ears, fever, loss of appetite, itching in the ears, sores on the ears, and more. Depending on the type of ear ailment, a patient may experience one or more of these symptoms.

Common causes of ear diseases include allergies, the common cold, infections, smoking, and changes in air pressure. Occasionally, ear problems can also arise from birth defects or when an individual suffers physical injury due to accidents or trauma.

To treat ear diseases, doctors may prescribe medications or advise surgical procedures on the patient’s ears. Based on the type and severity of the condition, a person may lose their hearing if their condition isn’t addressed promptly.

History of Ear Diseases

The field of study and treatment of ear diseases is called otology. The term is derived from the Greek word for ear, which is “ous.” In ancient times, before 4,000 BC, records regarding conditions affecting the ears, such as otitis media or ear discharge, already existed. According to Ebers and Brugsch, which are papyruses of medical files, otitis media was described as the “fire in the heart of the ear” and the remedy for it was honey.

In 400 BC, the Father of Medicine, Hippocrates, described parts of the ear such as the tympanic membrane and mastoid air cells. Furthermore, he provided an accurate description of ear diseases like acute and chronic otitis media, as well as the causes of deafness.

Besides Hippocrates, Aristotle, a Greek philosopher, also developed a theory about hearing. According to him, the inner ear is a resonating chamber that reverberates in response to the sounds it perceives.

Between 130-200 AD, Galen, the personal physician of the Roman Emperor Marcus Aurelius, introduced the auditory nerve. Galen also became recognized as a skilled surgeon for various ear conditions.

During the Middle Ages, in the 16th century, Vesalius of Padua conducted dissections of the ear. This helped with the better understanding of the parts of the ear, especially the middle ear. Meanwhile, Du Verney, the personal physician to the French royalty during the 17th century, wrote a book containing images of the parts of the ear. As a result, he was dubbed the “father of otology.”

The 18th century appeared to be an era dedicated to studying the parts of the ear. Numerous doctors, researchers, and scientists performed dissections on the ear to examine each of its parts. Consequently, by the 19th century, there was a better understanding of where various ear diseases originated and many surgical methods were invented to remedy them.

Although there were many treatments for ear diseases developed by the 20th century, doctors often still recommend surgery even for simple ear infections like ear discharge. Sometimes, these surgeries weren’t successful and further weakened the patient’s hearing. However, in 1928, Alexander Fleming invented penicillin. This became the primary medication for ear infections due to its antibacterial properties. Thus, patients were no longer prescribed surgeries whenever they had infections in their ears.

Characteristics

The ear can be affected by various conditions. Depending on the type of ear disease, a patient may experience various symptoms such as the following:

• Hearing Loss. When a person suffers hearing loss, there might be an obstruction in the ear or damage to some of its parts. Hearing loss also becomes more common as a person gets older.
• Ear Pain. Pain is a sign that there’s a problem in the ear. One might experience ear pain when it has an infection, there’s a change in air pressure, a buildup of earwax, trapped water, or a small object obstructing it.
• Dizziness. Dizziness is also a sign that there’s an issue with the ears. The ear might be blocked by water, or it might have an infection. Often, when there’s a problem with the ears, the dizziness experienced can be likened to the feeling as though the surroundings are spinning.
• Nausea or Vomiting. If the ears have a problem, the patient might also experience nausea or vomiting due to conditions like vertigo. This often accompanies dizziness.
• Difficulty in Balancing. A patient might also have difficulty balancing or walking when they have an ear problem. This is because the Eustachian tube, the part of the ear responsible for body balance, might be obstructed or damaged. Often, the Eustachian tube gets blocked when a person has allergies, a cough and cold, or infections.
• Ringing in the Ears. A ringing in the ears can be a symptom of an ear disease like Meniere’s disease. Meniere’s disease is characterized by abnormalities in the pressure of the fluid in the inner ear. However, there are times when the ringing is merely caused by an earwax blockage or exposure to very loud sounds.
• Ear Discharge. The ear naturally produces earwax, which helps protect its interior. However, if the ear discharges fluid, it could indicate eardrum damage. The eardrum is the part of the ear that translates sounds into vibrations.
• Fever. Having a fever can also be a symptom of an ear disease. A fever is one of the body’s ways of fighting off infections.
• Loss of Appetite. A person might lose their appetite if their ears are hurting. This happens often in children, who may lose their appetite because they feel discomfort in their ears.
• Itchy Ears. An itching in the ears might be caused by the buildup of earwax. Sometimes, it indicates an ear infection.
• Ear Sores. If the ear is wounded or has sores, it might be due to an infection caused by bacteria or a virus.

Causes

There are various reasons why a person might develop ear problems. It could be due to the following:

• Food Allergies. Consuming foods that trigger allergies can lead to ear problems. This is because allergies may cause the ears to produce excessive earwax; they may also result in a cough and cold for the patient. If ears produce more earwax or more fluid due to a cold, it can lead to an infection, especially if not cleaned properly.
• Having a Cold and Cough. Often, when one has a cold and cough, they may have difficulty hearing. This is because the nose and ears are interconnected. Sometimes, mucus can flow to the ears, causing blockage and some hearing loss. Though this is a normal occurrence, if excessive mucus accumulates in the ears, it can lead to an infection or ear discharge.
• Having an Infection. An ear infection indicates that there might be an underlying issue. Some signs of an ear infection include itching, pain, and ear discharge, among other symptoms.
• Smoking. Smoking can sometimes lead to hearing loss. Because cigarettes contain many toxic substances, the middle ear might get irritated and damaged. Moreover, smoking affects the transmission of signals from the ear to the brain, which could impair sound processing.
• Changes in Air Pressure. Often, when someone goes to a high-altitude place or dives underwater, they might experience temporary deafness. This is due to the air pressure of the environment. When air pressure changes, the Eustachian tube can’t adjust immediately, causing momentary deafness. Apart from body balance, the Eustachian tube manages the balance between middle ear pressure and environmental air pressure. A continuous increase in air pressure can damage the ear and result in deafness.
• Birth Defects. Some babies are born with ear problems. Sometimes, the ear, especially the outer ear, is underdeveloped or too small. This affects their hearing.
• Physical Injury. The ears can also have problems if they sustain physical damage due to accidents or injuries. Besides physical damage, the nerves in the ear, which help transmit signals to the brain, can also get injured.
• Regular Exposure to Loud Noises. A person’s ears can only tolerate up to 85 decibels of daily noise. As reference, the noise level of regular conversations can reach 60-70 decibels. If sounds reach or exceed 85 decibels, the ears can get damaged, especially the eardrum. This situation usually affects people living or working in cities.
• Having Other Illnesses. Diseases like chickenpox, measles, encephalitis, meningitis, and mumps, among many others, can result in ear problems. This is because the interconnected nerves of the brain and ears can get damaged due to complications of these diseases. If the present condition isn’t treated, it can lead to permanent deafness.

Risk Factors

A person’s likelihood of developing ear problems based on the following:

• Age. Children more commonly experience mild ear problems because their immune systems aren’t as strong. Thus, they more easily contract a cough and cold, which can lead to ear infections. However, as time goes on, older individuals have a higher likelihood of experiencing hearing loss.
• Race or Ethnicity. According to studies, Caucasians frequently experience hearing issues, especially in their elder years, possibly due to their different ear structures.
• Individuals with Birth Defects. If one has birth defects like deafness, their Eustachian tube might have difficulty draining fluid, leading to the accumulation of fluids and earwax, as well as frequent infections.
• People with Allergies. People with allergies have a heightened risk of ear problems. Whether caused by food or dust, allergies often lead to cold symptoms, which can cause temporary deafness or infections.
• Excessive Drinkers and Smokers. Studies show that drinking and smoking slow the brain’s processing of sounds. Regular consumption of alcohol and cigarettes can lead to chronic ear problems and balance issues.
• People with Other Diseases. Infectious diseases like mumps, chickenpox, and measles, can cause swelling and infections in the body’s nerves, including ear nerves.

Treatment and Prevention

Experiencing ear problems can affect daily life. Not only can it impact one’s hearing, but it can also result in balance issues. Although most ear problems are not dangerous, they still need appropriate treatment.

Treatment for ear problems

Treatments for ear issues depend on the type and severity of the condition. However, doctors commonly recommend the following:

• Pain Relievers. Ears typically hurt when they have a disease or injury. To alleviate the pain, doctors prescribe pain relievers like ibuprofen and acetaminophen. These medications can also be purchased over the counter without a prescription.
• Ear Drops. Doctors may also prescribe ear drops for pain or infections. There are also ear drops specifically designed to soften earwax, making it easier to remove.
• Decongestants. Decongestants can come in the form of tablets, syrups, or sprays. They are often prescribed if the ear problem is due to a cold or cough. Treating the cold or cough can help remove mucus from the ears and reduce middle ear pressure.
• Medication for Infections. One of the most common complaints from patients is ear infection. To treat this, doctors prescribe antibiotics. However, if the infection is caused by a virus or fungi, antibiotics won’t be effective as these are specifically for bacterial infections. For viral causes, doctors will recommend antiviral medication. For fungi, antifungal medication will be prescribed.
• Antihistamines. Doctors may prescribe antihistamines if a patient is experiencing itching in their ears. Reducing itching brings relief to the inner ear and lessen dizziness.
• Earwax Removal. If ear problems are due to accumulated and hardened earwax, earwax removal may be performed. During this procedure, a doctor uses a small tube or other tools to suck out or remove the earwax.
• Ear Irrigation or Ear Lavage. In this procedure, the ear is filled with water mixed with salt and hydrogen peroxide to lift hardened earwax. The mix of salt and hydrogen peroxide provides relief and helps treat any skin damage inside the ear. Keep in mind that this should only be done based on a doctor’s advice.
• Using Hearing Aids. Those with hearing impairment or hearing loss may opt to use a hearing aid. This device makes sounds from the environment louder, acting like an amplifier. A hearing aid is comfortable to use and worn like a wireless headset.
• Cochlear Implant. If a hearing aid isn’t suitable for a patient, a cochlear implant may be an option. This involves a quick surgical procedure where a receiver is attached inside the ear.
• Surgery. Patients with severe ear infections might need to undergo surgery. Certain surgical procedures may also be conducted to repair the tiny bones in the ear to improve hearing.

Prevention of ear problems

To avoid ear problems, consider the following precautions:

• Clean the Ears. To avoid infection, make it a habit to clean your ears regularly. Ear drops can be used to soften earwax, and a soft, clean cloth or towel can be used to clean the ears. It’s not recommended to use cotton buds as they might damage the eardrums and push the earwax further inside.
• Prevent Colds and Coughs. The common cold and coughs are the primary reasons for ear infections. To avoid these illnesses, maintain good physical hygiene and wash hands frequently. Also, avoid inhaling droplets from someone who has a cold or cough to prevent getting infected.
• Stop Smoking. Smoking is also a common cause of cough and cold. Moreover, it can damage the nerves in the ears. Hence, if you are a smoker, it’s recommended to quit smoking.
• Avoid Listening to Loud Music. Remember, the ears can only tolerate up to 85 decibels daily. Even if the ears won’t burst immediately from listening to loud sounds, constant exposure can gradually damage the eardrums.
• Protect the Ears. If exposure to loud noises is inevitable due to work conditions or because of where you live, ensure that ears are protected with earplugs or earmuffs. With these accessories, ears can be shielded from loud noises.

Types of Diseases

There are many types of ear diseases. These include the following:

• Acoustic trauma
• Acute otitis externa
• Acute mastoiditis
• Airplane ear
• Anotia
• Aural polyps
• Autoimmune inner ear disease
• Benign paroxysmal positional vertigo
• Bilateral vestibulopathy
• Ear tumors
• Cauliflower ear
• Cholesteatoma
• Chondrodermatitis nodularis helicis
• Cisplatin-induced hearing loss
• Collaural fistula
• Constricted ears
• Cryptotia
• Drug-induced ototoxicity
• Ear hemangiomas
• Ear keloids
• Ear tags
• Earlobe deformities
• Enlarged vestibular aqueducts
• Ear pain
• Enlarged vestibular aqueduct
• Eustachian tube dysfunction
• External otitis (Swimmer’s ear)
• Glue ear
• Grommets
• Hemotympanum
• Herpes zoster of the ear
• Hyperacusis
• Infectious myringitis
• Keratosis obturans
• Labyrinthitis
• Middle ear infection (Otitis media)
• Low-set ears
• Macrotia
• Mastoiditis
• Tinnitus (Ringing in the ears)
• Meniere’s disease
• Microtia
• Misophonia
• Mixed hearing loss
• Mondini dysplasia
• Otosclerosis
• Otomycosis
• Perforated ear drum
• Purulent labyrinthitis
• Quinism
• Ear wax impaction (Cerumen ear wax impaction)
• Deafness
• Perichondritis
• Balance disorder
• Protruding ears or bat ears
• Sensorineural hearing loss
• Ruptured eardrum
• Sopite syndrome
• Split earlobes
• Stahl’s ear
• Superior canal dehiscence syndrome
• Surfer’s ear
• Tonic tensor tympani syndrome
• Traumatic ear deformities
• Usher syndrome
• Vestibular migraine
• Vestibular neuronitis
• Vestibulopathy

If you feel something unusual in your ear or experience a decline in hearing capabilities, you can consult an ENT doctor. ENT stands for eye, nose, and throat. Apart from an ENT doctor, one can also consult an otologist. Otologists are doctors trained in performing ear surgeries.