There are several ear disorders that affect a person in one way or the other. Every year, millions of people get affected that further causes various problems, of which, some are able to heal on its own, while there are other kinds of ear disorders that require special treatment from professional doctors.
Otology is the branch of medicine that is involved in the study and research of the ear. It deals with the various diseases and disorders that can commonly occur in the ear and how these affect the lives of people of all age group. It is estimated that more than a million people are affected by otic disorders in various parts of the world.
Let’s look at some of the most common ear diseases and treatment that have affected millions of lives through the years, while also knowing what their symptoms and causes are.
Earache is also called as Otalgia in pathology terms. It is common with individuals who travel by air, especially when they have a cold or stuffy nose. The air pressure in the middle ear does not equalize during the flight’s take off as well as landing, as it would if the Eustachian tube were unblocked.
When an individual suffers an earache, the pain often distracts every thought and absorbs every ounce of your attention and you may just want to end it as quickly as possible.
Earaches can be caused by a blocked Eustachian tube, which is a thin tube that connects the inner back portion of the nose with the middle ear. The air in the middle ear is constantly absorbed by its membranous lining, but the air is never depleted, as long as the Eustachian tube remains open and is able to resupply air while swallowing.
In this manner, the air pressure on both sides of the eardrum stays equal. But when the Eustachian tube is blocked, the pressure in the middle ear cannot be equalized. Thus, the air that is already absorbed with an incoming supply, a vacuum occurs in the middle ear, sucking the eardrum inwards and stretching it painfully.
- Ear pain
- Impaired hearing
- Fluid drainage from the ear
- A sense of fullness in the ear
- A headache
- Loss of appetite
- Ear infections
- Change in pressure(like flying on a plane)
- Earwax buildup
- Foreign object in the ear
- Strep throat
- Sinus infection
You can try the following Home Remedies to reduce the earache pain:-
- Put a cool washcloth to the ear, avoiding the ear getting wet
- Sit straight to help relieve ear pressure.
- Use relatively ear drops and pain relievers.
- Chew gum to help reduce pressure
In another case, if a buildup of wax is the cause of your ear pain then you may be prescribed wax-softening eardrops which causes the ear wax to fall out on its own.
It is very important to finish your entire prescription to ensure that the infection will be clear up completely.
Otitis Externa (Swimmer’s Ear)
A swimmer’s ear, or in medical terms called ‘otitis externa’ (of the outer ear), is a condition that involves infection and inflammation of the ear canal and is typically caused by a virus or bacterial infection due to the water getting trapped in the ear.
It is often called swimmer’s ear because it mostly occurs in individuals who stay for a long time in the water – as swimming is the most popular and common sport amongst children and adults of any age group.
This condition in individuals is often followed by a few symptoms, such as itchiness in the inner ear, redness, and swelling of the ear, pain when the ear is tugged, or when some sort of pressure is applied on the ear and there is the draining of pus from the ear.
- Severe ear pain
- Itching in the ear canal
- Discharging pus or liquid from the ear
- Some amount of temporary hearing loss
- Swelling and redness of outer ear
- Tenderness while moving ear or jaw
- Swollen/sore glands in the throat
- Bacterial infection
- Seborrhoeic dermatitis
- Fungal infection
- Allergic reaction
Otitis externa sometimes gets better even without any treatment. But if you have a repetitive occurrence of otitis externa than you should definitely concern an audiologist. That audiologist may take a swab inside of your ear. This will be tested to help to find what type of infection you have, so best suited medication can be prescribed.
Otitis media is the inflammation of the middle ear and is very common in children. It is typically the result of a virus or bacterial infection that spreads into the middle ear. Individuals in their children usually develop this condition and many children often experience recurrent ear infections. In starting phase ear infection medicine or ear infection drops can help to prevent infection.
Since the infections occur prior to a child being old enough to be able to communicate verbally, some physical signs may include tugging at the ears, excessive fussiness and crying, trouble sleeping, fever, fluid draining from the ears and trouble hearing or responding to quiet sounds.
The treatment of otitis media require routinely prescribed antibiotics from a qualified doctor. Children with persistent or recurrent disease are often treated through the method of surgery, in which a tube is inserted through the tympanic membrane that allows ventilation of the middle ear cavity along with the localized delivery of topical antibiotic ear drops.
- Ear pain
- A headache
- Neck pain
- Feel of fullness in the ear
- Liquid drainage from the ear
- Lack of balance
Otitis media occurs when Eustachian tube gets swollen or blocked and traps fluid in the middle ear. This fluid can become infected. The eustachian tube is the tube that runs from the middle of the ear to the throat’s back.
This tube can become swollen or blocked for several reasons:
- Sinus infection
- Infected/enlarged adenoids
Apply a warm, moist washcloth upon the infected ear. You can use over-the-counter ear drops for pain relief or you can take an over-the-counter pain reliever.
You can also get prescription from a doctor for eardrops and for other pain relievers such as ibuprofen and acetaminophen. If your symptoms don’t go away after a few days of treatment than your doctor may prescribe antibiotics too.
If your infection doesn’t respond to treatment than your doctor may recommend any of the two surgery
- Adenoid Removal – Your adenoids will be surgically removed if they are enlarged or have an infection that keeps coming back.
- Ear tubes – A surgical procedure to insert tiny tubes in your ear. These tubes allow air and fluid to drain from the middle ear.
Your adenoids will be surgically removed if they are enlarged or have an infection that keeps coming back.
Labyrinthitis (Otitis Interna)
Labyrinthitis is defined as inflammation of the inner ear (or otitis interna). Severe dizziness or vertigo occurs during this condition, which is a sensation where the affected person feels that either he/she or the surrounding around him/her is spinning.
This also causes light-headedness and vomiting, which are some of its common symptoms. This, however, can get scary and may also stir worries in the affected individuals. Therefore, if a person is suffering from labyrinthitis, it is advised to see a doctor immediately. It’s possible that the root of your problem may be identified as labyrinthitis, which is basically a group of chambers filled with fluid in the inner ear.
The labyrinth is also responsible for controlling the balance. Even though vertigo will make it extremely difficult for your ears to function properly, the infection itself may not be very dangerous. In such cases, bed rest is a helpful remedy. Your doctor may prescribe medicines that could help in combating dizziness, as well as nausea and vomiting.
In most cases, the symptoms of labyrinthitis or ‘otitis interna’ may automatically heal itself within a couple of weeks, but recurrent episodes of vertigo should be properly investigated by your doctor as they may cause further complications.
- Loss of balance
- Nausea and vomiting
- Difficult to focus eyes
And if you have any of the below symptoms then you should immediately seek medical attention
- Slurred speech
- Double vision
- Respiratory illness
- Viral infection in the inner ear
- Stomach viruses
- Herpes viruses
- Bacterial infection(middle ear including)
- Infectious organism
- Prescription antihistamines (desloratadine)
- Medication to reduce dizziness and nausea (meclizine)
- Sedatives (diazepam)
- Corticosteroids (prednisone)
- Over-the-counter antihistamines (fexofenadine, Benadryl, Claritin)
Some techniques you can use to get relief from vertigo:
- Avoid quick changes in position or sudden movements
- Sit still during a vertigo attack
- Get up slowly from a lying down position
- Avoid television, computer screens, and bright/flashing lights during a vertigo attack
- Try sitting up in a chair and keep your head still if vertigo happens while you are in bed.
Tinnitus is well-known for causing a ringing, wheezing or booming sensation in the ear of the affected person. Thus, it is also called Meniere’s disease because of the common symptoms they share. Everyone gets a little ringing in their ears at times, but when it goes on incessantly, it can simply make the person go nuts. There is a huge availability of hearing aids for tinnitus.
It is basically a result of damage to the tiny hair cells that are located in the inner ear. These tiny hair cells have an important function, that is, they pick up sound vibrations and sends electrical impulses through the auditory nerve to the brain. The hair cells are usually active all the time, which also makes the brain think that sound vibrations are entering constantly in the ear.
Possible causes of tinnitus may include acoustical trauma or loud noise, earwax build-up, virus or bacterial infection, perforated eardrum, fluid accumulation, tumor, diabetes, aging, high blood pressure or the side effects of certain medicines.
Types Of Tinnitus
Subjective tinnitus is tinnitus that only you can hear and it is a most common type of tinnitus. It can be caused by a problem with the auditory nerve or auditory pathways.
Objective tinnitus is tinnitus that your doctor can hear too when he/she does an examination. It can be caused by a blood vessel problem, a middle ear bone conduction or muscle contractions.
Age:- In many people hearing worsens with age. Usually after age 60. Tinnitus can cause by Hearing Loss. Presbycusis is the medical term for this kind of hearing loss.
Exposure to loud noise:- The common sources of noise-related hearing loss are loud noises from heavy equipment such as Chainsaws and firearms. Listening to songs in loud volume and for long period can also cause Tinnitus.
Earwax blockage:- Earwax protects the ear canal by trapping dirt and bacteria but, when a big amount of earwax stacked up it becomes too hard to wash away naturally. This cause hearing loss or irritation of the eardrum which can lead to Tinnitus. An earwax cleaner can help you out from this.
Ear bone changes:- Stiffening of the bones in the middle ear may affect hearing and cause tinnitus.
Here are the names of some medications that can also cause tinnitus:
- Antibiotics, including erythromycin, vancomycin, neomycin and polymyxin B
- Cancer medications, like mechlorethamine and vincristine
- Water pills (diuretics), like bumetanide and furosemide
- Quinine medications that used for malaria or other health conditions
- Certain antidepressants can worsen your tinnitus
- Aspirin, when taken in high doses like 12 or more in one day
An Underlying health condition
In this, the doctor will try to find a main treatable condition that may be linked with your symptoms. If there is any health condition, your doctor can take the following steps to reduce the noise:
- Earwax removal
- Treat a blood vessel condition
- Change in medications
There is some electronics device available to suppress the sound so it can be less bothersome. These are:
White Noise Machines. These devices produce fake environmental sounds like falling rain or ocean waves. This method considers being an effective treatment for tinnitus.
Hearing aids. These will be helpful especially when you have a hearing problem as well as tinnitus. There are plenty of best hearing aids available. People often think that hearing aid price is high but these hearing aids cost is not as high as people think. Most popular is Behind the ear hearing aid.
Masking devices. It is similar to digital hearing aids and worn in the ear. There are different types of hearing aids. These devices produce a frequency, low-level white noise which suppresses tinnitus.
Tinnitus retraining. This is a wearable device that provides individually programmed tonal music to cover the specific frequencies of tinnitus that you are experiencing.
Medicines can’t cure tinnitus but in some cases, they can help reduce the intensity of symptoms. These are:
- Tricyclic antidepressants (amitriptyline and nortriptyline)
- Alprazolam (Niravam, Xanax)
Few alternative therapies that have been tried for tinnitus:
A cholesteatoma is an unusual skin growth that can develop in the middle section of the ear, behind the eardrum. It may be by birth but mostly it is caused by continues middle ear infections.
A cholesteatoma develops a sac-like pocket of membranous tissue (cyst) that shades layers of old skin. These dead skin cells huddles, it can increase in size and the result will be the destruction of the delicate bones of the middle ear.
A cholesteatoma affected ear may channel a foul-smelling fluid. As the cyst grows, it will begin a sense of pressure in your ear. You may also feel an aching pain in or behind your ear. Its pressure can also cause hearing loss.
Seek for medical attention right away if you are having any of these symptoms:
- Facial muscle paralysis
A cholesteatoma can also be caused by the poor functioning of the Eustachian tube. This tube allows the air to flow through the ear and equalize air pressure. The eustachian tube may not work properly because of any of the following reasons:
- Chronic ear infections
- Sinus infection
Technically speaking, the only effective way to treat a cholesteatoma is to surgically remove it. Cholesteatoma doesn’t go away naturally. They often continue to grow and can cause other problems.
When a cholesteatoma is diagnosed, a continuity of antibiotics, ear drops, and careful cleaning of the ear will mostly be prescribed to treat the infected ear.
Once the cholesteatoma is removed, you must attend follow-up appointments to check results and ensure the cyst will not come back.
In case, if the cyst broke any of your bones in the ear than you will need a second surgery to treat them.
After the surgery, you may experience temporary dizziness or taste oddity. These side effects can last a few days.
Ototoxicity is a drug/chemical related damage to the inner ear or damage in the organs which are responsible for hearing and balance. This damage can lead to temporary or permanent hearing loss.
Ototoxic can be caused by various therapeutic medicines and environmental substances.
Some of these are in the table below:
| Type Name of substance/medicine|
Aminoglycoside antibiotics -Gentamicin, streptomycin, tobramycin, neomycin,
Non-aminoglycoside -Vancomycin, erythromycin
Loop diuretic -Furosemide, ethacrynic acid, torsemide, bumetanide
Chemotherapeutic -Cisplatin, carboplatin, nitrogen mustard
Anti-malarial drugs -Quinine, chloroquine
Environmental chemicals and -Lead, mercury, carbon monoxide, arsenic, carbon
Other substances disulfide, tin, hexane, toluene, alcohol
Most common symptoms that are experienced in ototoxicity are:
- Tinnitus/Ringing in the ear
- Bilateral/Unilateral hearing loss
- Incoordination in movements
- Unsteadiness in walking
- Shaking or bouncing vision
As for now, no specific treatment is available for ototoxicity but the withdrawal of the related drugs can be possible. Prevention is very important in avoiding permanent hearing loss.
Any ototoxic should be prescribed after frequent balance and hearing test. Before starting an ototoxic drug, kidney function should also be measured. Wherever possible, ototoxic medication should be avoided, strictly in combination.
Some available treatments are aimed at reducing the effect of the damage or to restore functioning. For restoring lost balance function, physical therapy can be used. It can help to retrain the brain to evolve other ways for maintaining balance. And it is quite successful in younger patients.
Ramsay Hunt Syndrome
Ramsay Hunt Syndrome (RHS) is a rare neurological disorder marked by a rash affecting the ear and paralysis of the facial nerve. Ear oddities such as tinnitus or ringing in the ear. Hearing loss may also be possible.
RHS is caused by the Varicella Zoster Virus, the same virus that causes Chickenpox and ringworm. This disorder is named after James Ramsay Hunt, the physician who first mentioned the disorder in 1907.
The rash in the ear caused by RHS appears red with blisters and is often painful. It affects the inner and outer portion of the ear. In this condition, the pain in the ear canal can be very intense and may spread down into the sufferer’s neck. Some RHS affected persons can develop Sensorineural Hearing Loss.
People With RHS can experience other symptoms like:
- Nausea and vomiting
- Dizziness or vertigo
- Hearing loss
- Facial pain including a runny nose or watering eyes
- Ringing in the ears
- Sounds seem much louder than average
- Dry mouth and loss of test (if the ear rash affects mouth and throat too)
- Dry eyes or unwanted movement of the eye
Ramsay Hunt Syndrome is caused due to the varicella-zoster virus. The same virus causes chickenpox.
An individual who ever had chickenpox in childhood can also develop a painful rash (Shingles). The Varicella Zoster Virus can reactivate after decades of inactivity. And if this happens, the same individual can also develop RHS. However, the reason for its activation is still unknown.
If a person is diagnosed with RHS their doctor should start treatment as soon as possible. Figuratively, treatment with antiviral medications and drugs like steroids (if needed) should begin within the first three days after symptom appear.
Additional treatment will be prescribed depending on other symptoms like dizziness, nausea, vomiting or the sensation of vertigo. In these conditions, medication such as antihistamines can be prescribed.
If a person is going through intense pain in the ear or ear canal, Opioid painkillers can be subscribed. Nerve block or local anesthetic can also be used for severe pain.
Treatment Should Not Be Ignored
It is important to treat such common ear disorders quickly, given the compliance challenges of a few doses of ear drop regimens for treating common problems in the ear, such as pain, discharges, etc., and anatomical barriers that are associated with achieving high and sustained drug levels in the inner ear via various medical solutions.
Your doctor will prescribe medicines that can heal the symptoms of the identified ear disorder. However, you should also regularly see a doctor for further analysis and to make sure that the problems are being treated properly and no complications exist.
Have your ear checked regularly by an ENT specialist. Your ears need care as your other body parts. Not only cleaning of your ears is enough, safety from noise and injury is also important. Get hearing protection during exposure of loud noise, not only at work but at home also. Use earplugs at concerts, car racing, or in a night club.
Wear a helmet when you ride a bike, doing a ski or rollerblade and at any other similar activity.
If you notice any kind of ear pain or any kind of problem in hearing, immediate concern to a doctor before it gets late even for treatment.