1) What are the
common problems in the ear ?
The common problems
affecting the ear are :
* Ear discharge
* Pain in the
* Tinnitus (sounds in the
2) What are the
common causes of deafness ?
Deafness can be caused by
diseases in one or more parts of the ear.
External ear : Wax,
fungus, foreign bodies, acute infection.
Middle ear : Acute or
chronic infection, collection of fluid in the ear,
otosclerosis causing fixity of the ossicles, injury.
: Birth defects,infections, injuries, tumor of the auditory
nerve, ototoxic medicines, Meniere's Disease (producing
vertigo), uncontrolled blood pressure and diabetes, ageing,
noise induced deafness.
3) How do I
know that I have a hearing problem ?
Recognition of the hearing
problem is the first step in rectifying it. Some of the common
indicators of hearing loss are -
* High pitched voices like that
of women and children being missed.
* Difficulty in hearing at public
gatherings, theatres, etc. where the source of sound is
* Difficulty in understanding
conversation within a group of people.
* Difficulty in listening
to the radio or TV.
4) How can I
get my hearing tested ?
If a hearing loss is suspected,
an appointment with an ENT specialist is essential in testing
and evaluation. A short and simple test conducted by the
hearing health care professional determines the type and
severity of hearing loss. After the age of 50, a hearing test
must be taken regularly along with a physical check
5) What are the types of
Hearing Loss ?
Hearing is tested by
audiometry and a graphic record of the hearing is obtained,
which helps to determine the type and degree of hearing loss
* Conductive hearing loss : due to
injury or problems in the external or middle ear with defects
in the bones, eardrum or membranes which transmit sound from
the external and middle ear to the inner ear. This type of
loss can be usually overcome by medication or
* Sensorineural hearing loss : caused by the deterioration of the inner ear or the auditory
nerves. In these cases hearing-aids are often the only
* Mixed hearing loss : caused by a
combination of both.
deafness be treated ?
The deafness which occurs as a
result of the diseases in the external ear and the middle ear
is called conductive deafness and usually can be corrected by
medicines or surgery. Wax and fungus in the ear along with
various infections in the ear can be treated medically while
diseases like perforations in the ear drum or fixation of the
innermost small bone in the middle ear can be treated by
operations like tympanoplasty or stapedectomy with teflon
piston grafting. As all the structures in the ear are very small,
the surgery of the ear has to be performed under a special
binocular operating microscope, under good illumination and
magnification. The deafness of the inner ear is called
sensorineural deafness and is often difficult to treat.
Whenever the deafness cannot be treated medically or
surgically, the patient can use hearing aids.
7) How does the
hearing aid work ?
Hearing aid is an electronic
device which magnifies sounds selectively in various
frequencies. For using a hearing aid, the patient should get
his ears examined and an audiogram should be obtained.
Audiogram is a graphic record of the hearing. A hearing aid
which matches with the audiogram should be tried by the
patient for a few minutes. If it is suitable, it can be
purchased. To have better fitting, an ear mould having the
shape of the ear of the patient is prepared for the hearing
aid. Besides the old pockets type of hearing aids, smaller
behind the ear hearing aids are also available. Of late, very
small hearing aids are available which fit into the ear canal
and are hardly visible.
Complete in the canal hearing aids
cannot be seen from outside and hence are called "Invisible".
Different models of hearing-aids remedy different types of
hearing loss. Completely in the Canal (CIC), In The Canal
(ITC) and In The Ear (ITE) hearing-aids are custom designed to
fit the wearer's ear inconspicuously; (perfect for those
conscious of their looks).
Behind The Ear (BTE) hearing aids
are attached to a customised ear mould. These can be modified
so as to be compatible to external sound sources such as
hearing training equipment, stereos or TVs, etc. These are useful for
children and those who require high amplification.
The pocket hearing-aid is
economical and suitable for young children and elderly people
with dexterity problems.
Digital and Programmable computerised
aids are the most technologically advanced and are available
in CIC, ITC, ITE and BTE models. Digital technology enables
one to hear loud and soft sounds, high and low tones
practically at the level of a person with normal hearing.
Added to which comes excellent speech intelligibility in
noise. This means that low frequency noise, such as in a car
or aircraft, is reduced and the clarity of speech enhanced to
a pleasant level. You hear your environment again just as you
would like to. There are individually adjustable hearing
programs to provide this facility, e.g. for your home and your
place of work. No internal noise spoils the hearing experience
and, thanks to the latest technology, interference from
cordless and mobile telephones is now drastically reduced.
With precise fitting and smooth functioning, it is the ideal
hearing instrument class for all age groups.
8) What is a
cochlear implant ?
Patients with very severe
deafness who do not benefit with very powerful hearing aids
can be treated by cochlear implant where electrodes are
implanted in the inner ear.It is an expensive procedure and
hearing is of limited type.It requires intensive speech
therapy after the operation. In future, further improvements
can make this procedure more desirable.
9) Can severe
deafness cause mutism ?
If a child loses his hearing
before the age of 5 years, his speech is also lost. The speech
develops by hearing the speech and if there is severe
deafness, speech does not develop. Such children need
education in special schools with the help of hearing aids and
other educational aids and can develop useful speech. A
sizable number of such children may be integrated in normal
schools after proper training.
10) What are
the common causes of discharging ear ?
Some of the common causes of
discharging ear are :
External ear : Fungus, acute infection
of external ear, rarely cancer.
Middle ear : Acute or chronic
infection of the middle ear with perforation of the eardrum,
11) Can the
discharging ear be dangerous ?
perforations occuring in the upper or marginal areas of the
ear drum can be associated with cholesteatoma, which gradually
erodes surrounding bone leading to complications like mastoid
infection, paralysis of the face, giddiness, meningitis and
brain abscess. Majority of the perforation however are benign
and do not result in dangerous complications. They cause
deafness with intermittent discharge from the
12) How can
the discharging ear be treated ?
MEDICAL : The infection can be
controlled by antibiotics, antibiotic or antiseptic ear drops
along with care of ear like preventing entry of water into
ears. Fungal infection is treated by antifungal ear drops and
antibiotics. Perforations of a short duration may heal on
their own in majority of cases. If they do not heal in one and
half or two months, small perforations can be closed by
chemical cautery to make the edges of the perforation raw and
by paper patching under surgical microscope.
SURGICAL : Large benign perforations
or perforations resistant to chemical cautery can be closed by
tympanoplasty operation. As the structures in the ear
are very small, the surgery of the ear is performed through a
binocular surgical microscope for precision. Microsurgery has
revolutionised the treatment of the ear diseases and benign
perforations can be closed by tympanoplasty operation, where a
new eardrum is created from the remnants of the eardrum and
other tissues from the body.
Dangerous perforations can also
treated by microsurgery and the offending cholesteatama can be
removed with precision, making the ear safe and free from life
threatening complications by tympano-mastoidectomy. These
operations have a very high success rate in our clinic. With
meticulous care, the results are still more improved. After
tympanomastoidectomy for dangerous perforations, discharge
from the ear can occur at times but the diseased ear does not
lead to dangerous complications.
causes pain in the ear ?
Some of the common causes
of earache are :
External ear : Wax, injury, fungus,
infection, foreign body.
Middle ear : Infection, injury.
Referred pain : The ear has a rich nerve supply and many of
these nerves also supply surrounding structures like teeth,
tongue, cheek, throat, jaw joint and the neck. Since the ear
is a very sensitive structure, the brain may misinterpret pain
arising from these surrounding structures to be originating
from the ear. Neuralgic pain : due to oversensitive nerves.
Symptomatic relief from earache can be obtained by painkillers
and fomenting the ear with hot water bottle or heating pad.
But the ear should be checked by an E.N.T. surgeon for the
diagnosis and treatment.
giddiness be caused by ear problems ?
The inner ear performs two
functions, hearing by its cochlear part and maintenance of
balance by its vestibular part. Lesions affecting the
vestibular part of the ear can cause giddiness, but giddiness
can also result from general diseases like high or low blood
pressure, diabetes, anaemia and neurological
disorders(including tumours). Mental stress can also cause
vertigo or aggravate vertigo.
15) What is
the treatment for vertigo ?
Examination and investigations of
the ear and other parts of the body can help the ENT surgeon
to diagnose the cause of giddiness, and then its treatment can
be outlined. Consultation by other specialist also may be
required. Treatment may have to be prolonged and recurrence of
giddiness may occur. Majority of patients having giddiness do
not have a dangerous disease, but giddiness occurring in a
healthy individual often results in mental tension which can
aggravate giddiness. Recurrence can be minimised by proper
diagnosis, treatment and exercises for
16) What can
be done for tinnitus (noises in the ear )?
Tinnitus is the noise in
the ear or head. It is a very annoying symptom which can be
caused by diseases in the ear or diseases outside the ear.
Rarely tinnitus can be a symptom of a dangerous disease. Hence
the ear should be checked by an E.N.T. surgeon. It tends to be
most harassing to the patient when he is in a quiet place.
Treatment of the cause should take care of tinnitus but
tinnitus may persist even after the disease causing tinnitus
has been cured, which can be quite disturbing. If the patient
hears voices of persons, he may need psychiatric opinion.
Tinnitus maskers are sometimes recommended. These are similar
to hearing aids and generate continuous noise. Their use is
based on the fact that the patient is more comfortable in a
noisy environment than in a quiet surrounding.
17) Prevention of
1.Cleaning of ears : Self
cleaning of their ears by patients often creates problems.The ear has a self cleaning mechanism for wax and there is no
need for cleaning of the ear in majority of cases. Often
during self cleaning, one clears the outer part of the ear
canal while pushing the wax in the deeper part of the ear
2.Swimming : If there is any
disease or infection in the ear one should avoid swimming. If
water enters the ear, one can place a cotton pledget in the
outer part of the ear canal and bend down on the affected side
of the ear and water will get absorbed by capillary action
into the cotton pledget.
3.Loud sounds : One should
avoid exposure to loud sounds like standing near lighted
crackers and listening to loud music. Loud sound can cause
temporary or permanent deafness depending upon the intensity
and duration of loud sound. Noise pollution can also affect
4.Foreign bodies in the ears :
Children often insert items like grains, grams and stones in
the ears while in adults a part of the stick or cotton can get
stuck inside the ear while cleaning the ear.
5.High blood pressure and
diabetes : These can damage the nerve of the ear. These
diseases should be kept under control as they are also known
as silent killers.
6.Fatty diet : It can cause
thickening of the walls of the blood vessels supplying the
nerve of the ears and can cause deafness.
7.Neglecting "Colds" : It
can lead to infection of the middle ear through the Eustachian
tube connecting the ear with the nose and
8.Diseases during pregnancy :
High blood pressure, diabetes, German measles, injuries during
pregnancy and difficult labour can cause congenital
9.Hereditary factors :
Consaguinous marriages between close relatives and Rh
incompatibility between parents also can lead to congenital