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Ear Conditions & Disorders

Acoustic Neuroma/Vestibular Schwannoma

An acoustic neuroma is a tumor of the nerve cells that transmit balance information from the inner ear to the brain. It is not malignant; that is, it does not produce cells that travel to other places in the body and start additional tumors. Nonetheless, an acoustic neuroma is a problem because it slowly grows toward the brain’s hearing, breathing, and blood pressure centers and compresses them. Untreated, acoustic neuromas can create serious neurological problems and even become life-threatening. Acoustic neuromas large enough to cause these symptoms are rare, occurring in only 1 out of 100,000 people per year. They generally happen in people between the ages of 30 and 60.

Aerotitis

An acute or chronic inflammation of the middle ear; a functioning middle ear requires equal pressure on each side of the tympanic membrane. By opening and swallowing you allow passage through the Eustachian tube into the middle ear that can change the pressure. Activities such as flying or swimming into deep water can create a change in pressure.

Atresia

This refers to the absence of an external ear canal, typically there is some degree of malformation of the outer and middle ear, sometimes called cauliflower ear. Sometimes the inner ear will be healthy and normal other times these parts of the ear may not have fully developed, if at all. These malformations may cause a hearing loss. A narrow ear canal can be referred to as a stenotic canal or canal stenosis. Atresia repair can be completed and is referred to as Canal-plasty.

Autoimmune Ear Disease

This is a syndrome that can create a progressive hearing loss and may include tinnitus and vertigo due to cells attacking the inner ear; this is similar to meniers disease however the blood results of an autoimmune disease will come back abnormal.

Balance Disorder

The balance system is very complex and can be comprised of visual, muscle and joint sensory nerves and the inner ear. Symptoms can range from feeling unbalanced to a sensation of vertigo. Nausea, vomiting, disorientation, lack of concentration, irritability, tinnitus and anxiety may be associated with this disorder. Some medical treatments may be medication, diet, life style modification, allergy evaluation and or vestibular rehabilitation therapy.

Benign Paroxysmal Positional Vertigo

BPPV is caused by calcium particles called otoliths that are displaced in the semicircular canals of the labyrinth of the inner ear resulting in dizziness. These otoliths can be displaced by aging, infection, head trauma or disease and leave them floating in the inner ear. Changing position of the head will cause these particles to move resulting in vertigo.

Cerumen

Cerumen is better known as ear wax and is a healthy substance created in the outer ear canal that serves to protect the venerable part of the outer ear. Using hearing devices can stimulate cerumen secretions because of the placement of the device as well as displacing the cerumen deeper into the canal. Impacted cerumen can create a conductive hearing loss and or cause recurrent infections. Sometimes you can clean out the cerumen by way of water irrigation however this may lead to a perforation of the eardrum if not completed properly, removal can also be completed by scooping the cerumen out of the ear this method can be one of the safest.

Cholesteatoma

This is a growth of skin cells occurring behind the ear drum that causes damage to the ear drum, middle ear, inner ear, facial nerve and blood vessels and will generally produce an odorous discharge. This growth can lead to problems such as ear infections, hearing loss, dizziness, facial nerve paralysis and brain abscesses.
There are two kinds of cholesteatomas, one is an acquired and the other is congenital, the most common is acquired and it grows over time. The problem may begin with a retracted ear drum or a perforation in the ear drum which allows healthy skin cells to move from the ear canal and begin growing behind the ear drum. When individuals have a congenital cholesteatoma this means they are born with it and the skin has been growing behind the ear drum and may go unnoticed for a long period of time.

Chronic Middle Ear Fluid and Otitis Media

Allergies, infections, and other factors can cause a chronic condition which causes the middle ear to fill up with fluid. The middle ear is necessary for the brain to develop understanding of spoken language in background noise. The abnormality of this brain function is known as Central Auditory Processing Disorder. It is normal for fluid to last up to several weeks after an ear infection however if the fluid persists for longer than 3 months medical intervention is required the alleviate the fluid. Otitis Media is a middle ear infection where after a cold or infection the Eustachian tube does not drain the fluid because it may become swollen or blocked from the cold and the fluid remains in the ear and is susceptible to germs. This can cause pain by causing pressure on the ear drum. It can also cause fevers and a decrease in hearing and even dizziness. If there is drainage from the eardrum it may be from an ear drum bursting. The common treatment is an antibiotic, some are oral and some are ear drops or a combination of both.

Dermatitis or Eczema

This can make the ear canal itchy and possibly painful due to the skin becoming red and swollen around the external auditory canal.

Exostosis

This is the medical term for an abnormal growth of bone within the ear canal, generally from frequent exposure to cold water causing the bone surrounding the ear canal to thicken and constrict the ear canal creating a blockage which can lead to a conductive hearing loss.

Eustachian Tube Dysfunction

This occurs when there is a narrow passageway connecting the middle ear with the nose and it malfunctions and does not allow the pressure to equalize. Everyone has experienced this to some degree when they have had a cold or been exposed to pressure changes. When the pressure changes the Eustachian tube will pop and the pressure on the outside and middle ear will become equal when it does not pop it can cause pain and fullness within the ear.

Hair Cell

Hair cells in the inner ear are essential for hearing and balance and without them we would be deaf or disoriented. Hair cells are called stereocilia and they bend in response to a sound. There are two types of hair cells in the ear, the auditory and vestibular. Auditory hair cells are located in the cochlea of the inner ear and detect sound, the vestibular hair cells are responsible for our sense of balance and are located in a different part of the inner ear. Hair cells are connected to the auditory centers of the brain through nerve fibers. Sounds louder than 85 dB will cause temporary damage to hair cells and the cells are flattened, they will usual regain their shape within 48 hours however if there is long term exposure the hair cells do not regain their shape and a permanent hearing loss evolves. Other factors that can damage hair cells include ototoxic drugs, disease and presbycusis (the aging process).

Menieres Disease

Sometimes this is called endolymphatic hydrops and is an excess of endolymph fluid. This is an inner ear disorder which affects hearing and balance. Individuals who suffer from meniers disease will generally have dizziness and tinnitus and a progressive sensorineural hearing loss often in the low frequencies. It may only affect one ear and there may also be a pressure buildup in the inner ear.

Otalgia

Otalgia is an ear pain commonly referred to as an ear ache and it may originate outside of the ear.

Otitis Externa

This is inflammation or an infection of the external ear canal where the skin of the canal is less protected and can be more prone to infection. This will not cause a hearing loss unless the swelling blocks the ear canal. If an individual produces too much cerumen this may cause the retention of water and debris leading to an increase in ear infections.

Otosclerosis

This is a disease which causes spongy changes in the bony capsule surrounding the inner ear. Gradually the footplate of the stapes becomes fixed and loses its mobility and can cause a hearing loss of 60 to 65 dB. This can evolve over time and can affect more areas of the body where bones are present. This can also be inherited and can be resolved by surgeries such as stapes mobilization and stapedotomy.

Perforation in the Tympanic Membrane

A perforation is a tear or an opening in the ear drum. The ear drum is a small delicate oval membrane that separates the middle ear from the outer ear that prevents infections from spreading from the outer to the middle ear and is involved with the hearing process. The perforation can be the result of an infection, ear trauma or by using objects such as cotton swabs or bobby pins in attempt to remove ear wax. Changes in pressure cause also cause a perforation, such as flying or swimming. Perforations that are small may heal naturally within a few weeks however larger perforations may require surgical procedure such as tympanoplasty or myringoplasty. When a sound wave hits the ear drum it vibrates the ear drum and these waves are carried to the middle ear then the inner ear and relay to the brain where the sounds are processed as speech music and other auditory sensations.

Prolapsed Canal

This can be associated with the aging process and is a breakdown or sag of tissue around the canal and can cause the walls to collapse. This may also be a congenital condition.

Recruitment

This occurs when a small increase in sound intensity results in a rapid increase in apparent loudness. A person may barely be able to hear a sound of moderate intensity but a sound of slightly greater intensity seems unbearably loud.

Single Sided Hearing Loss

This refers to a unilateral hearing loss where only one ear has been affected. This can be a result of a disease, physical damage, tumors, circulatory issues, meniers disease, trauma, pressure on the nerve, hereditary factors or an infection. In some cases surgeries may be suitable for SSD or a CROS or BI-CROS or BAHA (Bone-Anchored-Hearing-Aids) instruments.

Sudden Sensorineural Hearing Loss

This sudden hearing loss is a medical emergency defined as an individual experiencing at least 30 dB of sensorineural hearing loss occurring over a period of three days or less. Sensorineural hearing loss occurs when there is damage to the inner ear cochlea or the nerve pathways to the brain.

Tinnitus

This is a noise heard in the ear that is not coming from the environment outside and is extremely common. This noise may arise in the inner ear, hearing nerve pathways and surrounding structures or the brain itself.

Typanograms

This is a measurement used to evaluate the ear drum and the middle ear by a device that pumps air into the ear canal with various tones and the results are measured by the response on the microphone. This allows us to know if there is something behind the ear drum preventing movement; typically fluids build up after an ear infection was or is present.

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