How the Ear Works
The ear has three main parts: the outer ear, the middle ear & the inner ear.
The outer ear, including the external auditory canal, (the part you can see) opens into the ear canal. The eardrum (tympanic membrane) separates the ear canal from the middle ear. The middle ear contains three small bones which help amplify and transfer sound to the inner ear. These three bones, or ossicles, are called the malleus (or hammer), the incus (or anvil), and the stapes (or stirrup). The inner ear contains the cochlea which changes sound into neurological signals and the auditory (hearing) nerve, which takes sound to the brain.
Any source of sound sends vibrations or sound waves into the air. These funnel through the ear opening, down the external ear canal, and strike your eardrum, causing it to vibrate. The vibrations are passed to the three small bones of the middle ear, which transmit them to the cochlea. The cochlea contains tubes filled with fluid. Inside one of the tubes, tiny hair cells pick up the vibrations and convert them into nerve impulses. These impulses are delivered to the brain via the hearing nerve. The brain interprets the impulses as sound (music, voice, a car horn, etc.).
Hearing & Ear Problems
- Balance Disorder
- Central Auditory Processing Disorder
- Chronic Ear Infections
- Chronic Middle Ear Fluid
- Dizziness: Lightheadedness & Vertigo
- Benign paroxysmal positional vertigo (BPPV)
- Meniere’s Disease/ Endolymphatic hydrops
- Earaches & Otitis Media
- Ear wax/ Cerumen/ Glue Ear
- Eustachian Tube Dysfunction
- Exostosis/ Surfer’s ear
- Hearing loss
- Perforated Eardrum
- Vestibular neuritis/ Labyrinthitis
- Cerumen (ear wax) removal
- Otoplasty Ear Correction Plastic Surgery
- Myringotomy with (Ventilating) Tubes
- Tinnitus Evaluation and Retraining Therapy
- Vestibular Rehabilitation
Outer Ear Infections
Outer ear infections can cause itching in the ear canal, pain and swelling of the ear canal, discharge from the ear, and crusting around the ear canal. Your physician will carefully clean and dry your ear. If your ear is very swollen, the physician may insert a wick soaked with an antibiotic into the ear to get the medicine into the infected area. You may need to put drops in your ear several times a day to keep the wick moist. Oral antibiotics may also be indicated if you have a severe infection, or your physician may suggest a cream or ointment medicine for some types of infection.
Middle Ear Infections
A middle ear infection is an infection of the air-filled space in the ear behind the eardrum. Ear infections usually begin with a viral infection of the nose and throat. Ear infections may also occur when you have allergies. Symptoms of a middle ear infection include earache, hearing loss, feeling of blockage in the ear, fever, and dizziness. The physician will check for fluid behind the eardrum, and a hearing test may also be recommended if you are experiencing hearing loss. Antibiotic medicine is a common treatment for ear infections. However, recent studies have shown that the symptoms of ear infections often go away in a couple of days without antibiotics. Your provider may recommend a decongestant (tablets or a nasal spray) to help clear the eustachian tube.
Benign Paroxysmal Positional Vertigo
Benign Proxysmal Positional Vertigo is one of the most common causes of vertigo in adults. It presents with the illusion of movement, which occurs within a few seconds of a change in head positioning. Most commonly a short sensation of spinning is experienced after lying down in bed, arising in the morning, or rolling over in bed at night, but may also occur when one looks up to a high shelf, or down under furniture. Typically, the symptoms last seconds to minutes or so before resolving. BPPV is due to microscopic crystals, or otoconia, floating around in one of the compartments of the inner ear. The movement of these particles stimulate the sensory endings of the vestibular (balance) nerve, producing vertigo.
The good news is that BPPV responds well to physical therapy maneuvers. Medications rarely help. A trained physician or vestibular therapist can perform therapy which can rapidly eliminate the symptoms of dizziness. These maneuvers are designed to relocate the crystals to a part of the inner ear where they will not produce any symptoms. Treatments for BPPV can usually be performed in one or two sessions with very high success rates. This office frequently diagnosis and properly treats this disorder.
Meniere’s Disease is a problem in the inner ear. It can cause severe dizziness (vertigo) and hearing loss. It usually affects just one ear, but it can happen in both ears. There can be a significant hearing loss, but complete deafness is rare. The symptoms can be mild or severe. Although the dizziness can be very disabling, it can usually be controlled.
Excessive amounts of earwax, or cerumen, can block the ear canal and cause temporary hearing impairment. Earwax should be removed only by a professional. Q-tips, ear candeling, or other methods of home earwax removal are not recommended. Please consult your physician if you suspect earwax impaction.
Labyrinthitis is an inflammation of the inner ear. Vestibular neuritis is an inflammation of the nerves connecting the inner ear to the brain. In vestibular neuritis, a virus similar to the herpes virus causes an infection. This infection causes swelling and inflammation of the vestibular nerves or the labyrinth. Sometimes bacteria from a middle ear infection cause labyrinthitis. Symptoms of vestibular neuritis and labyrinthitis include dizziness or vertigo, trouble maintaining balance, and nausea. Diagnosis may include a hearing evaluation, balance testing, an MRI scan, and possible blood testing.
Otosclerosis is the abnormal growth of bone in the middle ear which can cause conductive hearing loss, or the prevention of the normal transmission of sound. It is most common for otosclerosis to affect one of the bones in the middle ear called the stapes. Other symptoms of otoscerlosis may include ringing in the ears and dizziness. Otosclerosis can be diagnosed by your ENT physician, and will include a hearing evaluation by an audiologist. Treatment may consist of a surgery called a stapedectomy, where a prosthetic device replaces the abnormal bone growth.
Tinnitus (ringing in the ears)
Tinnitus (ringing in the ears) is not normal, and can be a symptom of other disorders. Some of the causes of tinnitus are hearing loss, noise exposure, ear infections, sinus infections, Meniere’s disease, ear or head injury, otosclerosis, cardiovascular disease, certain medications, anxiety or stress, heavy smoking, and thyroid disorders. Tinnitus can be described as ringing, buzzing, crickets, escaping air, and many other types of sound. Your physician will ask about your symptoms and may order a hearing test, scans, or blood work to determine the possible cause. Treatment options may include a hearing aid or masking device, Tinnitus Retraining Therapy (TRT), and perhaps certain medication.
Types of hearing loss: Hearing loss is categorized by what part of the auditory system is damaged. These fall into three categories: Conductive hearing loss, sensorineural hearing loss, or mixed hearing loss.