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Diagnosis and Treatment of Ear and Hearing Disorders

The ear is the organ primarily responsible for hearing and balance. It consists of three parts, namely: the outer ear or pinna, which consists of the auricle, auditory canal and tympanic membrane through which sound is collected; the middle ear, which houses the eardrum, tympanic cavity and ossicles that allow sound to travel further to the inner ear; and the inner ear or labyrinth, which holds the cochlea and converts soundwaves into electrical signals which are then transmitted to the brain. The inner ear also contains the vestibule and fluid-filled semicircular canals, which aid in equilibrium.

Types of Ear Disorders

As with most organs, the ear and its functions can be impaired by injury, infections or illnesses, resulting in hearing loss and balance problems. Such issues fall under the care of an ENT specialist, who deals with conditions involving the head and neck, specifically the ears, nose and throat.

Types of ear disorders include:

  • Earache – Ear pain is common in children and adults, affecting one or both ears, and may be persistent or intermittent. Characterized by dull and sharp pains, ear discharge and impaired hearing, an earache is often caused by viral or bacterial infections, air pressure and wax buildup.
  • Injury – Ear trauma is either external or internal. Common ear injuries are barotrauma (caused by increased air or water pressure) and noise-induced hearing loss (sudden or continuous exposure to loud noises).
  • Vertigo – Vertigo or dizziness creates a feeling of being off-balance, or that an individual or his/her surroundings are spinning. It is often caused by problems in the inner ear or by motion sickness and certain medications. Though not life-threatening, vertigo can affect one’s quality of life.
  • Tinnitus – This refers to the perception of sounds such as ringing even when no external noise is present. It is common and rarely poses a serious risk. However, in cases where the noise is so persistent and loud that it becomes a distraction in one’s day-to-day life, then it should be assessed by an ear specialist.
  • Temporomandibular Joint (TMJ) Dysfunction – This refers to pain in the jaw muscles and temporomandibular joints, which serve as a hinge that attaches the jaw to the skull and controls facial muscles used for talking and chewing. It is usually accompanied by ear pain and tinnitus.
  • Otitis Media – This is an umbrella term for inflammatory diseases that affect the middle ear. One type of otitis media is glue ear, which happens when the usually empty cavity in the middle ear becomes filled with fluid, resulting in temporary hearing loss.
  • Deafness – This is defined as the partial or complete inability to hear sounds. In the case of the former, hearing aids and cochlear implants may be used to help the person hear better. In the case of the latter, sign language may be the only recourse to communicate effectively.

Symptoms of Ear Disorders

Symptoms vary based on the type of ear condition causing them. Common symptoms include:

  • Redness or tenderness in the ear canal
  • Dull, sharp or burning pain
  • Bleeding from the ears
  • Difficulty hearing
  • Itchiness in the ear
  • Foul-smelling ear discharge
  • Temporary or permanent hearing loss
  • Weakness of facial muscles
  • Dizziness

Diagnosis of Ear Disorders

The first step to check for ear disorders is through a physical assessment of the ear. Hearing tests are also conducted to determine loss of hearing and balance problems.

Many ear conditions are diagnosed using an otoscope, a lighted instrument that provides a view inside the ears, specifically the ear canal and eardrum. This method allows the ear specialist to check for wax or fluid buildup, injuries, infections and inflammations. In some cases, a pneumatic otoscope is used, in which air is blown against the tympanic membrane to check for mobility in the presence of pressures.

Similarly, examinations such as tympanometry and acoustic reflectometry are conducted to measure movement in the eardrum. Little to no movement in the eardrum when pressure or sound is applied may indicate a perforation, fluid accumulation in the middle ear, infections or structural problems.

Rarely, the ear doctor would perform a tympanocentesis in which a tiny cannula is used to pierce the eardrum and drain the fluid from the middle ear. The extracted fluid will also undergo further testing to accurately determine the type of infection and how to effectively treat it.

Treatment of Ear Disorders

Most ear problems are mild and require little to no treatment. Some are merely symptoms of other conditions and resolve themselves once the illness goes away. Others are serious and require more complex forms of treatment such as:

  • Cochlear Implants – This is a medical device that helps transmit electronic sound signals to the brain if the cochlea is damaged. It is different from a hearing aid, which merely amplifies sounds. Cochlear implants are also surgically implanted on the skin behind the ear.
  • Hearing Aids – Unlike cochlear implants, hearing aids are wearable, battery-powered devices that help patients hear and interpret sounds by amplifying their volume.
  • Microscopic Aural Toilet – Done alongside a microscope examination or otoscopy, a microscopic aural toilet refers to the process of removing wax, fluid and other foreign materials from the middle ear and ear canal. This involves the use of cotton tips, curettes, suction and forceps.
  • Grommet (Ventilating) Tubes – Suitable for patients suffering from glue ear, this method involves surgically placing a tiny grommet in the eardrum to reduce pressure and fluid buildup.

Dr Lau Chee Chong, senior ENT surgeon at Ear Nose & Throat Centre CC Lau, specializes in the diagnosis and treatment of ear and hearing disorders in both children and adults. Schedule an appointment with him today by calling 6235-9535.

Dr Lau Chee Chong Senior Consultant,
Ear Nose Throat, Head & Neck Surgery

Dr Lau Chee Chong at Mount Elizabeth Centre treats both adults and children. His practice covers all areas diagnostic, surgical and medical of ENT, head and neck practice. The clinic is well-equipped for almost all ENT procedures to be done in-clinic, including NBI (Narrow Band Imaging) video rhinolaryngoscopy, which gives very clear images and is particularly effective in identifying early-stage nose, head and neck cancers.

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