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The Sense of Sound / All About the Ears
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submitted by Dr. Gary Farr - Contact the author here.
Last Updated June, 13, 2002
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Some diseases of the ear can cause partial or total deafness. In addition, most diseases of the inner ear are associated with a disturbance of balance. Ear problems should be evaluated by specially trained physicians called otolaryngologists, who treat conditions ranging from eardrum injuries caused by physical trauma to bony deposits in the inner ear caused by the aging process.
The auricle and the opening into the outer auditory canal may be missing at birth. Acquired malformations of the outer ear include scarring from cuts and other wounds. Othematoma, known popularly as cauliflower ear, is a common result of injury to the ear cartilage followed by internal bleeding and excessive production of ear tissue.
Inflammation of the outer ear may result from any condition that causes inflammation of the skin, such as dermatitis, burns, and frostbite. Erysipelas, a skin disease caused by bacteria, and seborrhea, a skin disease caused by the malfunction of the skin's oil glands, are common afflictions of the auricle. In the outer auditory canal, foreign bodies such as insects, as well as abnormal buildups of cerumen, cause ear disturbances and should be removed by a physician.
Diseases of the middle ear include perforation of the eardrum and infection. Perforation of the eardrum may be caused by injury from a sharp object, a blow to the ear, or by sudden changes in atmospheric pressure.
Infection of the middle ear, whether acute or chronic, is called otitis media. Acute otitis media with effusion includes all acute infections of the middle ear caused by pus-forming bacteria, which usually reach the middle ear by way of the eustachian tube. Bacterial infection of the mastoid process, a cone-shaped, honeycombed projection of bone behind the auricle, may occur as a complication of middle ear infections. Hearing impairment often follows because newly malformed tissues affect the mobility of the eardrum and the ossicles. Painful swelling of the eardrum may require a surgical incision to permit drainage of the middle ear. Since the use of penicillin and other antibiotics became widespread, mastoid complications have become much less frequent. Sometimes acute otitis media with effusion leads to a chronic infection that does not respond readily to antibacterial agents.
Acute and chronic nonsuppurative otitis media, which do not involve the formation or discharge of pus, are caused by closure of the eustachian tube due to conditions such as a head cold, diseased tonsils and adenoids, inflammation of the sinuses, or riding in airplanes without pressurized cabins. The chronic form can also result from bacterial infection. Because the watery discharge impairs hearing, chronic otitis media in young children may interfere with language development. A variety of treatments are employed, including use of antibiotics and antihistamines, removal of tonsils and adenoids, and insertion of tubes into the middle ear to allow drainage.
About 1 in 100 adults has hearing loss due to a condition called otosclerosis or otospongiosis, in which an abnormal amount of spongy bone is deposited between the stapes and the oval window. As a result, the stapes becomes immobilized and can no longer transmit sensations to the inner ear. If the condition progresses, surgical removal of the bony deposit is necessary, followed by reconstruction of the connection between the stapes and the oval window. Sometimes the surgeon will replace the stapes with a mechanical piston-like device. Even after successful surgery, deposits of bony tissue may again build up and cause hearing loss several years later.
Diseases of the inner ear can affect the sense of balance and cause symptoms of motion sickness. Anemia, tumors of the acoustic nerve, exposure to abnormal heat, disturbances of the circulatory system, skull injuries, poisoning, emotional disorders, and hyperemia, or increased blood flow, may also cause these symptoms. Ménière's disease results from abnormalities in the semicircular canals and produces nausea, hearing loss, a disturbed sense of balance, and tinnitus, or a persistent ringing in the ears. Destruction of the inner ear by cryosurgery or ultrasound is sometimes used to combat intractable dizziness.
Damage to the organ of Corti in the inner ear accounts for the condition of many people who are either totally deaf or severely hearing-impaired. Scientists have addressed the difficulties of such people by developing an electronic device called a cochlear implant. This device is more sophisticated than a hearing aid, which merely increases the volume of the sounds that pass through the normal hearing organs. The cochlear implant works by translating sound waves into electric signals. These signals are relayed to electrodes that have been surgically implanted in the cochlea so that the auditory nerve is directly stimulated. After successful surgery, once deaf or severely hearing-impaired patients can usually detect a wide range of sounds, but results depend on factors that include the health of the auditory nerves and the duration of deafness. Nonetheless, lip-reading ability often improves, and implant users have varying degrees of success in using the telephone.
Otalgia, or earache, is not necessarily associated with ear disease; occasionally it is caused by impacted teeth, sinus disease, inflamed tonsils, infections in the nose and pharnyx, or swelling of the lymph nodes in the neck. Tinnitus may also result from these conditions. Permanent tinnitus is most often caused by prolonged exposure to loud noise, which damages the hair cells of the cochlea. A sound masker, worn like a hearing aid, may offer relief to some sufferers by blocking the perception of ringing in the ears.
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Additional information regarding conditions of the ears can be found here.
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