TINNITUS

Is the Ringing in My Ears Normal?

Not at all. Tinnitus is the name for these head noises, and they are very common. Nearly 36 million Americans suffer from this discomfort. Tinnitus may come and go, or you may be aware of a continuous sound. It can vary in pitch from a low roar to a high squeal or whine, and you may hear it in one or both ears. When the ringing is constant, it can be annoying and distracting. More than seven million people are afflicted so severely that they cannot lead normal lives.

Can Other People Hear the Noise in My Ears?

Not usually, but sometimes they are able to hear a certain type of tinnitus. This is called “objective tinnitus,” and it caused either by abnormalities in blood vessels around the outside of the ear or by muscle spasms, which may sound like clicks or crackling inside the middle ear.

What Causes Tinnitus?

Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear. The health of these nerve endings is important for acute hearing, and injury to them brings on hearing loss and often tinnitus. If you are older, advancing age is generally accompanied by a certain amount of hearing nerve impairment and tinnitus. If you are younger, exposure to loud noise is probably the leading cause of tinnitus, and often damages hearing as well.

There are many causes for “subjective tinnitus,” the noise only you can hear. Some causes are not serious (a small plug of wax in the ear canal might cause temporary tinnitus). Tinnitus can also be a symptom of stiffening of the middle ear bones (otosclerosis).

Tinnitus may also be caused by allergy, high or low blood pressure (blood circulation problems), a tumor, diabetes, thyroid problems, injury to the head or neck, and a variety of other causes including medications such as anti-inflammatories, antibiotics, sedatives, antidepressants, and aspirin. If you take aspirin and your ears ring, talk to your doctor about dosage in relation to your size.

Treatment will be quite different in each case of tinnitus. It is important to see an otolaryngologist to investigate the cause of your tinnitus so that the best treatment can be determined.

Tinnitus Treatment

In most cases, there is no specific treatment for ear and head noise. If your otolaryngologist finds a specific cause of your tinnitus, he or she may be able to eliminate the noise. But, this determination may require extensive testing including X-rays, balance tests, and laboratory work. However, most causes cannot be identified. Occasionally, medicine may help the noise. The medications used are varied, and several may be tried to see if they help.

The following list of DOs and DON’Ts can help lessen the severity of tinnitus:

  • Avoid exposure to loud sounds and noises.
  • Get your blood pressure checked. If it is high, get your doctor’s help to control it.
  • Decrease your intake of salt. Salt impairs blood circulation.
  • Avoid stimulants such as coffee, tea, cola, and tobacco.
  • Exercise daily to improve your circulation.
  • Get adequate rest and avoid fatigue.
  • Stop worrying about the noise. Recognize your head noise as an annoyance and learn to ignore it as much as possible.

Can You Help Me Cope With Tinnitus?

Concentration and relaxation exercises can help to control muscle groups and circulation throughout the body. The increased relaxation and circulation achieved by these exercises can reduce the intensity of tinnitus in some patients.

Masking. Tinnitus is usually more bothersome in quiet surroundings. A competing sound at a constant low level, such as a ticking clock or radio static (white noise), may mask the tinnitus and make it less noticeable. Products that generate white noise are also available through catalogs and specialty stores.

Hearing Aids. If you have a hearing loss, a hearing aid(s) may reduce head noise while your are wearing it and sometimes cause it to go away temporarily. It is important not to set the hearing aid at excessively loud levels, as this can worsen the tinnitus in some cases. However, a thorough trial before purchase of a hearing aid is advisable if your primary purpose is the relief of tinnitus.

Tinnitus maskers can be combined within hearing aids. They emit a competitive but pleasant sound that can distract you from head noise. Some people find that a tinnitus masker may even suppress the head noise for several hours after it is used, but this is not true for all users.

Summary

Prior to any treatment of tinnitus or head noise, it is important that you have a thorough examination and evaluation by your otolaryngologist. An essential part of your treatment will be your understanding of tinnitus and its causes

(SOURCE: http://www.entnet.org/healthinfo/hearing/tinnitus.cfm)

SWIMMER’S EAR

 

Causes Of Swimmer’s Ear

Swimmer’s ear is an infection of the outer ear structures. It typically occurs in swimmers, but the since the cause of the infection is water trapped in the ear canal, bathing or showering may also cause this common infection.When water is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection and irritation of the ear canal. If the infection progresses it may involve the outer ear. 

Symptoms Of Swimmer’s Ear

The most common symptoms of swimmer’s ear are mild to moderate pain that is aggravated by tugging on the auricle and an itchy ear.Other symptoms may include any of the following:   

  • Sensation that the ear is blocked or full
  • Drainage
  • Fever 
  • Decreased hearing
  • Intense pain that may radiate to the neck, face, or side of the head
  • The outer ear may appear to be pushed forward or away from the skull
  • Swollen lymph nodes

 Treatment Of Swimmer’s Ear

Treatment for the early stages of swimmer’s ear includes careful cleaning of the ear canal and eardrops that inhibit bacterial growth. Mild acid solutions such as boric or acetic acid are effective for early infections.

For more severe infections, if you do not have a perforated ear drum, ear cleaning may be helped by antibiotics. If the ear canal is swollen shut, a sponge or wick may be placed in the ear canal so that the antibiotic drops will be effective. Pain medication may also be prescribed.

Follow-up appointments with your physician are very important to monitor progress of the infection, to repeat ear cleaning, and to replace the ear wick as needed. Your otolaryngologist has specialized equipment and expertise to effectively clean the ear canal and treat swimmer’s ear.

 Prevention Of Swimmer’s Ear

A dry ear is unlikely to become infected, so it is important to keep the ears free of moisture after swimming or bathing. Removable earplugs, sometimes worn for hearing protection, can be used to keep moisture out of the ear canal. Q-tips should not be used for this purpose, because they may pack material deeper into the ear canal, remove protective earwax, and irritate the thin skin of the ear canal creating the perfect environment for infection.

The safest way to dry your ears is with a hair dryer. If you do not have a perforated eardrum, rubbing alcohol or a 50:50 mixture of alcohol and vinegar used as eardrops will evaporate excess water and keep your ears dry.

Before using any drops in the ear, it is important to verify that you do not have a perforated eardrum. Check with your otolaryngologist if you have ever had a perforated, punctured, or injured eardrum, or if you have had ear surgery.

People with itchy ears, flaky or scaly ears, or extensive earwax are more likely to develop swimmer’s ear. If so, it may be helpful to have your ears cleaned periodically by an otolaryngologist

(SOURCE: http://www.entnet.org/healthinfo/ears/swimmers.cfm)

PERFORATED EAR DRUM

 

A perforated eardrum is a hole or rupture in the eardrum, a thin membrane that separates the ear canal and the middle ear. The medical term for eardrum is tympanic membrane. The middle ear is connected to the nose by the eustachian tube, which equalizes pressure in the middle ear.

A perforated eardrum is often accompanied by decreased hearing and occasional discharge. Pain is usually not persistent.

Causes Of Eardrum Perforation

The causes of perforated eardrum are usually from trauma or infection. A perforated eardrum can occur:

  • If the ear is struck squarely with an open hand
  • With a skull fracture
  • After a sudden explosion
  • If an object (such as a bobby pin, Q-tip, or stick) is pushed too far into the ear canal.
  • As a result of hot slag (from welding) or acid entering the ear canal

Middle ear infections may cause pain, hearing loss, and spontaneous rupture (tear) of the ear-drum resulting in a perforation. In this circumstance, there maybe infected or bloody drainage from the ear. In medical terms, this is called otitis media with perforation.

On rare occasions a small hole may remain in the eardrum after a previously placed PE tube (pressure equalizing) either falls out or is removed by the physician.

Most eardrum perforations heal spontaneously within weeks after rupture, although some may take up to several months. During the healing process the ear must be protected from water and trauma. Those eardrum perforations which do not heal on their own may require surgery.

Effects On Hearing From Perforated Eardrum

Usually, the larger the perforation, the greater the loss of hearing. The location of the hole (perforation) in the eardrum also effects the degree of hearing loss. If severe trauma (e.g. skull fracture) disrupts the bones in the middle ear which transmit sound or causes injury to the inner ear structures, the loss of hearing maybe quite severe.

If the perforated eardrum is due to a sudden traumatic or explosive event, the loss of hearing can be great and ringing in the ear (tinnitus) may be severe. In this case the hearing usually returns partially, and the ringing diminishes in a few days. Chronic infection as a result of the perforation can cause major hearing loss.

Treatment Of The Perforated Eardrum

Before attempting any correction of the perforation, a hearing test should be performed. The benefits of closing a perforation include prevention of water entering the ear while showering, bathing, or swimming (which could cause ear infection), improved hearing, and diminished tinnitus. It also may prevent the development of cholesteatoma (skin cyst in the middle ear), which can cause chronic infection and destruction of ear structures.

If the perforation is very small, otolaryngologists may choose to observe the perforation over time to see if it will dose spontaneously. They also might try to patch a cooperative patient’s ear-drum in the office. Working with a microscope, your doctor may touch the edges of the eardrum with a chemical to stimulate growth and then place a thin paper patch on the eardrum. Usually with closure of the tympanic membrane improvement in hearing is noted. Several applications of a patch (up to three or four) may be required before the perforation doses completely. if your physician feels that a paper patch will not provide prompt or adequate closure of the hole in the eardrum, or attempts with paper patching do not promote healing, surgery is considered.

There are a variety of surgical techniques, but all basically place tissue across the perforation allowing healing. The name of this procedure is called tympanoplasty. Surgery is typically quite successful in closing the perforation permanently, and improving hearing. It is usually done on an outpatient basis.

Your doctor will advise you regarding the proper management of a perforated eardrum

(SOURCE: http://www.entnet.org/healthinfo/ears/perforation.cfm)