PATIENT INFO
Ear Leaflets

Conditions and surgery of the ear

A surgeon employs various strategies to access different sections of the ear when addressing a medical condition. Certain procedures can be conducted through the ear canal, eliminating the need for additional incisions around the ear. This method, referred to as a permeatal or transmeatal approach, is applicable in cases like otosclerosis, grommet insertion, and newer techniques for delivering drugs to the inner ear in vertigo. Nevertheless, more commonly, a surgical incision around the ear becomes necessary to provide enhanced access to the middle ear, mastoid, or inner ear. On occasion, this may involve an incision located just in front of the ear, known as an endaural incision.

Dizziness

Numerous factors can contribute to feelings of dizziness, and these may not necessarily be related to the inner ear’s balance organ. Instances such as fainting attacks, heart issues, thyroid abnormalities, and neurological problems can all manifest as sensations of light-headedness, giddiness, and overall imbalance.

Glue Ear (OME)

Adhesive otitis, commonly known as glue ear, is a prevalent condition. Approximately eight out of every ten children (80%) experience a brief episode of glue ear before commencing primary school. The medical term for glue ear is “otitis media with effusion.”

The precise causes of glue ear remain uncertain to doctors. While it sometimes occurs subsequent to an ear infection, many children with glue ear have never encountered such infections. In certain cases, infections affecting the adenoid at the back of the nose, triggered by coughs and colds, may lead to the spread of bacteria into the ear, resulting in inflammation. It is likely that the fluid, often referred to as “glue,” accumulates in the ear as a consequence of this inflammatory process.

Grommets – A decision-making aid for parents
Grommets, tiny tubes inserted into the eardrums, play a crucial role in managing conditions like glue ear. Also known as tympanostomy tubes, these small devices facilitate proper airflow, preventing fluid buildup in the middle ear. Grommets are often recommended to improve hearing and alleviate ear-related issues in both children and adults.

Hearing aids and how to get one

A hearing aid is a tool that makes sounds louder for people with hearing issues. It has three main parts: a microphone, an amplifier, and a speaker. Most are worn in or behind the ear, but there are also implantable ones for specific situations.

Hearing and deafness

Hearing loss is widespread, impacting people of all ages. Approximately 16% of UK adults and half of those over 75 experience some hearing loss. Children, often affected by ear issues or infections, are the next most affected group. Whether from birth or early childhood illness, hearing loss can disrupt daily communication with others.

Hearing Loss

Hearing loss is a symptom of a variety of conditions affecting the hearing organ or its nerve connection to the brain. It may be caused by problems affecting the transmission of sound through the eardrum and bones of hearing (called ossicles) to the cochlea (the organ of hearing), or it may be due to problems in the cochlea and the auditory nerve that connects the cochlea to the brain (Figure 1).​
Hole in the Eardrum & Myringoplasty
If a hole in the ear is due to recent injury or infection, it’s often observed because some holes can heal without treatment. Smaller holes may not show symptoms, but preventing water from entering the ear is crucial to minimize infection risks.
How to use ear drops or sprays
To properly apply ear drops, follow these steps: Wash your hands and bring the drops to body temperature by holding the bottle. Remove the cap, lying on your side with the affected ear up. Gently pull the outer ear to open the canal, then apply drops and press on the tragus. Remain on your side for three minutes, wiping away excess medication. Repeat if necessary and replace the cap after use.

For ear sprays, sit upright and follow a similar process: wash hands, prepare the spray, tilt your head, apply, press on the tragus, wait, and wipe away any excess. If needed, repeat for the other ear and secure the cap after use. These steps ensure proper administration and absorption of the medication.

Mastoid Surgery / Cholesteatoma
Surgery is the recommended treatment for cholesteatoma, provided the patient is medically suitable for general anesthesia. The growth of a cholesteatoma sac can lead to severe complications such as meningitis, brain abscess, complete hearing loss, persistent dizziness, or facial weakness. Postoperatively, temporary dizziness is common, and alterations in taste on the operated side may occur, though permanent damage is rare. Hearing outcomes vary, with potential for improvement, maintenance, or worsening. Facial muscle weakness, though typically temporary, can occasionally be permanent. Tinnitus may develop post-surgery, and there’s a rare risk of allergic reactions to the ear dressing medication.

Menière’s disease

Menière’s Disease impacts the inner ear, presenting three main issues: intermittent vertigo attacks, varying hearing loss, and fluctuating tinnitus. Diagnosis requires experiencing all three symptoms, making it prone to overdiagnosis. The condition, affecting one or both ears, is linked to increased pressure in the inner ear fluid compartments. Elevated pressure leads to distorted hearing, louder tinnitus, and a sensation of ear fullness.

Middle Ear Infections (Otitis Media)

Middle ear infections, especially in children, are common, with acute otitis media being the most frequent. This type is marked by severe ear pain and high temperature, typically seen in children, often accompanied by temporary deafness. When the eardrum bursts and pus drains out, the pain usually diminishes, and the eardrum generally heals with restored hearing. However, recurrent infections may lead to issues such as eardrum damage or persistent deafness due to lingering fluid (glue ear). In such cases, consulting a specialist is advisable.
Otosclerosis and Stapedotomy
Otosclerosis might not require treatment, and hearing loss can be managed with a hearing aid. Following a stapedectomy, temporary dizziness is common, with rare cases of prolonged dizziness. Changes in taste on the operated side are possible, though permanent damage is uncommon. Hearing outcomes post-surgery vary, with the possibility of improvement, maintenance, or even a dead ear. Facial muscle weakness is very rare, usually temporary, and tinnitus may develop. There’s also a rare risk of allergic reactions to ear dressing medication.

Outer Ear Infections (Otitis Externa)

Ear infections are frequent and make up a substantial part of a family doctor’s workload. Thankfully, most infections in the outer, middle, or inner ear resolve without lasting effects, though occasional longer-term issues may arise. The ear is divided into three parts: outer, middle, and inner. Infections in each part produce distinct symptoms, including pain or earache, discharge (possibly blood-stained or smelly), deafness, dizziness, and noises like tinnitus.

Protruding ears / bat ears / pinnaplasty

Protruding ears in children can result in teasing at school, often caused by a defect in the ear cartilage. The operation aims to reduce the ear’s protrusion, helping the child feel less self-conscious. While surgical correction can occur at any age, it’s typically done after around six years when the ear cartilage is more mature.
Self-help tips: itchy ears and earwax build-up
The ear canals are self-cleaning, with wax produced to protect them. The skin in your ear canal acts like a conveyor belt, moving wax and skin cells from the eardrum to the outer ear. It’s sufficient to clean the outer ear. Using cotton buds or fingers to remove wax can disrupt this process, pushing wax deeper and potentially damaging the ear canal skin, leading to infections.
Tinnitus (ringing in the ears)
Tinnitus is the perception of sound without an external source. It can be experienced in one or both ears, inside the head, or in the surrounding environment. While commonly thought of as a ringing noise, tinnitus can manifest in various forms like hissing, whistling, humming, or buzzing. The sound may be constant or ever-changing, and some individuals hear one noise, while others perceive multiple. In rare cases, tinnitus may have a musical quality or resemble distant, unclear speech.

Vertigo

A very common form of vertigo is benign positional vertigo, marked by sudden dizziness that quickly resolves within seconds or a few minutes. It often occurs when a person abruptly looks upwards or sideways, and some experience it when turning in bed. In between episodes, the individual feels entirely normal. This vertigo may result from a small piece of lining in the inner ear detaching and floating into the balance receptor, causing a sudden increase in nerve stimulation to the brain. While sometimes triggered by head injuries, many cases have no apparent cause and typically fade away over time.