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ENT - Ear

The ear has external, middle, and inner portions. The outer ear is called the pine and is made of ridged cartilage covered by skin. Sound funnels through the pine into the external auditory canal, a short tube that ends at the eardrum (tympanic membrane).

Sound causes the eardrum and its tiny attached bones in the middle portion of the ear to vibrate, and the vibrations are conducted to the nearby cochlea. The spiral-shaped cochlea is part of the inner ear; it transforms sound into nerve impulses that travel to the brain.

The fluid-filled semicircular canals (labyrinth) attach to the cochlea and nerves in the inner ear. They send information on balance and head position to the brain. The Eustachian (auditory) tube drains fluid from the middle ear into the throat (pharynx) behind the nose.

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Ear Conditions

Earache

Pain in the ear can have many causes & some of these are serious, some are not serious.

Otitis media

(middle ear inflammation): Inflammation or infection of the middle ear (behind the eardrum). Usually, this is caused by an infection.

Swimmer's ear

(Otitis external): Inflammation or infection of the outer ear (pinna and ear canal). Sudden cases are usually infections; chronic otitis is often a skin condition (dermatitis).

Meniere's disease

A condition in which the inner ear on one side malfunctions. Vertigo, tinnitus, hearing loss, and ear fullness are common symptoms.

Tinnitus

Ringing in one or both ears. Usually this is due to damage from noise exposure, or from aging.

Cerumen

(ear wax) impaction: Ear wax may block the ear canal and adhere to the eardrum.

Ruptured eardrum

Very loud noises, sudden changes in air pressure, infection, or foreign objects can tear the eardrum. The small hole usually heals within a few weeks.

Acoustic neuroma

A noncancerous tumor that grows on the nerve travelling from the ear to the brain. Hearing loss, vertigo, and tinnitus can be symptoms.

Mastoiditis

Infection of the mastoid bone, just behind the ear. Mastoiditis can result from untreated middle ear infections.

Benign paroxysmal positional vertigo (BPPV)

A disruption of function in the inner ear, causing episodes of vertigo. Although not medically serious, its symptoms can be distressing.

Cholesteatoma

This is a benign condition. It is the buildup of fibrous tissue within the middle ear and surrounding bones. Often there is a foul smelling discharge associated with hearing loss.

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Few Common Ear Surgeries

Tympanoplasty

Tympanoplasty is an operation that is aimed to remove infection from your ear and close a hole in your eardrum. The aim of this operation is to prevent repeated ear infections.

Ossiculoplasty

Ossiculoplasty is an operation to help improve hearing in those patients where hearing loss is due to damage to the ossicles (tiny hearing bones) following chronic ear infection. In this operation we may either use your own residual ossicle or an artificial ossicle to achieve the desired result.

Mastoidectomy

Mastoidectomy is an operation that is aimed to remove any pocket of dead skin and infection in your ear and mastoid bone (ear bone) and thus stop ear discharge. Infection in the ear can spread to the temporal / mastoid bone. Your ENT specialist may need to evacuate parts of the temporal bone if this happens. This can cause hearing loss. You can expect some hearing distress from a radical and modified radical mastoidectomy. This operation isn't as common as it used to be.

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Why people keep scratching Ear ?

Why People keep scratching ears or use ear buds frequently?

Most of my outdoor patients complain of itching in the ear. On examination, I find often no abnormality in ear except for broken hairs, bald canal skin or scratch marks. The problem is really not in the ear but in the mind. the Indian mindset is set from childhood that ear is a dustbin full of dirt and it should be cleaned regularly. but the truth is else.

There are Two Myth

That the ear contains dirty substance or Wax

So Ear should be cleaned regularly.

I tell you the Wax is natural gift of the God to man. its a substance secreted by modified sweat glands and it contains lysozymes which inhibit the growth of bacteria. it's being a sticky substance catches all dust, foreign particles etc and does not let go towards the eardrum. it also acts as a physical barrier.

But then still wax become the center of all ear problems why?

Sometimes wax becomes dry or hard then it may cause discomfort but if you put some wax softening drops, then most of the people even will not have this discomfort. and rarely Wax is the cause of ear problems unless water enters into ears when it swells up or catches fungal infection.

Ear has a natural mechanism of cleaning the wax in form of migratory epithelium and hair which push the wax out.

Problem comes when people starts using earbuds thinking by promotional advts that these are the right instruments for cleaning ear.

But they are not Why?

Can you take out ice-cream from ice-cream pot with an instrument like ear bud. NO, in fact you require scoop. but even with scoop would you like to take out ice-cream with your eyes closed. Never, but most of people do this to ear while cleaning the ear. their this very act injures the skin and delicate hairs resulting in bruises, infection, eczema skin, stenosis ear canal and much more

It's a psychological problem. a kind of obsessive compulsive disorder. Ear is a special sense organ. any sub-threshold stimulus here is perceived as pleasant to brain and brain signals hand to scratch ear again. this is vicious cycle and in this process Ear gets the injury.

Ear share it's nerve supply with Tonsil, Teeth, Throat, Larynx and Stomach. A simple acidity can cause low grade itching in ear. So Why should you scratch the ear when gulping few antacids can solve your problem.

The best way to solve your problem is first to consult a ENT specialist to rule out other causes of itching and then if this is the cause (indeed this is the cause in most of the cases), forget the ear. I quote like this

IF YOU FORGET THE EAR, THE EAR PROBLEMS WILL FOGET YOU :-)

NOISE INDUCED HEARING LOSS??

What is noise induced hearing loss & How does it occur???When excessive sound energy strikes the inner ear, it damages the hair cells of the cochlea. If it is brief and not very loud, the noise may cause a temporary reversible damage called temporary threshold shift. This is seen in the initial stages off factory exposure, music concerts, loud i-POD music etc. If the noise is loud and for long duration or sudden and very loud, it may cause a permanent (irreversible) threshold shift.??

SUDDEN HEARING LOSS( An ENT Emergency)

This is a real E.N.T emergency. Many a time it is termed as ear attack like heart attack. Pathophysiology behind it is decreased blood supply to the inner ear/ hypoxia or baro trauma, or any other cardiovascular event . It can be reversed if patient reports with in 5-15 days. When this kind of symptom is noticed, immediately contact an E.N.T doctor.

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