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Archive for the ‘Middle Ear Disorders’ Category

As you may well know, earplugs fulfill the demand of occluding the ear from water, foreign bodies, and noise.  Although earplugs are imperative to protect the eardrums and ear canals from damage, there are certain dangers of wearing earplugs that are often overlooked.  

We all know of the benefits of wearing earplugs, for example a teenage concert junkie can protect their hearing with the help of earplugs. The decibel of sound entering their ear will be lowered with the assistance of the earplugs, preventing long-term hearing damage.  They are also useful at preventing water from going into the ear canal while swimming, preventing ear infections.

However, as a lifeguard at a community pool, I began to recognize a hidden danger of wearing earplugs. The other day a young camper, who was wearing a pair of earplugs, was playing water volleyball in the pool with her friends. She was talking to a friend, not paying attention to the game when the ball hit her right ear lodging her earplug deep into her ear canal. She came to me with overwhelming fear and pain regarding her ear, urging me to remove the stuck earplug. After seeing the damage to her ear, I knew I could not help her. We had to call for an ambulance, and she had to go to the ER immediately. Later, I found out that she suffered from eardrum perforation, which can cause permanent damage to the ear if not treated by a professional.

Scenarios similar to this young camper’s injury happen everyday, and many individuals have no idea what the correct action is to take when faced with similar dilemmas. For example, an individual may try to remove the lodged earplug from the ear canal, which can ironically lead to severe ear damage. Most individuals do not understand the anatomy of the human ear and the irreversible damages that can occur in not seeking medical attention.

In addition to ear perforation, earplugs can cause impacted earwax, which includes tinnitus (ringing in the ear), discharge, pain, and infection. It is also known to muffle your hearing causing a temporary conductive hearing loss. This can be caused by not properly cleaning your earplugs allowing bacteria to develop on the plug.

Preventive measures to take:

–       When wearing earplugs you should be cautious of your surroundings. The environment in which you surround yourself with while wearing earplugs will have an impact on the damages that can occur to your ears.

–       Do not leave earplugs in your ear for an extensive period of time, because it can cause a temporary hearing handicap by muffling sound. This is dangerous while driving, walking alongside a busy road, riding a bike, and etc. In addition to this, it may cause pain and irritation by trapping air in the ear canal.

–       Properly and fully insert earplugs.

–       Do not sleep with a pair of disposable earplugs in your ears because it may lead to minor infections.

A guide to picking out the right earplugs:  http://site.earplugstore.com/reusable_consumer_plugs.htm

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Everyday I think about how important our senses are. Especially hearing. Imagine a world without sound. It would be so dead and dull. No jamming out to your favorite song. No whistling. I’d never hear the sound of my Mustang starting or my best friend’s contagious laughter. I can’t even begin to imagine living in a world and not being able to hear, but there are people out there who live with that reality everyday.

Some people are born deaf. Some people lose their hearing through injury and sometimes the ability to hear fades away with age.

But in today’s world through the help of modern medicine, many people are fortunate enough to be able to regain their hearing and some are even able to gain the ability, which they never possessed to begin with.

This reminds me of a video I saw once (video below) of a 29 year-old woman who had received an ear implant and finally heard herself for the first time. The sound of my own voice is something I never really think about. And this woman was brought to tears by it. I found the experience extremely moving and it revitalized my passion in someday helping people with their hearing disabilities as well.

I imagine people who experience traumatic hearing loss have the hardest times coping with their deafness. They know what they are missing out on. Like soldiers who lose their hearing after being too close to a bomb explosion. I imagine their experiences to be much like the time my sister accidentally kicked me in the ear while we were horsing around in the pool. My vision went blurry for a few moments and it felt like my ear canal was vibrating. I could not hear my sister apologizing or my mom telling me to get out of the pool. Their mouths were moving and all I could hear was a steady ringing. I panicked when I thought I might be like that forever. Luckily, after shaking the water out and letting a few minutes pass my hearing returned and my panic dissipated.

To continue research on traumatic hearing loss, please visit: http://www.dmrti.army.mil/documents/Acoustic%20Trauma%20and%20Hearing%20Loss%20Information%20Paper%2021%20Jul%2007.pdf

This also makes me think of Ms. Dotty. She’s 93 years-old and very hard of hearing. She has a hearing aid, which she’s only remembered to wear about fifty percent of the times I’ve visited with her. Even though her memory isn’t the sharpest (though I can’t say the same about all her witty remarks) I’m so grateful for our ability to communicate which would be almost impossible without the assistance of her hearing aid and my hearing. Being able to still tell Ms. Dotty how my job and my studies are doing and seeing her be proud of me after telling her about my classes reinforces my commitment to learning more about the ear with hopes of one day being able to benefit others who have lost their hearing due to old age.

I just hope that people realize how important of a sense hearing truly is and how complex and fragile the human ear can be.

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Function of the Middle Ear:

The middle ear works as an energy transducer and must be present to address the impedance mismatch that exists between air and water. Essentially, the middle ear acts as a middle man in the hearing process. The action of the middle ear is to convert acoustical energy from the outer ear into mechanical energy, which stimulates the structures of the inner ear. If no middle ear was present only, 0.01% of the acoustic wave energy traveling through air would enter the fluid filled cochlea and 99.99% would be reflected. In addition, the middle ear provides protection from loud sounds and is a pressure equalizer.

Anatomy of the Middle Ear:

The malleus (hammer), incus (anvil), and stapes (stir up) are three tiny bones found in the middle ear, known as the ossicles. The area ratio, lever action, membrane buckling of these bones contribute to the impedance matching mechanisms, and serve to increase sound pressure level by about 33 dB from the tympanic membrane to the oval window.

  • Malleus: Shaped like a hammer and transmits the vibration from the eardrum and to the incus.
  • Incus: Shaped like a anvil and transmits sound vibration from the malleus to the stapes.
  • Stapes: Shaped like a stirrup and transmits sound vibration from the incus to the membrane of inner ear inside the oval window. The stapes is the smallest and lightest bone in the human body.

Middle ear muscles: stapedius and tensor tympani muscles. They are normally activated by loud sounds (>70 dB SPL) to protect the ear from damage.

The Eustachain Tube provides air and drainage for the middle ear. At rest, the tube is normally closed. If tube fails to open properly, it can lead to a build up of negative pressure in the middle ear functions as a pressure equalizer.

Disorder of the Middle Ear: Otitis Media (OM):

Otitis media is an inflammation of the middle ear, or a middle ear infection. It develops when viruses and bacteria get into the ear and multiply. Otitis Media occurs between the tympanic membrane and the inner ear, including the Eustachian tube.

Signs and Symptoms:

  • Intense pain, caused by the build up of pressure behind the ear drum
  • Drainage from the ear (May appear as blood, colorless fluid, pus, or as a dry crust on the outer portion of the ear after sleeping.)
  • Fever
  • Hearing loss
  • Disturbed sleep
  • Chills
  • Irritability
  • Some children show no symptoms

Risk Factors:

  • 75% of young children will get an ear infection before their third birthday
  •  Age: Children between 6 months and 6 years old are prone to ear infections because of their shorter and straighter Eustachian tubes
  • Upper respiratory infection
  • Exposure to groups of children
  • Exposure to smoke
  • Allergies and asthma

Treatment:

The goals of treatment are to eliminate the infection and prevent hearing loss and other complications.

  • Medication: Antibiotics to clear infection, if present. About 80% usually show improvement in 48-72 hours
  • Myringotomy (“Tubes”): A small incision is made in the tympanic membrane and tube is inserted to drain fluid. This step is taken if the child is non-responsive to medication.

Impact on Hearing:

All children with Otitis Media will have a slight degree of hearing loss. The equivalent to a child wearing ear plugs. A child experiencing hearing loss due to an infection will hear muffled sounds and speak loudly. In noisy environments, such as a classroom, the child may misinterpret speech leading to a delay in learning important  language skills. Conductive hearing loss due to an infection is temporary and once treated hearing will return to normal.

Prognosis:

If otitis media is treated in a timely manor a child’s hearing will not be negatively impacted, and the infection and symptoms will go away quickly. Opting to not treat an infection can have adverse effects on a child’s learning development. The long lasting accumulation of fluid within the middle ear is a risk for both hearing and speech disorders and for the repeated development of infections.

For more information, please visit:

http://kidshealth.org/parent/infections/ear/otitis_media.html

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