HEARING IMPAIRMENT (CONDUCTIVE- SECRETORY OTITIS MEDIA)

The child will have decrease in hearing,irritation in the ears and earache sometimes. The main complaint comes from the teacher who reports that the child is inattentive in class or parents observe that the child listens the television at a higher level.On eamination there can be retraction of tympanic membrane or bubbles of fluid can be seen through it.The diagnosis can be made with pure tone audiometry (hearing test) and impedence audiometry (tympanogram).Treatment can be removal of the causative factor that is adenoids.Oral and nasal decongestants help. If not cured then myringotomy that is giving a small cut in the drum or myringotomy with grommet insertion can be done to cure the child. Grommets are small ventilation tubes which are inserted in the drum after giving a small incision in the drum.

If remained untreated ,this condition leads to hearing loss and deposition of chalky white patches in the drum called tympanosclerosis.

HEARING IMPAIRMENT (CONDUCTIVE)

In children glue ear or secretory otitis media is a leading problem which causes conductive hearing loss.The main condition which lead to secretory otitis media is a nasopharyngeal lymphoid tissue called adenoids. This tissue either cause mechanical blockade of Eustachian tubes causing decrease in middle ear pressure levels resulting in negative middle ear pressure and thus fluid in middle ear. Secondly adenoids become a continuous source of infection resulting in eustachian tube congestion and blockade causing recurrent acute otitis media and with inadequate treatment it ends in secretory otitis media.

HEARING IMPAIRMENT (CONDUCTIVE)

In conductive hearing loss, one of the commonest cause can be wax which usually gets pushed back due to self cleaning by cotton applicators available in the market by the name of buds.This wax can also swell and then gets hardened due to entry of water during bathing or swimming.The ear fells deaf and heavy and our own sound appears louder. One can instill wax solvent drops and get wax removed by an ENT specialist.

HEARING IMPAIRMENT

There can be a number of causes of decreased hearing causing conductive deafness. Conductive deafness means decreased hearing due to impairment in conduction of sound from external auditory canal to inner ear. The sound enters the external auditory canal, makes the drum vibrate, then gets transmitted due to movement of three small bones namely malleus ,incus and stapes which amplifies and concentrates the sound. Stapes is the smallest bone of the human body.From stapes ,this sound wave travels to the inner ear via oval window. Anything wrong with the above mechanism causes conductive deafness.

HEARING IMPAIRMENT

Decrease in hearing is a common problem. This is common with advancing age, due to misuse of medicines, noise induced or with middle ear diseases. This can be due to problem in external and middle ear, so called conductive type or problems in inner ear or cochlear nerve, also known as sensorineural type.In both the conditions the type and severity of hearing loss differs and treatment modalities also differ.

MYRINGOPLASTY:REPAIR OF DRUM

When there is a hole in the ear drum this is repaired by a surgery called myringoplasty. The graft material used is temporalis fascia, vein graft or perichondrium.The graft can be placed above or below the remnants of drum.good technique can give beautiful results.

HONEYMOON RHINITIS

The nasal secretions are in a way affected by our emotions. Whenever a person is excited or afraid, there is a change in his nasal secretions that can either be increase in secretions or their drying.Similarly when a person is sexually excited, his or her nose starts producing watery secretions. This commonly occurs at the time of honeymoon of newly weds. At the moments of sexual excitement of the newly weds, watery fluids starts coming out of their nose which is known as honeymoon rhinorrhea.This all depends on the activity of the sympathetic-parasympathetic nervous system.

RHINOPLASTY

Rhinoplasty is the plastic surgery of the nose done to correct the external deformity of the nose. External deformities of the nose can be depressed nose ( a nose which needs to be elevated and augmented), deviated or crooked nose ( a nose which is not straight but deviated to a side), a hump on the dorsum of the nose,wide or asymmetrical openings of the nasal cavities and deformities of the tip of the nose. In the deformities of the tip of the nose, there can be wide tip, rounded tip or a parrot beak deformity. Mainly these cause a cosmetic deformities and less of functional abnormalities but if this is accompanied by deviation of the nasal septum which is a partition between the nasal cavities, this can cause difficulty in nasal breathing causing nasal obstruction.

FRACTURE OF THE NOSE

Nasal bones are one of the commonest bones to get fractured because of their outward prominent position making them to become more prone to trauma due to accidents and fights. Secondly these bones are thin and easily broken. After nasal fracture, the patient usually bleeds from the nose. Swelling appears early and there can be black eye. Nose is tender to touch and on palpating the nose, a crackling sound can be heard. Bridge of nose can be depressed or deviated to one side.Patient should be given painkillers and anti-inflammatory tablets.After getting the x-ray done and after confirmation of the fracture, fracture is to be reduced if the injury is less than two days old or one has to wait till the swelling subsides. Fracture is to be reduced before ten days of injury,otherwise the bone gets fixed at the fractured position permanently and the shape of nose gets distorted. To correct this deformity, rhinoplasty (plastic surgery of nose) is needed which is a major surgery.

BOIL IN NOSE (FURUNCLE)

Boil also known as furuncle of the nose is a fairly common condition.The main cause is nose picking causing infection of the the hair follicle of the nasal vestibule. This is common in dry climate where the secretions of the nose get dried up and cause irritation in the nose forcing the person to introduce finger in the nose to remove the crust. The skin over that area becomes painful and swelling starts appearing over the area which spreads very fast.The patient can have fever also.The area over the tip of nose and central part of upper lip is called dangerous area of the face as infection from this area can spread to the brain (cavernous sinus) causing fatal complications. So never press or squeeze a boil over this area or you will land yourself in grave trouble.Give plenty of hot fomentation and take appropriate antibiotics and anti inflammatory drugs. Local application of antibiotic cream is also effective. With this treatment the recovery takes place in a couple of days. This disease is not to be taken lightly and early medical help is always rewarding and advocated.

PERFORATION OF DRUM

Perforation or hole of the ear drum (tympanic membrane) is a common problem. The cause of this problem can be injury from outside by inserting pins,match sticks etc during self cleaning of the ear or scratching the ear and blast injury due to slap on the ear, bomb blasts or blasts due to crackers.The patient feels heaviness of the ear and impairment in hearing. If the middle ear gets infected due to entry of water while bathing or swimming,the ear starts discharging.If the perforation is small,some times it heals by itself.If it does not heal,it can be treated by trichloracetic acid applications at regular intervals but if it is large,then the drum has to be repaired by surgery called myringoplasty. In myringoplasty, graft is placed after preparing the bed of the remnants of tympanic membrane. The graft material can be taken from temporalis fascia, perichondrium or a vein. The success rate of this operation has become high.If untreated,the patient lands in chronic ear infection due to repeated entry of water in the ear and the also suffers from hearing loss.

PAIN IN THE EAR-ACUTE SUPPURATIVE OTITIS MEDIA

Acute otitis media can occur in any age group but is more common in children.Most of the kids below the age of four years suffer atleast once from severe pain in the ear especially during the night time. This is an acute condition. The child becomes irritable in initial stages and as the stage progresses, feels severe pain in the ear and starts crying. If the child is sleeping, he get up crying. This attack is common in kids having upper respiratory infections like common cold. The infection travels from the nose to the ear via a tube connecting these two called eustachian tube when the child blows his nose. In the beginning the pain increases till a time comes when the ear starts discharging if the child remains untreated. The discharge is at first blood stained but later on, it is only pus like. The child is relieved of the pain as soon as the discharge appears.The child can have fever. On examination the child looks feverish, has a running nose and irritable. In the initial stage the drum looks red (congested) but when the ear start discharging, one can see a small hole in the drum. To treat the child, the child is given pain killers and antipyretics like paracetamol, decongestants,local decongestant nasal drops and a course of antibiotics. Steam inhailation gives a soothing effect. Mostly the child is fine after the attack is cured and the small hole (perforation) of the drum heals by itself. Recurrent attacks of this disease needs special attention as the child might be suffering from enlarged adenoids which is a lymphoid tissue mass present in the nasopharynx, a space present behind the nasal cavities above the level of palate. In such cases removal of adenoids and placement of a ventilation tube in the drum becomes necessary.

FUNGUS IN THE EAR-OTOMYCOSIS

Itching in the ear is a very common symptom. It can be assosiated with pain in the ear and discharge which is mainly watery in nature.This is an acute condition and its main cause is fungus in the external auditory canal and is known as otomycosis. The commonest fungus causing this is aspergillus fumagatus and niger and candida albicans. This is common in humid climates and also after swimming. Diabetics and immuno compromised persons have a more chance of getting the infection.The patient feels pain, itching and heaviness of the ear.On examination whitish or blackish cotton wool like fungus is seen in canal.Best treatment is to get suction cleaning of the ear and instillation of anti fungal drops like clotrimazole or miconazole and hot fomentation of the ear.

OTITIS EXTERNA

The inflammation or swelling of external ear which means that of pinna and ear passage known as external auditory canal is called otitis externa. The most common cause of this problem is pocking of objects like pins, match stick or keys when a person feels itching in ear or self cleaning of the ear. The patient feels pain in the ear especially while eating and on touching or pressing the auricle. The patient can have discharge from the ear. There can be fever also.Ear ache is one of the severest aches of the body. Painkillers help in reducing the pain as well as swelling. Hot fomentation over the pinna really helps in reducing the discomfort. Hygroscopic agents like glycerine should be instilled in the ear which helps in reducing the swelling. One should contact an ENT specialist who can pack the ear canal with a wick impregnated with antibiotic,steroid and keratolytic ointment. Oral antibiotics,pain killers and local drops containing antibiotic and steroids along with lignocaine are to be used for a couple of days.

EAR CLEANING

Most of us have the habit of cleaning our ears with readily available cotton buds or other cotton applicators. Instead of cleaning the ears, such instruments can injure the external auditory canal or push the wax deep in the passage. A common belief that wax accumulates due to dusty surroundings is incorrect. Wax is the secretion of wax secreting glands of the external auditory canal and helps to trap bacteria and dust particles. Thus wax help in protecting the ear from dust, bacteria and foreign bodies. Normally we do not have to clean the ears due to self cleaning property of the ear as a result of outward migration of the skin of the ear passage but if water enters the ear and makes the wax hard or the wax gets pushed due to using of buds then the patient feels pain, heaviness and hearing impairment. In such cases firstly the wax has to be softened with wax softeners containing turpentine oil and then one should get the services of some ENT specialist to get the wax removed by suction, dry moping or by syringing with luke warm water. In cases of perforation of the drum ,syringing with water is to avoided.

ear trauma

Ear is a vital organ which is a common organ to be neglected but can pose severe threat if kept unattended.
Most of us have a tendency to poke our ears with different objects like hair pins , keys and match stick etc. This also gives a sense of pleasure but it can cause problem if this injures the ear passage called external auditory canal and especially the drum known as tympanic membrane. If it hits the canal , it can produce painful condition called otitis externa, but if it hits the ear drum this can puncture it and cause perforation of the tympanic membrane. In patients with diabetes it can cause a serious painful disease. so better avoid fiddling with your ears.

ear

Ear is a vital organ which is a common organ to be neglected but can pose severe threat if kept unattended.

Most of us have a tendency to poke our ears with different objects like hair pins , keys and match stick etc. This also gives a sense of pleasure but it can cause problem if this injures the ear passage called external auditory canal and especially the drum known as tympanic membrane. If it hits the canal , it can produce painful condition called otitis externa, but if it hits the ear drum this can puncture it and cause perforation of the tympanic membrane. In patients with diabetes it can cause a serious painful disease. so better avoid fiddling with your ears.