Treatments: Ears
This section elaborates on specific treatments for improving ear problems.
hearing
Hearing is social. Hearing is fun. Hearing is safe. But did you know that hearing health is closely tied to brain health? Many scientific studies show that kids learn faster and better with hearing and adults loose brain function faster with poor hearing. Depending on the cause and type of hearing loss, there are always options for improving the situation.
Tinnitus (Ear Noise)
Hearing sound that is not present in the environment is called tinnitus. Different causes for tinnitus exist, some requiring medical evaluation, especially if the tinnitus is pulsatile (like a heartbeat), new, worse in one ear than the other, or worsening over time.
infection
The ear is prone to infections. Trouble clearing ears and equalizing air pressure (dysfunction of the Eustachian tubes) tends to cause middle ear infections, and having diabetes or using Q-tips tends to cause ear canal infections (otitis externa). Mastoiditis is when infection spreads to a boney space behind the ear, Ear infections can, but don’t always cause significant pain. They also can cause temporary or permanent hearing loss, and in extreme cases, can cause infection to spread to the brain.
balance
The inner ear plays an important role in our sense of rotation and acceleration. Other bodily senses that tell the brain about our position and motion include the eyes and our awareness of our body’s positioning (proprioception) as it relates to our neck, trunk, and limbs. These three types of information go to the part of the brain dedicated to balance (the cerebellum), where a conclusion is made about our body’s position and movement. If the various sources of information are in conflict (for example, the eyes say you’re not moving, but the ears say you are moving), then the brain is confused and we experience the uncomfortable sensation of dizziness. When it comes to determining if an ear is the culprit in causing dizziness, doctors ask about a spinning sensation (which suggests an ear is involved) and get a hearing test (since a sick ear causing dizziness may well have hearing loss as well). Among the types of ear related dizziness, some are quickly fixable (such as BPPV or benign paroxysmal positional vertigo), some are managed over time (such as Meniere’s disease), and some involve damage best addressed by physical therapy to maximize the body’s ability to compensate for a partial loss of function.
ear wax (cerumen)
Ear wax (cerumen) is not only normal, but it is protective. Like the oils on your skin, ear wax keeps the skin of the ear canal healthy. Because an ear canal can trap moisture, the water-proofing benefit of oily cerumen is especially important for avoiding infection. The most practical and healthiest way for most people to deal with ear wax is simply to ignore it. In less common cases where ignoring it is not workable, I often recommend washing one’s ears with soap (or shampoo) with each shower, provided that there is no hole (perforation) in the ear drum. Hydrogen peroxide drops applied before the shower may add to this approach, but again, only if no ear drum perforation exists. If necessary, the ear, nose, and throat clinic can also remove cerumen using a microscope and ear instruments.
air pressure and the ear (eustacian tube dysfunction)
“Popping” ones ears is a way to push air up the Eustachian tube by increasing air pressure in the throat. If the Eustachian tube opening in the throat is not working well because of swelling, identifying and treating the cause of the swelling (such as infection or reflux) may also solve the problem. A perforation in the tympanic membrane allows air (or fluid) to flow freely through the tympanic membrane, thus bypassing the Eustachian tube. When a perforation is created by a surgeon, a tube (acting as a grommet) is often placed to keep the hole from healing closed sooner than desired. A newer technique of enlarging the Eustachian tube by balloon dilation is another technique for treating Eustachian tube dysfunction.
ear reshaping
Prominent or misshapen ears can remarkably detract from self-esteem, and draw attention away from other features. Ear reshaping, called otoplasty, is an effective outpatient procedure to restore normalcy in the ear shape. Keloids are exuberant scars that tend to develop slowly after an injury such as a piercing. Keloids can be excised but need weekly steroid injections after the procedure to avoid recurrence of the keloid. Other trauma or surgery for skin cancer on the ear is also treatable to return ear shape as close to normal as possible. Lastly, a very narrow ear canal can surgically enlarged to treat infection, wax build-up, hearing loss, or trouble getting a hearing aid to fit.