Earwax, also called cerumen, has numerous protective functions such as trapping dust and debris, serving as a moisture barrier and killing microorganisms that enter the ear canal.
In general, individuals should not attempt to remove the earwax by inserting objects such as cotton swabs, paper clips or hairpins into the ears. Earwax will most often move out of the ear naturally over time without any assistance. Impaction occurs when the wax builds up or becomes too hard to exit the ear canal naturally.
In general, removing impacted ear wax includes saline irrigations – a salt-water flush of the ear canal – or direct removal under an operating microscope. Once earwax is fully removed, a maintenance regimen of at-home ear irrigations may be required.
If you are suffering from hearing loss, there are many options for aids to help you hear. It is important to find the right hearing device for you as they are not one-size-fits-all. A hearing test, general medical conditions and the anatomy of your ear will be evaluated to determine which device is appropriate for you.
If you have been using traditional hearing aids and they are no longer helping you hear, you should discuss possible alternatives with your hearing specialist. For some, traditional hearing aids are the only option. However, if you meet the criteria, implantable hearing devices may be a viable option for you:
- Bone-anchored hearing aids – for those with single-sided deafness and conductive (inner ear) or mixed (inner and outer ear) hearing loss who are unable to use conventional hearing aids
- Cochlear implants – for those with severe to profound hearing loss who receive little to no benefit from conventional hearing aids
- Totally implantable hearing aids – for those with moderate to severe hearing loss, these devices are implanted under the skin, making them completely invisible
- Partially implantable hearing aids – for those with moderate to severe hearing loss, these devices are implanted within the middle ear through a minimally invasive procedure
Meniere’s disease is a medical condition thought to be caused by fluid deregulation within the inner ear. Typically affecting just one ear, symptoms can include hearing loss, ringing in the ears, a sense of fullness and episodic true vertigo lasting at least 20 minutes and occurring at least twice.
While there is no cure for Meniere’s disease, many patients can manage their condition by following a low-salt diet, use of a diuretic, and use of anti-nausea or anti-motion sickness medications when dizziness occurs. If this does not work, then steroids or various surgical options may be recommended.
A middle ear infection, called acute otitis media (AOM), is an infection of the space located behind the eardrum. Middle ear infections are most common in children, but adults can also get middle ear infections. These infections result from bacterial or viral infections of the middle ear space along with blockage of the Eustachian tube. The Eustachian tube runs from the middle ear to the back of the nose and usually drains fluid produced in the middle ear.
Allergies, extra saliva or mucus produced during teething, cold/sinus infections, enlarged or infected adenoids or irritation from tobacco smoke can all lead to a middle ear infection.
Symptoms can include fever, ear pain, ear drainage and decreased hearing. A child may tug or pull at his/her affected ear, be irritable, cry more than usual, have trouble sleeping, lose his/her balance easily, have a fever over 100°F, have loss of appetite or vomit due to nausea.
Most ear infections do not need to be treated with antibiotics. Treatment will depend on several factors, including age and severity of symptoms. Symptoms usually improve within the first few days, and most infections clear up on their own without treatment within one to two weeks. Therefore, a “wait and see” approach is often recommended for the first 48 to 72 hours for children age 2 or older and adults who are otherwise healthy and have only mild, symptoms that do not get worse.
You should see a doctor if you or your child’s symptoms get worse over 24 to 48 hours with high fever, severe ear pain, ear discharge, severe headache, dizziness, swelling around the ear or weakness/twitching of facial muscles.
The ear drum, called the tympanic membrane, is a thin, drum-like layer of tissue that separates the external auditory canal from the middle ear. Several factors can cause a ruptured eardrum, including middle ear infections, injury to the ear from a very loud noise or a high-impact trauma, or insertion of cotton swabs and other foreign objects into the ear.
Some symptoms that may accompany a ruptured eardrum are ear drainage, earache, ringing in the ear and hearing loss. In more severe cases, facial weakness or dizziness may also occur.
Most ruptured eardrums will heal on their own in a few weeks without treatment. If the hole doesn’t close by itself, surgical repair may be recommended to improve hearing and prevent recurrent ear infections.
We all experience sinus issues like nasal congestion or a runny nose from time to time, but if you are experiencing these in combination with facial pressure, loss of smell or taste, or colored nasal discharge – lasting longer than a month – you may have a more serious condition.
Depending on your symptoms, an ear, nose and throat specialist, allergist or your primary care physician may prescribe antibiotics or suggest nasal irrigations or sprays. If symptoms persist, a longer course of antibiotics or oral steroids may be used. If these methods are unsuccessful, your physician will likely refer you to a head and neck surgeon.
The cranial base, where all of the critical blood vessels and nerves enter or exit the skull, is one of the most delicate and complex areas of the human body. Diseases of this region include both malignant and benign tumors as well as congenital and anatomical defects. When tumors show signs of growth or interfere with the function of the brain or nerves, surgery may be required.
Today, virtually all areas of the brain and skull base can be reached using advanced minimally invasive procedures meaning no scarring and a shorter hospital stay.
Swimmer’s ear, called acute otitis externa, is an infection of the outer ear canal – the area from the opening of the ear to the eardrum. It is usually caused by water or moisture that stays in the ear canal after swimming.
The first signs of swimmer’s ear include ear pain and a feeling of fullness in the ear. Then, the ear canal may swell and ear drainage may develop. Swimmer’s ear is typically very painful. Swimmer’s ear is diagnosed by careful history and a microscope examination of the ear. The main goal of treatment is to stop the infection and allow the ear canal to heal. Typically care will involve a thorough ear cleaning in the office, pain control as needed, and use of topical antibiotic ear drops/creams.
Tinnitus is the phantom perception of noise in the ears that occurs in the absence of an external sound source. It is estimated that about one in five people experience tinnitus.
Tinnitus by itself is not a disease but may be a symptom of another condition. Some of the most common causes of tinnitus include age-related hearing loss, exposure to loud noises, earwax impaction, certain medications or a stiffening of the middle ear bones. Often, a precise cause is never identified.
If there is no source identified for tinnitus or if the cause is unable to be treated, there are several management options to consider. Often, the tinnitus never goes away completely, so finding strategies for coping with symptoms is critical. Cutting down or stopping smoking/consumption of alcohol along with regular exercise and relaxation may improve the tinnitus. Consultation with an audiologist may also be useful.
Tonsillitis is an infection of the tonsils, and is evidenced by red, swollen tonsils sometimes coated with white, gray or yellow patches. Other symptoms include difficulty swallowing, fever, enlarged or tender lymph nodes in the neck and extreme fatigue or weakness. Both children and adults can get tonsillitis.
Most cases of tonsillitis can be treated with extra rest, plenty of fluids, throat lozenges and over-the-counter pain medication. If the tonsillitis is caused by bacteria such as group A streptococcus ("strep throat"), your physician may prescribe antibiotics. If you or your child is suffering from frequent tonsillitis your physician may recommend evaluation by an ear, nose, and throat specialist to consider surgery to remove the tonsils, called a tonsillectomy.
If you are experiencing voice-related issues or if you have been examined previously and your symptoms are not improving, it’s important to visit with your primary care physician or your ear, nose and throat specialist. Your physician may determine your condition warrants a further, more detailed evaluation by a laryngologist. A laryngologist studies the larynx, also known as the voice box, is the area of the throat that controls voice, breathing and swallowing.
Larynx disorders can include:
- Vocal nodules or polyps – tissue growths on the vocal cords
- Vocal fold/cord paralysis
- Respiratory papilloma – growths in the airway
- Spasmodic dysphonia – spasms of the vocal cord muscles
Depending on your condition, treatment options include outpatient speech and language pathology therapeutic treatments – just like physical therapy, but for your voice – injections or implants to improve voice quality and swallow function, as well as surgical options such as laser surgery to change anatomy contributing to voice and swallow dysfunction.