Ear Conditions

Background
Ear problems can cause deafness or hearing impairment, earache, a discharge from the ear, noise in the ear (tinnitus) or balance problems (vertigo). In the clinic the doctors will take a detailed history and examine your ear, sometimes with a special microscope that magnifies the ear drum. We see adults and children.

Treatment
Often this can be started in the clinic.

Common Ear Conditions

• Infection
  Ear infections of the ear canal are relatively common. The ear canal is usually swollen and inflamed and needs to be cleaned which can be done in the clinic using the ear microscope to visualise the canal and ear drum. A swab may be taken to identify the type of germs causing the infection and appropriate ear drops or a spray will be prescribed. In severe infection the patient may require a small sponge wick to be placed in the canal to allow the drops to bathe the inflamed ear canal skin.

  Another common cause of ear infection is a hole in the ear drum known as a perforation. The infection can be treated by cleaning the ear canal in the clinic and by using ear drops or a spray. Often the patient suffers from recurrent infections and the ear drum will need to be repaired. This is an operation performed under general anaesthetic (the patient is asleep) usually as a day case. The covering tissue of muscle or cartilage is usually used to repair the hole. This may also improve the hearing in the ear.

• Wax
  Everyone produces wax from the outer part of the ear canal. This is normal and does not cause harm, it may in fact protect against infection. However, if the wax becomes compacted it can cause pain and deafness. We can usually remove the wax in the clinic by suction or with special ear instruments using the ear microscope to prevent damage to the ear canal or ear drum.

• Glue Ear
  This is a condition that usually affects children causing mild or moderate hearing impairment. It is caused by fluid building up behind the ear drums. Sometimes the fluid is very thick, hence the term ‘glue ear’. If persistent, the patient may benefit from the placement of small plastic tubes called grommets into the ear drums under a short general anaesthetic as a day case. This is the most common operation on children in the UK.

• Deafness
  Patients often present with hearing impairment and this can be caused by a wide variety of conditions including those already mentioned. Following examination and appropriate hearing tests, we will explain the treatment options available. These may include surgery in some cases or we will refer for the fitting of a hearing aid if required.

• Tinnitus
  This is defined as hearing noise in the ears not due to an external source of sound. This often takes the form of a whistling sound although it may be pulsatile or clicking in nature. It is not specific to any particular ear condition and can be caused by any ear abnormality including a build up of wax. It often improves spontaneously but if persistent there are many treatments available for tinnitus. We are at present evaluating new forms of treatment.

• Balance Disorders (Vertigo)
  We see patients with balance disorders. These can be caused by a wide variety of conditions. Often the problem is related to the ears and the patient may or may not have other ear related symptoms. Vertigo may also be caused by neurological and cardiovascular causes and sometimes can be related to the patient’s medication. The detailed assessment of the individual patient is paramount in the investigation and diagnosis of balance disorders. Often patients require investigations such as MRI scanning or computerised balance testing and sometimes they will require referral to other specialties which we will arrange. The treatment of imbalance very much depends on the cause but often includes medication, balance physiotherapy and occasionally specialised treatment such as injection of medication into the ear or surgery, although this is unusual.