Ear Disorders & Treatment
Otitis media is inflammation of the middle ear. When this inflammation occurs with infection it is called "acute otitis media". Acute otitis media is associated with the accumulation of pus and mucus behind the eardrum (initiated by an allergy, cold or upper respiratory infection with the presence of bacteria or virus) and blocking of the Eustachian tube. This will lead to earache and swelling. Fever may also be present. "Otitis media with effusion" is when fluid forms in the middle ear, and can occur when an ear infection is recovering or when one is about to occur. The fluid can be present in the ear from a week to many months. Discharge from the ear that is persistent or frequent can be called chronic middle ear infection, and if not treated, chronic ear infections can potentially lead to temporary or permanent hearing loss.
Some degree of hearing loss will occur in all children with middle ear infection or fluid. The amount of hearing loss will range from 24 decibels (about the level of a quiet whisper) to about 45 decibels (the level of conversational speech) in those with thicker fluid in the middle ear. If your child is speaking more loudly than normal or is not able to understand certain words he or she may be experiencing hearing loss. Hearing loss may be conductive or sensorineural (the latter being mostly prevalent in middle age and older patients), the former can be caused by untreated chronic ear infections. Conductive hearing loss can be treated by draining the infected middle ear drum thereby returning hearing to normal.
The insertion of ear tubes is a treatment that may be recommended for chronic ear infections. Ear tubes allow air into the middle ear and are small cylinders that are placed through the ear drum. There are short or long-term ear tubes. Smaller tubes that are designed to stay in place for six months to a year before falling out on their own are short-term, and long-term tubes are larger and constructed to stay in place for a longer period of time. It is possible that long-term tubes fall out on their eventually, but removal by an otolaryngologist may also be necessary. Ear tubes can improve speech, balance and sleep problems associated with chronic ear infections, as well as reduce the risk of future ear infection. They are also used to improve and restore hearing loss caused by the presence of fluid in the middle ear.
Children with chronic ear infections, fluid in the ear for more than three months, or hearing loss for more than six weeks should have a hearing test performed. There are other reasons a child can incur temporary hearing loss as well, such as trauma to the ear or head, compressed earwax, inflammation of the external auditory canal and other various conditions. Signs of hearing loss in children include a lack of reaction in any way to unexpected loud noises, sleeping through loud noises, poor language development, inability to follow or understand directions, and speaking loudly and not using age-appropriate language skills. If you notice any of these signs in your child, report them to your doctor.
If your child is found to have conductive or mixed hearing loss, or single-sided deafness a Baha® Systemshould be considered. The Baha System is an implantable medical device for the treatment of hearing loss that works through direct bone conduction. There are three parts involved in aBaha system:
- Sound vibrations are picked up and amplified by a digital sound processor worn behind the ear.
- Amplified sound vibrations are transferred by a connector or abutment and transferred from the processor to the implant.
- Through a process called osseointegration, a small titanium implant placed behind the ear becomes fused with bone. Sound vibrations are then able to be transferred to the cochlea via direct bone conduction, bypassing the outer and middle ear.
A cochlear implant is an alternative to treating a patient who does not receive a benefit from a conventional hearing aid. An implant is surgically placed into the inner ear and this is activated by a device worn outside the ear. The cochlear implant does not amplify or provide clarity to sound as a hearing aid would, it instead bypasses damage to the auditory system and directly stimulates the nerve of hearing, allowing those with profound hearing loss to receive sound.