Ear (Otology/Neurotology)

Diseases of the ear include: infection, trauma (injury), cancer, and nerve pathway disorders which can affect hearing and balance.

Swimmer's Ear (Otitis External)

Swimmer’s ear is an infection of the ear canal.  It typically occurs in swimmers, but bathing or showering may also cause this infection as well as cleaning the ears with Q-tips®. 

Symptoms include ear pain that is aggravated by pulling on the ear, ear fullness or pressure, drainage, fever, decreased hearing, swelling and redness around the ear.

Treatment includes careful cleaning of the ear canal by an otolaryngologist using specialized equipment, eardrops and possibly antibiotics.  If the ear canal is swollen shut, a sponge or wick may be placed in the ear canal so that the ear drops will be more effective.

Ear Infections (Otitis Media)

Otitis media is inflammation or infection of the middle ear which is located behind the eardrum. This occurs when the eustachian tube (the natural opening of the ear into the nose) becomes blocked during a cold, allergy or upper respiratory infection and fluid and pus develop. Otitis media is most common in young children but also affects adults.

Symptoms can include: earache, fever, irritability, pulling on the ear, hearing loss, fullness or pressure, dizziness and noise in the ear (tinnitus). Occasionally, the eardrum may rupture and fluid or blood may leak out. The associated hearing loss in children may impair learning and even delay speech development.

Treatment includes antibiotics, pain medicine and decongestants. Most of the time, the infection clears up with proper treatment. Sometimes, without treatment, the ear infection can become chronic and result in permanent hearing loss. Additionally, the fluid in the middle ear may remain for weeks or months and become chronic causing recurrent ear infections and difficulty hearing. A procedure called a myringotomy and tube may be required to drain this fluid in certain cases.

Earwax (Impacted Cerumen)

Earwax is normal in small amounts and acts as a water barrier in the ear canal. The absence of earwax may result in dry, itchy ears.  Ear canals are self-cleaning and there is not usually a need to clean your ears.  Using cotton tip applicators (Q-tips®), hair pins, pen caps and fingers to remove earwax not only pushes the wax further into the ear canal but also causes it to build up.

Symptoms of excessive earwax include pressure, pain, ear congestion, ringing and decreased hearing.  Treatment includes drops of mineral oil, olive oil, glycerin, or commercial earwax removal drops to clean the ears.  If these treatments are not successful and the earwax has accumulated to the point of causing symptoms, an otolaryngologist will need to remove the wax using a microscope and specialized equipment.

Hearing Loss and Tinnitus (Noise in the ears)

Hearing loss affects one out of every ten patients.  Hearing loss may be caused by noise exposure, infection, tumors (cholesteatoma), age related or genetic.  The loss is usually gradual but can be sudden.

Symptoms include hearing loss, pressure sensation, tinnitus (noise in the ear) and imbalance or dizziness.

Diagnosis of hearing loss involves a thorough physical examination as well as an audiogram (hearing test) and tympanogram (ear pressure exam).  Treatment is based on the diagnosis but most hearing loss is related to nerve damage and is usually irreversible.  Hearing aids can amplify sounds and may be recommended for treatment.  Loud noise (music, power tools, machinery and firearms) may damage your hearing permanently.  It is always recommended to protect your hearing and turn the volume down and wear appropriate hearing protection such as noise reducing earplugs.

Sudden Sensorineural Hearing Loss is an inflammatory condition of the inner ear that presents with sudden hearing loss in one or both ears.   This is a medical emergency and evaluation with a hearing test is necessary.  In certain cases, treatment can include steroids and antiviral medications

Tinnitus (noise in the ear) may be intermittent or continuous and can vary in pitch from a low roar to a high squeal or whine.  This is usually caused by damage to the auditory nerve in the inner ear and accompanies hearing loss.  In most cases, there is no specific treatment for tinnitus; however, a masking device may be used to create a white noise (background noise) or static sound that competes with the tinnitus making it less noticeable.

Dizziness (Vertigo)

This feeling has been described as feeling dizzy, lightheaded, unsteady, or off balance.  The sensation may also include the room or surroundings spinning or tilting around you.  Vertigo is frequently due to an inner ear problem but can be caused by an abnormality of circulation, high or low blood pressure, injury to the head or ear, infection, allergies, certain drugs and neurological diseases.

Diagnosis includes a physical examination including nerve and balance testing.  Since your inner ear is the center for balance and hearing, a hearing test is usually performed as part of the workup.  Further tests for diagnosis will be ordered depending on these findings.

Treatment may include medications such as meclizine (Antivert) or diazepam (Valium) to alleviate symptoms.Most cases of dizziness are mild and resolve with observation.  Vertigo exercises may be performed and prescribed in certain cases of vertigo for treatment.

Blocked Ears and Eustachian Tubes

The Eustachian tube is a small tube that connects your ear to your nose.  This tube can be blocked for a variety of reasons (allergies, infections, pressure changes in an airplane).  When this occurs, the middle ear pressure cannot be equalized and the ears cannot change their pressure.  This causes the ear to feel blocked with symptoms of pressure, pain and hearing loss. 

Treatments can include simply popping your ears (swallowing or pinching your nose and blowing).  Other forms of treatment can include; nasal sprays, decongestants and possibly a myringotomy (hole) to equalize pressure. 

If you fly and your ears usually become blocked, it is wise to have good air travel practices.  Swallow often or chew gum while flying.  Use an over the counter decongestant pill or nose spray before and during flying to help keep your eustachian tubes open.

Perforated Eardrum

A perforated eardrum is a hole or rupture in the eardrum.  This can be caused by infection or injury and may be accompanied by decreased hearing and ear discharge. Most eardrum perforations heal spontaneously within weeks, although some may take several months to heal. During this healing process, the ear must be protected from water at all times. If the eardrum perforation does not heal during this time, then surgery may be required to patch the hole.