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The term means "hardening" of the "drum". In this case, it is meant that the inner ear is calcified.
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Can conduction deafness result from the fusion of the ossicles?
Conduction deafness can occur anytime there is a disruption of the transmission and amplification of the sound vibrations by the auditory ossicles from the tympanic membrane to the oval window. This disruption can occur as trauma or a bony outgrowth to the ossicles themselves that would cause fusion or fixation of the ossicles.
What is adhesive otitis media?
Adhesive otitis media, also known as tympanosclerosis, is a condition where scar tissue forms on the middle ear structures, typically the eardrum and the tiny bones in the middle ear. This scar tissue can cause conductive hearing loss and may require treatment if it affects hearing significantly.
Ear infection - chronic?
DefinitionChronic ear infection is inflammation or infection of the middle ear that persists or keeps coming back, and causes long-term or permanent damage to the ear.See also: Acute ear infectionAlternative NamesMiddle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infectionCauses, incidence, and risk factorsFor each ear, a eustachian tube runs from the middle ear to the back of the throat. This tube drains fluid that is normally made in the middle ear. If the eustachian tube becomes blocked, fluid can build up. When this happens, germs such as bacteria and viruses can multiply and cause an infection. This is called an acute ear infection (acute otitis media).A chronic ear infection occurs when fluid or an infection behind the eardrum does not go away. A chronic ear infection may be caused by an acute ear infection that does not clear completely, or repeated ear infections. Fluid in the middle ear may become very thick. Sometimes, the eardrum (tympanic membrane) may stick to the bones in the middle ear.A chronic ear infection may cause permanent changes to the ear and nearby bones, including:Infection in the mastoid bone behind the ear (mastoiditis)Ongoing drainage from a hole in the eardrum that does not heal, or after the ear tubes (tympanostomy tubes) are insertedCyst of the middle ear (cholesteatoma)Hardening of the tissue in the middle ear (tympanosclerosis)Damage to, or wearing away of the bones of the middle ear, which help with hearing"Suppurative chronic otitis" is a phrase doctors use to describe an eardrum that keeps rupturing, draining, or swelling in the middle ear or mastoid area and does not go away.Ear infections are more common in children because their Eustachian tubes are shorter, narrower, and more horizontal than in adults. Chronic ear infections are much less common than acute ear infections.SymptomsA chronic, long-term infection in the ear may have less severe symptoms than an acute infection. It may go unnoticed and untreated for a long time.Symptoms include:Ear pain or discomfort, earacheUsually mildMay feel like pressure in the earFeverFussinessPus-like drainage from the earHearing lossNote: Symptoms may be continuous or come and go, and may occur in one or both ears.Signs and testsAn examination of the ear may show:DullnessRednessAir bubblesFluid behind the eardrumDraining fluid from the eardrumA hole (perforation) in the eardrumThe eardrum bulges out or pulls back inwardTests may include:Cultures of the fluid may show bacteria, and these bacteria may be resistant or harder to treat than the bacteria commonly involved in an acute ear infection.Skull x-rays or a CT scan of the head or mastoids may show that the infection has spread beyond the middle ear.Hearing tests may be needed.TreatmentThe health care provider may prescribe antibiotics if the infection may be due to bacteria. You may need to take antibiotics for a long time, either by mouth or sometimes into a vein (intravenously).If there is a hole in the eardrum, antibiotic ear drops are used. For a difficult-to-treat infected ear that has a hole (perforation), a dilute acidic solution (such as distilled vinegar and water) may be recommended by your health care provider.A surgeon may need to clean out (debride) tissue that has gathered inside the ear.Other surgeries that may be needed include:Surgery to clean the infection out of the mastoid bone (mastoidectomy)Surgery to repair or replace the small bones in the middle earRepair of the eardrumExpectations (prognosis)Chronic ear infections usually respond to treatment. However, your child may need to keep taking medicines for several months.Chronic ear infections are not life threatening, but they can be uncomfortable and may result in hearing loss and other serious complications.ComplicationsPartial or complete hearing loss due to damage of the middle earSlow development of language or speechParalysis of the faceInflammation around the brain (epidural abscess) or in the brainDamage to the part of the ear that helps with balancePermanent hearing loss is rare, but the risk increases with the number and length of infections.Calling your health care providerCall for an appointment with your health care provider if:You or your child has signs of a chronic ear infectionAn ear infection does not respond to treatmentNew symptoms develop during or after treatmentPreventionGetting prompt treatment for an acute ear infection may reduce the risk of developing a chronic ear infection. Have a follow-up examination with the health care provider after an ear infection has been treated to make sure that it is completely cured.ReferencesChole RA, Sudhoff HH. Chronic otitis media, mastoiditis, and petrositis. In: Cummings CW, Flint PW, Haughey BH, Robbins KT, Thomas JR, eds. Otolaryngology: Head & Neck Surgery. 4th ed. Philadelphia, Pa: Mosby Elsevier;2005:chap 133.Morris PS, Leach AJ. Acute and chronic otitis media. Pediatr Clin North Am. 2009 Dec;56(6):1383-99.
Otitis media with effusion?
DefinitionOtitis media with effusion (OME) is fluid in the middle ear space without symptoms of an acute ear infection. Unlike children with an acute ear infection, children with OME do not act sick.Almost every acute ear infection is followed by days or weeks of OME. In addition, many people develop OME without first having acute inflammation.Alternative NamesOME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue earCauses, incidence, and risk factorsOME occurs when the Eustachian tube, which connects the inside of the ear to the back of the throat, becomes blocked. This tube helps drain fluids to prevent them from building up in the ear. The fluids drain from the tube and are swallowed.When the Eustachian tube is partially blocked, fluid builds up in the middle ear. Bacteria that are already inside the ear become trapped and begin to multiply.The following can cause swelling of the lining of the Eustachian tube, leading to increased fluid:AllergiesIrritants (especially cigarette smoke)Respiratory infectionsThe following can cause the Eustachian tube to close or become blocked:Drinking while lying on your backSudden increases in air pressure (such as descending in an airplane or on a mountain road)Although many things can lead to a blocked tube, getting water in a baby's ears will not.OME is most common in winter or early spring, but can occur at any time of year. It can affect people of any age, although it occurs most often in children under age 2. (It is rare in newborns.)Younger children get OME more often than older children or adults for several reasons:The tube is shorter, more horizontal, and straighter, making it easier for bacteria to enter.The tube is floppier, with a tinier opening that's easy to block.Young children get more colds because it takes time for the immune system to be able to recognize and ward off cold viruses.The fluid in OME is often thin and watery. It used to be thought that the longer the fluid was present, the thicker it became. ("Glue ear" is a common name given to OME with thick fluid.) However, it is now believed that the thickness of the fluid has more to do with the particular ear than with how long the fluid is present.SymptomsOME often does not have obvious symptoms.Older children and adults often complain of muffled hearing or a sense of fullness in the ear. Younger children may turn up the television volume.Signs and testsMost often OME is diagnosed when the health care provider examines the ear for another reason, such as at a well-child physical.A general ear examination may show:Air bubblesDullnessFluid behind the eardrumReduced movement of the eardrumA test called tympanometry is a more accurate tool for diagnosing OME. The results of the test can help tell the amount and thickness of the fluid.An acoustic otoscope or reflectometer is a more portable device that accurately detects the presence of fluid in the middle ear.An audiometer or some other type of formal hearing test may help the health care provider decide what treatment is needed.TreatmentIn otherwise healthy children, the first treatment is to change environmental factors, if possible. This includes:Avoiding cigarette smokeEncouraging breastfeeding for infantsReconsidering group day careIf the child has allergies, staying away from triggers (such as dust) can help.Most often the fluid will clear on its own. You doctor may suggest waiting and watching to see if the condition worsens.If the fluid is still present after 6 weeks, treatment might include:Further observationA hearing testA single trial of antibiotics (if not given earlier)If the fluid is still present at 12 weeks, the child's hearing should be tested. If there is significant hearing loss (> 20 decibels), antibiotics or ear tubes might be appropriate.If the fluid is still present after 4 - 6 months, tubes are probably needed even if there is no significant hearing loss. Laser myringotomy is a newer alternative to ear tube surgery.Sometimes the adenoids must be removed to restore proper functioning of the Eustachian tube.Expectations (prognosis)Otitis media with effusion usually goes away on its own over a few weeks or months. Treatment may speed up this process. Glue ear may not clear as quickly as OME with a thinner effusion.OME is usually not life threatening, but it may result in serious complications. If there is fluid in the middle ear, hearing will be affected. Hearing problems can interfere with language development in children. Any fluid that lasts longer than 8-12 weeks is cause for concern.ComplicationsAcute ear infectionCyst in the middle earPermanent damage to the ear with partial or complete hearing lossScarring of the eardrum (tympanosclerosis)Speech or language delayNote: Permanent hearing loss is rare, but the risk increases the more ear infections a child has.Calling your health care providerCall your health care provider if:You suspect you or your child might have otitis media with effusion. Continue to monitor the condition until the fluid has disappeared.New symptoms develop during or after treatment for this disorder.PreventionPrevention tips:Avoid irritants such as cigarette smoke, which can interfere with Eustachian tube function.Identify and avoid any allergans that may lead to your child's OME.Consider a smaller day care, especially in the winter months. Day care centers that have six or fewer children result in fewer ear infections.Wash hands and toys frequently.Use air filters and get fresh air to help decrease exposure to airborne germs.Avoid overusing antibiotics. The overuse of antibiotics breeds increasingly resistant bacteria.Breastfeeding for even a few weeks will make a child less prone to ear infections for years.The pneumococcal vaccine can prevent infections from the most common cause of acute ear infection (which leads to OME). The flu vaccine can also help.ReferencesAmerican Academy of Family Physicians; American Academy of Otolaryngology - Head and Neck Surgery; American Academy of Pediatrics Subcommittee on Otitis Media With Effusion. Otitis media with effusion. Pediatrics. 2004;113:1412-1429.Paradise JL, Feldman HM, Campbell TF, Dollaghan CA, Rockette HE, Pitcairn DL, et al. Tympanostomy tubes and developmental outcomes at 9 to 11 years of age. N Engl J Med. 2007;356:248-261.
Eardrum repair?
DefinitionEardrum repair, called tympanoplasty, is a procedure to correct a tear in the eardrum (tympanic membrane). Ossiculoplasty is the repair of the small bones in the middle ear.Alternative NamesTympanoplasty; Ossiculoplasty; Ossicular reconstructionDescriptionUsing general anesthesia, an ear-nose-throat (ENT) specialist grafts a small patch from a vein or fascia (muscle sheath) onto the eardrum to repair the tear.For problems with the small bones (ossicles), the surgeon will use an operating microscope to view and repair this chain of small bones using plastic artificial bones or ossicles from a donor.Why the Procedure Is PerformedA number of problems can permanently damage your eardrum (tympanic membrane) or harm the very small bones (ossicles) that are right behind the eardrum. These problems include chronic ear infections, trauma, cancer, and cholesteatoma.This damage may cause hearing loss, pain, or an infection that does not go away.If antibiotics or other treatments do not heal chronic ear infections, then surgical eardrum repair may be necessary.RisksRisks for any surgery are:BleedingInfectionProblems breathingReactions to medicationsAdditional risks include:Complete less of hearingDamage to the facial nerve or nerve controlling the sense of tasteDamage to the small bones in the middle ear, causing hearing lossDizziness or vertigoIncomplete healing of the hole in the eardrumBefore the ProcedureAlways tell your doctor or nurse:What allergies you may have to any medications, latex, tape, or skin cleanserWhat drugs you are taking, including herbs, herbs, and vitamins you bought without a prescriptionOn the day of the surgery:Take only a small sip of water with any drugs your doctor has prescribedTell your doctor if you have signs of illness or infectionYou will usually be asked not to drink or eat anything after midnight the night before surgeryYour doctor or nurse will tell you when to arrive at the hospitalAfter the ProcedurePatients usually leave the hospital the same day as the surgery. It is important to avoid water in the ear. There are sometimes stitches behind the ear for the first week and packing material in the ear. Your health care provider may recommend the use of a hair cap when showering for a few weeks after the procedure. Outlook (Prognosis)In most cases, the operation relieves pain and infection symptoms completely. Hearing loss is minor. The outcome may not be as good if the bones in the middle ear need reconstruction along with the eardrum.ReferencesJavia LR, Ruckenstein, MJ. Ossiculoplasty. Otolaryngol Clin North Am. 2006;39(6):1177-1189.El-Kashlan HK, Harker LA. Tympanoplasty and ossiculoplasty. In: Cummings CW, Flint PW, Haughey BH, Robbins KT, Thomas JR, eds. Otolaryngology: Head & Neck Surgery. 4th ed. Philadelphia, Pa: Mosby Elsevier; 2005: chap 136.
