The human ear is divided into three parts, namely the outer, middle and inner ear. All these parts function in coherence with each other and help us in converting vibrations into sound and information. The middle ear consists of the air space between the inner ear and the outer ear and contains the bones that transmit the vibrations of the outer ear and translate them into information. This area is prone to infections, especially among children and thus may cause discomfort or pain. 

Symptoms of middle ear infections
Middle ear infections primarily tend to manifest themselves as inflammation of the tissues and buildup of fluids. Some of the symptoms are mentioned below.

1. Infections in children - middle ear infections primarily occur in children although it can occur in adults as well. Some of the common symptoms could be:
A. Ear pain either sitting or standing up and especially while lying down
B. Irritability and crying, which in infants could translate to more than usual crying 
C. Problems with sound and difficulties in hearing
D. Fluid buildup causing balance related problems
E. Discharge of fluid in certain cases
F. Unable to sleep and also loss of appetite
G. In some cases children may have high fever

Causes of middle ear infections 
The primary cause of middle ear infection is due to the presence of bacteria or virus in the area. The eustachian tube, which runs from the middle ear to the back of the throat, is connected to nasal passages as well. Any infection that affects the throat or the nose may also affect the middle ear through this tube. Primary causes for the infections could be
A. Cold or flu like symptoms, which then infect the middle ear as well
B. Otitis media, which is the buildup of fluid and inflammation either due to the presence of bacteria and viruses or even without it
C. Seasonal infections, which are common during late autumn or winters
D. Air pollution is also known to be a factor
E. Infection from others, especially in the case of children when they are part of a group care
F. Children from 6 months to 2 years are also susceptible to middle ear infections as their immune systems are much less developed.

Treatment of middle ear infections
Usually, middle ear infections resolve on their own within a day or so. You can try warm compress with a soft piece of cloth to ease the pain. However, if pain persists for too long then antibiotic medications may be required to fight the infection with pain relief medications to lessen the pain and discomfort.

All About Middle Ear Infections

Ringing in the ears, medically called Tinnitus, is a condition in which the individual hears a certain sound continuously in the ears.

The nature of this sound varies with different individuals. The sound may be whistling, buzzing or bell-like; it might be low or high; seeming to come from a far point or from inside of one's body.

Tinnitus in most cases is subjective where only the affected individual is able to hear the sounds. In some cases, the condition might also be objective wherein the doctor/examiner might be able to hear the sounds on examining.

Understanding the most common cause:

The process of sound waves travelling from the ear to the brain is facilitated by hair cells. When these hair cells are damaged, the brain does not receive signals which cause dysfunction in the activity of neurons. This dysfunctional neuron activity results in the illusion of sounds in the said individual. This illusion is referred to as Tinnitus.

Other causes that might result in Tinnitus are:

Damage around the hearing sections of the brain also might result in ringing sounds / tinnitus. Excessive noise might result into Tinnitus and if not prevented might even progress to hearing loss. There are also some drugs that may cause or worsen the condition.

When to seek help:

In the case of a sudden episode of Tinnitus, it may be associated with hearing loss. Such an episode should be followed by visiting the doctor immediately to prevent any further damage.

Sometimes, the ringing sound occurs rhythmically with your heart beat. It might be because of a pulsating blood vessel and/or because of a sudden hike in blood pressure. This condition would also be relatively easy to cure if reported immediately to the doctor.

If ringing sound occurs with a certain movement, it might be associated with stroke in some cases. In such incidents, conveying the exact symptoms and seeking help sooner would help in treating the underlying cause effectively.

With the first episode of Tinnitus, a regular medication that you intake should be shown to the doctor to rule out medication as the cause or to discontinue a certain medication if found to the causative agent.

Ringing In Ears - What Does it Mean and When to Seek Help

Swimmer's ear is a medical condition, which involves inflammation, irritation or infection of the ear. It may affect the outer ear and also the ear canal. Swimmer's ear is called Otitis externa in medical terms. The condition may be acute to chronic in nature.

Causes
Swimmer's ear is an infection that's usually caused by bacteria commonly found in water and soil. Infections caused by a fungus or a virus are less common. This condition is more common in teenagers and young adults. It may occur due to a middle ear infection or because of a respiratory infection such as cold.
Swimmer's ear can occur as a result of swimming in unclean or contaminated water. These waters contain pseudomonas and other harmful bacteria, which can lead to such ear infections. The infections are rarely caused by fungus.

Swimmer's ear may also result due to other reasons. They can be:
1. Scratching the inside or outside of the ear.
2. Having something stuck in the ear. When you clean ear wax with cotton swabs or small objects, damage may occur. Using headphone or ear plugs for a long period of time may also cause swimmer's ear.
3. Allergic reaction to some object or anything placed in the ear may also cause Swimmer's ear. These may be hair products or jewelry.
4. Some chronic skin conditions like eczema and psoriasis may also lead to this infection.

Risk factors
There are several factors, which may enhance the risk of getting swimmer's ear. They are as follows:
1. Swimming in water, which has got elevated levels of bacteria. This includes lakes and ponds.
2. People having narrow ear canals are at a more risk of swimmer's ear.
3. Aggressive cleaning and scratching of the ear canal.

Symptoms
The symptoms which indicate swimmer's ear are:
1. tching of the ear canal. This becomes intense as the condition progresses.
2. Redness on the inside parts of the ear, which get more extensive in later stages.
3. Discomfort which worsens by pulling on the outer ear or pushing on the tragus of the front part of the ear.
4. Drainage of a fluid which is clear and odorless. As the condition worsens, there is excessive drainage of fluid along with the discharge of pus.
4. A fullness feeling in the ear and a partial blockage of the ear canal because of swelling and fluids.
5. In advanced stages, fever and swelling of lymph nodes in the neck is indicated. Hearing impairment may occur.

Swimmer's ear is a health condition, which involves the ear. The ear gets inflamed because of a certain bacterial infection. Although it is not a very severe condition, in some cases it can do significant harm.

Causes of Swimmer's Ear

The infection of the bone of the ear is Mastoiditis. This may be an acute infection needing hospitalisation and injectable drugs or may be in the form of slow bone eroding processes like cholesteatoma.

Let us learn more about this condition and its treatment

Understanding the mastoid bone: The mastoid bone is made up of air sacs and it looks a lot like a sponge. In this sense, it is different from the other bones that can be found in the human body. In order to function properly, this bone requires air from the other parts of the ear, including the Eustachain Tube which connects the middle part of the ear with the portion that lies at the back of the throat. If this tube gets infected due to any reason, the infection and bacteria can also travel to the Mastoid bone, leading to an infection in this area. Another form of the infection starts from the ear drum and a slowly progressive bone eroding process starts which spreads into the air sacs and can potentially spread to the brain.

Symptoms: Acute mastoiditis will present with earache, ear discharge and onset of fever and chills, as well as redness and inflammation behind the ear. Pain in the ear may be experienced along with headaches and swelling that may be experienced behind the eyes. At the very earliest sign, these symptoms must be reported to an ENT or ear throat nose specialist so that the treatment can happen at the earliest. Chronic mastoiditis may be due to repeated infections and bone eroding cholesteatoma which presents with repeated episodes of ear discharge which may be foul smelling and may even have blood.

Diagnosis: The diagnosis is mostly made on ear examination and may involve imaging tests like a CT scan as well as an MRI scan of the head and the ear. A simple X-ray of the mastoids can help in detecting the severity of the infection, and it spread.

Treatment: After diagnosing the problem with imaging tests as well as a detailed ear examination, the doctor will usually start the treatment by admitting the patient in the hospital. Antibiotic medication will be administered through intravenous methods, after which oral antibiotics will be prescribed for many days after the patient has been discharged from the hospital. Surgery may be required if the infection has not cleared up even after the use of antibiotics and is also done in cases of bone erosion. This surgery will be done to drain the infected fluid from the ear and remove a part of this Mastoid bone. Complications like facial paralysis and vertigo need to be discussed with the surgeon before the surgery.

Acute Mastoiditis - Symptoms, Diagonisis & Treatment

BAHA Implant
Bone Anchored Hearing Aid (BAHA) is a device surgically implanted to help people suffering from a loss of hearing. Most conventional hearing aids transmit sound through air conduction. The BAHA device is suitable for conductive or mild-moderate mixed hearing loss.

Problems with hearing in the middle or outer ears can be helped with the BAHA device. The sound waves received by the BAHA device bypass the middle ear and get delivered straight to the functioning cochlea in both ears.

A BAHA device comprises of two parts:
a) The processor 
b) A fixture which is surgically implanted behind the ear in the bone.

The implant is embedded in the bone. The processor, which remains outside, is attached to the implant. There is a microphone on the processor that picks up sounds. The sounds are passed on to the implant. The implant vibrates which triggers the Cochlear. You can consider wearing a BAHA implant if other conventional hearing aids do not work for you. BAHA implants are also given to people with collapsed or irritated ear canals.

Cochlear Implant Surgery

A complex, small electronic device that helps hearing in people with severe hearing loss or deafness is used in the Cochlear Implant Surgery. The cochlear implant comprises of an external piece behind the ear and another piece that is surgically implanted under the skin. A cochlear implant comprises of four parts:
1. A microphone which picks up sounds from the surroundings
2. A speech processor which chooses and arranges the sounds the microphone picks up
3. A receiver/stimulator and transmitter that picks up signals from the speech processor and changes them into electric impulses
4. An electrode ray, a bunch of electrodes, receives impulses the stimulator sends and transmits them to different areas of the auditory nerves.
The implant does not cure deafness; it only gives you a useful portrayal of sounds in the environment and considerable aid in understanding speech.

The surgery is done in the following way:
i. The area around the site of the implant is shaved or cleaned
ii. The patient's vital signs are monitored through cables, patches and monitors attached to him or her
iii. General anaesthesia is administered through IV or through a face mask
iv. After the device is implanted, the patient is taken to the recovery room for the anaesthesia effect to lessen.

BAHA Implant and Cochlear Implant Surgery

Cotton swabs or cotton buds, are commonly used in our daily lifestyle. Many people use it for various purposes, such as make-up, bacterial culture, and most commonly for extracting wax and debris from the ear. Even though they are sometimes handy in our busy schedule, they usually cause much more harm than benefits.

How are they misused?
Cotton buds are toothpick like pieces made of wood, plastic, or rolled paper, which have cotton stuck at both ends with a roundish edge. It came into existence during the 1920s for a safe purpose of ear cleaning by Leo Gerstenzang, when he saw his wife cleaning their baby s ear with a toothpick. They are until now used by the general population for ear cleaning, but these hardly remove the outer debris which are stuck near the outer edges. Impressing it inside the ear canal only does further damage, by forcing the inner wax further inside Sometimes extensive force also causes damage to the ear drums.

How does it cause the damage?
Applying a tool like the cotton bud inside the ear with hands usually creates a force that impresses upon the eardrum, also accumulating the surrounding earwax to that area, resulting in impaction of the wax. The force applied most often, if not always, causes a damage to the ear drums, which might cause severe pain, also leading to leakage, causing improper balance, deafness, and certain similar abnormalities.

Alternative measures
Although we are worried about cleaning our ears, it doesn t really require our notice, since our usual showers allow an adequate quantity of water to enter the ears and clean the accumulated debris automatically. The structure, in which our ear canal is designed, is usually naturally assisting in cleaning up the unusual wax around the ear.

If there is an uncontrollable build up of earwax that is not cleaned off normally, you can always consult an ENT or any general physician and get it cleaned under medical surveillance, which is best advised.
Doctors and medical practitioners all around the world have been trying to spread the message of preventing the use of cotton buds for ear cleaning. It is important that the message reach the greater part of the population. Spread it to your family, your closest friends, their friends, and as further, you can reach!

Cotton Buds - Why You Must Not Use Them?

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