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Diseases & Abnormalities

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Hearing loss can happen for many reasons. Some people may be born with hearing loss while others may lose their hearing slowly over time.  There are diseases, infections and cancers that affect specific parts of the ear and can lead to hearing loss in children and adults. 

Approximately 36 million American adults report some degree of hearing loss.  Consider these facts:

  • About 2 to 3 out of every 1,000 children in the United States are born deaf or with hearing loss.
  • Nine out of every 10 children who are born deaf are born to parents who can hear.
  • One in three people older than 60 and half of those older than 85 have hearing loss.

 

Cancers of the Ear

Cancers of the ear usually occur on the skin of the outer ear. Cancers of the ear can develop inside the ear too, but these are very rare.  There are different types of cancers (carcinomas and melanomas) that can affect the ear.  Most ear cancers are squamous cell carcinoma on the outer ear, but basal cell carcinoma and malignant melanoma can also occur inside the ear.

Cancer of the Outer Ear

Symptoms:
A scabbed area of skin that is jagged and irregular with crusting and oozing—usually on the upper edge of the outer part of the ear.  This area may be present for many years and may or may not be associated with a swelling or lump in the neck.

Cause: Long periods of time in the sun

Treatment for people with small cancers of the skin of the ear includes surgery to remove the affected area.  Often no further treatment is required, especially if the cancer is confined to the outer edge of the ear.

Cancer of the Auditory Canal

Symptoms: 

  • Discharge from the ear canal, often tinged with blood
  • Hearing loss
  • Sometimes facial paralysis on the side of the affected ear
  • Earache


Cause: Unknown—but may be more common in adults with long history of outer ear infections.

Treatment for people with cancer of the auditory cancel includes surgery to remove parts of the middle ear.
 

Cancer of the Middle Ear

Symptoms:

  • Discharge from ear for long period of time
  • Recent blood stained discharge
  • Hearing loss
  • Sometimes facial paralysis


Cause: Unknown—but may be more common in adults with history of discharge from ears for long periods of time.

Treatment of people with cancer of the middle ear includes surgery and radiation, which targets rays of energy at small areas of cancer cells that might not have been removed during surgery. 

Otosclerosis

Otosclerosis is the buildup of spongy or bone-like tissue in the middle ear that prevents the ossicles, namely the stapes in the middle ear, from working properly.  The impaired movement and function reduces the sound that actually reaches the ear. Otosclerosis usually results in conductive hearing loss, a hearing loss caused by a problem in the outer or middle ear.  

If the buildup of tissue spreads to the inner ear, it is called Cochlear Otosclerosis.  This can cause permanent sensorineural hearing impairment due to interference with how the nerves in this part of the ear work. 

Scientists aren’t sure about the exact cause but there is some research suggesting a relationship between otosclerosis and the hormonal changes associated with pregnancy and also with viruses.

Treatment for people who are diagnosed with otosclerosis depends on the extent of hearing loss and may include surgery to replace some or all of the ossicles with artificial ones. It is important to discuss the risks and possible complications of this and any procedure, as well as the benefits, with a doctor and a surgeon.

If the hearing loss is mild, surgery may not be an option but a properly fitted hearing aid may help some people with otosclerosis. A hearing aid is designed to compensate for a hearing loss by amplifying sound.

Ménière's disease 

Ménière's disease affects the inner ear and the vestibular system, which is the system that helps to maintain balance. In this disease, a part of the cochlea called the organ of Corti becomes swollen, leading to a loss of hearing that may come and go over time. It can also cause severe dizziness, lack of balance, tinnitus (ringing/buzzing sound in the ears), ear pain, and pressure. The disease can exist in mild or severe forms.

Approximately 615,000 individuals have been diagnosed with Ménière's disease in the United States. Another 45,500 are newly diagnosed each year. Diagnosis is based on symptoms and results of hearing tests. Unfortunately, doctors don’t know what causes Ménière's disease, and there is no cure. Researchers think that it may have to do with fluid levels in the inner ear.

Treatment for people with Ménière's disease includes medicines to help control dizziness and fluid retention in the body, and devices that deliver air pulses to the middle ear. Surgery may also be required. Estimates suggest that 6 out of 10 people will get better on their own or can control the symptoms with diet, drugs, or devices.  

Ear Infections

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Germs such as bacteria and viruses can get into the ear and cause an infection. In particular, the middle ear cavity behind the eardrum can fill up with fluid. Treatment may include managing the pain and taking antibiotics, which are medications that fight infections. Ongoing fluids in the middle ear and ongoing infections over time may cause hearing problems or other difficulties.

Otitis Media

Infections of the middle ear are one of the most common reasons for children to see a doctor. Three out of 4 children experience ear infection (otitis media) by the time they are 3 years old. Children are more likely to have ear infections like otitis media that come from bacteria or viruses than adults because of their developing ear anatomy. The middle ear is connected to the back of the nose by the auditory tube (also called the eustachian tube) and its location allows easier access to germs. This may lead to a buildup of fluid and pressure, painful infections, and even hearing loss. Infections in children can affect early speech and language development.  

If the infection is due to bacteria, treatment is possible with antibiotics but if the infection is viral, antibiotics won’t work. Surgery is another treatment option, especially for children with ongoing infections. Small tubes placed inside of childrens' ears help fluid drainage and relieve pressure in the ears so that hearing improves.

Chronic otitis media can affect adults, too. It is a long-lasting middle ear infection that can damage the ossicles (middle ear bones), and even lead to a perforation in the eardrum. Perforations can heal but when a chronic infection is present this is less likely and hearing loss can occur.

If you're experiencing hearing difficulties and aren't sure where to turn, schedule a consultation with your local hearing healthcare professional.

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