ENT
Hearing Loss: Types, Causes, Testing and Treatment
Hearing loss may develop gradually or suddenly and may affect one or both ears. The main types are conductive hearing loss, caused by problems in the outer or middle ear; sensorineural hearing loss, caused by damage in the inner ear or hearing nerve; and mixed hearing loss, which combines both.
Conductive causes include earwax blockage, fluid behind the eardrum, ear infection, a perforated eardrum and problems with the small middle-ear bones. Sensorineural causes include ageing, repeated loud-noise exposure, certain medicines, genetic conditions, head injury and inner-ear disorders.
Signs include difficulty following conversation, asking people to repeat themselves, increasing television volume, struggling in noisy places, tinnitus, delayed speech in children or reduced response to sound. Hearing loss that develops suddenly over hours or a few days requires urgent ENT assessment because early treatment may improve the chance of recovery in selected cases.
Evaluation usually includes an ear examination and a formal hearing test performed by an audiologist. Tests help identify the degree and type of hearing loss. Additional tests or imaging may be requested depending on the pattern and associated symptoms.
Treatment depends on the cause. Wax, infection or middle-ear fluid may be managed medically or procedurally. Permanent hearing loss may be supported with hearing aids, assistive devices, communication strategies or implantable hearing devices in selected patients. Children should be assessed promptly because hearing is important for speech, language and learning.
Protecting hearing includes using suitable hearing protection around loud sound, keeping personal audio at safe levels and obtaining testing when changes are noticed.
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Ear Infections: Types, Symptoms and Treatment
Ear infections can affect the ear canal, middle ear or, less commonly, inner ear. Outer-ear infection, often called swimmer’s ear, affects the canal and may cause pain when the outer ear is touched, itching, swelling and discharge. Middle-ear infection occurs behind the eardrum and is especially common in children after colds. It may cause ear pain, fever, irritability, reduced hearing or fluid leaking if the eardrum perforates.
Diagnosis requires examination of the ear. Treatment depends on the location, cause, age and severity. Outer-ear infections are commonly treated with prescribed ear drops and keeping the ear dry. Middle-ear infections may improve without antibiotics in selected cases, while antibiotics are recommended when clinical criteria indicate bacterial infection or increased risk. Pain relief and hydration remain important.
Do not insert cotton buds, oils or unprescribed drops into a painful or draining ear. Drops may be unsafe if the eardrum is perforated, unless specifically selected by a clinician.
Medical assessment is recommended for severe pain, persistent fever, discharge, swelling behind the ear, dizziness, facial weakness or significant hearing reduction. Infants, people with diabetes, immune suppression or previous ear surgery may need earlier assessment. Repeated infections or persistent middle-ear fluid can affect hearing and may require ENT and audiology review.
Prevention includes avoiding trauma from ear cleaning, drying the outer ear gently after swimming and keeping vaccinations up to date. Children exposed to tobacco smoke have a higher risk of middle-ear problems.
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Swimmer’s Ear: Symptoms, Treatment and Prevention
Swimmer’s ear, or acute otitis externa, is inflammation or infection of the outer ear canal. Water that remains in the canal can soften the skin and allow bacteria or fungi to grow, but the condition can also follow scratching, cotton-bud use, hearing devices or skin disorders.
Symptoms commonly include ear pain, especially when the outer ear or tragus is touched, itching, redness, swelling, discharge and a blocked sensation. Marked swelling may temporarily reduce hearing.
Diagnosis is made by examining the canal and eardrum. Treatment usually involves prescribed ear drops selected according to the condition of the eardrum and suspected infection. The canal may need gentle cleaning so the medicine can reach the affected skin. A wick may be placed when swelling is severe. Oral antibiotics are not routinely needed unless infection has spread beyond the canal or the patient has additional risk factors.
During treatment, keep the ear dry and avoid swimming, earbuds and inserting objects. Do not use home mixtures or unprescribed drops when the eardrum’s condition is unknown. Pain should begin to improve after appropriate treatment, but the full course should be completed as directed.
Seek early care for severe pain, fever, swelling spreading around the ear, facial weakness or symptoms in a person with diabetes or reduced immunity. Prevention includes drying the outer ear gently after swimming, avoiding trauma from cleaning and discussing preventive drops with a clinician when infections repeatedly follow water exposure. Earplugs should fit correctly and should not irritate the canal.
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