SAFE EAR

By virtue of its anatomical position on the base of the skull, the ear maintains multiple direct and indirect connections to the brain. Any infective and non-infective disease arising in the ear is at risk of travelling to the brain. Infections of the outer ear and in the particular middle ear are often treated promptly to avoid such complications. Acute bacterial infections respond to oral antibiotics. However, urgent ear surgery may be indicated when we suspect complications of untreated or non-responsive middle ear infections. These can include:

Acutely

• hearing loss

• perforations of the drum

• mastoiditis

• facial paralysis

• inner ear infections

  • leading to severe permanent hearing loss and balance dysfunction

• meningitis and brain abscesses.

Chronic complications

• glue ear formation

• damage and retractions of the drum

• cholesteatoma formation, spread, erosion of hearing bones, invade the dura/brain

DRY EAR

Wet and weeping ears may arise from non healed perforations, that are prone to infection/inflammation. This is often due to a persisting perforation that becomes irritated by moisture and super-infections. More concerningly, the skin from the outer layer of the eardrum may retract into the middle ear and become a skin sac (cholesteatoma). This causes chronic reactive inflammation resulting in wet malodorous ears. They are typically painless, but can lead to slow erosive complications that affect hearing, balance, facial nerve function, and potentially lead to intra-cranial life-threatening complications.

HEARING RESTORATION

Surgical treatment for hearing loss conventionally includes:

• Grommets/temporary ventilating tube

• Tympanoplasty surgery to repair eardrum perforation or unsafe retractions

• Middle ear exploration and ossicular chain reconstruction

• Stapedectomy (in cases of otosclerosis)

Hearing beyond traditional surgery and hearing aids:

• Cochlear implants

• Middle ear implants

• Bone anchored hearing implants