Middle ear infections occur in the cavity behind the eardrum. The middle ear cavity is connected to the nose through a drainage system called the “Eustachian tube”. Dysfunction of this drainage system can lead to pressure, discomfort, hearing loss, and numerous other uncomfortable symptoms.

If the drainage system does not function properly due to inflammation inside the nose, (from a cold, allergies, tobacco-smoke exposure, enlarged adenoids, etc.); fluid can get trapped behind the eardrum creating a reservoir in which an infection can form. Although ear infections tend to be more common during childhood, they can appear at any age. With recurrent infections, hearing can be affected which can disrupt the proper development of speech and language.

A battery of tests may be necessary to ensure the hearing is intact. If middle ear issues persist, a hole may form in the eardrum which is called a perforation. In order to treat the middle ear, various medications may need to be used to treat the root of the problem. Hearing and allergy testing may also need to be performed. If conservative therapy fails, a drainage tube may need to be surgically placed into the tympanic membrane to help drain the middle ear (bypassing the Eustachian tube).

If a hole in the eardrum does not naturally heal, or the bones surrounding the ear become chronically infected, surgery may be required to repair the hole and clear out the infected bone.

If the above ailments do not resolve the ear pain. The source may be from neighboring anatomy. A common culprit is a jaw joint. Mild arthritis in the joint can cause excruciating ear pain. A soft diet, warm compresses, a bite guard, anti-inflammatory and muscle relaxants are sometimes needed to help alleviate the pain.

Inner ear ailments typically involve the balance and hearing nerves and sensors. This can produce dizziness, ringing in the ears and hearing problems. If an inner ear issue is diagnosed, various tests (hearing test, VNG, MRI, etc.) may be necessary to rule out more serious medical problems.

If damage to the inner ear results in hearing loss, this may be irreversible. It is imperative that we take the proper steps to augment hearing with hearing aids to avoid possible changes to the brain that may affect our cognition and ability to process information. In regards to dizziness, it is very important to rule out any underlying neurological issues.

The brain uses our eyes, our limbs, and our inner ear to calculate balance if any of these systems are not fully functioning, dizziness may occur. Typically, an MRI is performed to better visualize the brain anatomy and rule out tumors and other neurological issues. In those with normal MRIs, other ailments may be the source of the dizziness. For instance, crystalline structures that reside in the inner ear may get dislodged and be the source of the dizziness in a condition called Benign Paroxysmal Positional Vertigo.

In others, problems with the inner ear can result in a cluster of symptoms (dizziness, tinnitus, the fullness of ears, hearing loss) by the name of Meniere’s. Damage to the inner ear can also result in a phantom noise that seems to come from within the ear. This is called tinnitus and is often described as ringing, swooshing, or buzzing. Tinnitus is rarely serious. On occasion, tinnitus may simply go away; however, if there is a history of hearing loss, tinnitus may be permanent.

Some conditions associated with tinnitus include Hearing loss, Meniere’s disease, middle ear infections, Otosclerosis (fixation of middle ear bones), Vestibular Schwannomas (small, rare, benign tumor of the acoustic nerve). When tinnitus is caused by an obvious problem such as a blockage in the ear canal or a middle ear infection, it can be treated. However, in most cases, the cause is unknown or related to hearing loss. In these situations, hearing devices (i.e., hearing aids or maskers) or Tinnitus Retraining Therapy (techniques that decrease the perception of tinnitus until it becomes a neutral sound) may help make the symptoms more manageable.