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Hearing problems
Written By: Dr Ibrahim Issa MD. Otolaryngology Consultant , Laryngologist & Phonosurgeon.
Edited By: Dr Mohammad Murad MD. Otolaryngology Specialist.
Hearing is among the most important senses we are very lucky and gifted to have, any change in hearing abilities will cause major social, educational, and personal negative impacts on patients.
To have normal hearing; sound should reach the ear, go through the ear canal to the ear drum, the sound will get amplified by the drum and transmitted to the middle ear cavity, where the small middle ear bones (the ossicles) will amplify and transmit the sound to the cochlea of the inner ear, the cochlea will receive the sound signals and will transform them to electrical signals that will be transmitted to the brain through the hearing nerve.
Any defect in this process might cause problems in hearing;
* Any block of the ear canal by wax, cotton buds, foreign bodies, tumors, or inflammation will decrease hearing, and removal of the blocking factor will get hearing back simply.
* A perforation or stiffness of the ear drum will restrict its ability to move and transmit sound, and so will cause hearing problem, then a surgery might be needed to correct this perforation by a graft.
* Any problem in the ossicles (the middle ear bones) like dislocation or stiffness of the joints or erosion due to chronic inflammation will decrease their conducting and amplifying abilities, this is usually caused by trauma or autoimmune diseases and usually needs surgery to be fixed.
* Very commonly, abnormal ventilation of the middle ear cavity due to block of the conducting tube between the middle ear and the nose (the Eustachian tube) will cause accumulation of fluid in the middle ear and will restrict the range of ear drum and ossicles’ movement, a problem that happens commonly due to nose block and people manifest it usually with any change in the pressure like while landing in a flight, this can be temporary or chronic, and treatment includes treating the cause of nose block, but if it gets prolonged it might need removal of the fluid and inserting a small tiny tube in the ear drum to ventilate the middle ear. Sometimes, a mass can occupy the middle ear cavity and cause erosion and restriction of the ossicles, usually such a problem will need surgery to treat.
Generally speaking, when previously listed problems cause decrease in hearing the hearing is usually reversible by the treatment because the problem is in the conducting mechanism.
* But if a problem occurred in the sensory receptors of the cochlea, the nerve or the brain, the problem is most likely permanent then, and the treatment could include hearing aids, cochlear implants or other hearing assisting surgeries and devices. Problems in these areas might be congenital or acquired, might be related to use of specific drugs, exposure to some infections, exposure to loud sounds, or simply getting older.
Written By: Dr Ibrahim Issa MD. Otolaryngology Consultant , Laryngologist & Phonosurgeon.
Edited By: Dr Mohammad Murad MD. Otolaryngology Specialist.
