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  E N T (Ear Nose & Throat)

october 2012
Hear! Hear! Before It’s Too Late…
Dr Anita Krishnan
While most of us know that loud noise can damage the ears, very few of us are aware that a host of other situations too can affect the delicate mechanism that makes hearing possible. Foreign objects or sudden blows can damage the eardrum, resulting in temporary, or in some cases, permanent loss of hearing.

Causes And Prevention Of Ear Damage

Inserting Objects: One of the most common causes of ruptured eardrum and other ear damage is putting an object into the ear. All too often, people use the earbud in an attempt to completely clean the wax, or to relieve an itch. Most of the time it’s best to just Before It’s Too Late… leave earwax alone. It’s in your ear for a good reason: to trap dust, bacteria, and other particles that might cause injury, irritation, or infection.
  • Refrain from using buds. Ears are self-cleaning for the most part.
  • Jaw movements, when you eat and talk, eventually push wax to the outer ear, where you can easily remove it by wiping with a damp piece of cotton.
  • If earwax is truly bothering you, have a doctor remove it for you.
  • Steer clear of using over-the-counter drops to soften wax until you check with a doctor. If the problem is something other than earwax, the drops may exacerbate it.
The old folk wisdom about not putting anything in your ear smaller than an elbow, though exaggerated, isn’t such bad advice!

Loud Noise: Loud noise can harm hearing by damaging the sensitive, tiny hair cells in the inner ear. Certain conditions can make these hair cells even more sensitive than usual. During aerobic exercise our blood diverts from our ears to our legs, arms, and heart. This altered blood flow makes the hair cells more vulnerable to noise. Thus, many fitness experts warn that you double your risk of permanent hearing loss when you jog while wearing headphones with loud music, or dance to blaring music at a rock concert.

The solution is obvious: Stop the noise and use protective devices including acoustic earplugs or muffs.

Swimmer’s Ear (Otitis Externa)

This condition can crop up when bacteria nestle in the outer ear canal that is warm and moist. Being in the water a lot also tends to wash away the natural oily, waxy substance that normally lines and protects the ear canal. Bacteria can then get the upper hand, and cause infection. Water can also be left over in your ear after taking a shower. Poking around with a bobby pin or cotton-tipped swab can scratch the delicate skin in the ear canal and break down the barrier against bacteria, resulting in an outer ear canal infection also called otitis externa. Resist the urge to scratch; that will make the problem worse. To prevent infection:
  • Don’t let the water sit in your ear.
  • Shake the water out after a shower or swim.
  • The best way to dry the ear is to roll the corner of a soft cotton handkerchief and use it to mop the canal.
Middle Ear Infection (Otitis Media)
Middle-ear infection (known medically as otitis media) is the most common illness in babies and young children. The outer ear is connected to an aircontaining space called the middle ear. The air pressure in the middle ear is equalized more than one thousand times a day, every time you swallow, through the eustachian tube, which also carries fluid away from the middle ear.

Due to a cold or an allergy, the eustachian tube swells and air isabsorbed by the lining of the middle ear, creating a partial vacuum, and fluid seeps from the lining of the middle ear. Bacteria or viruses infect the stagnant, warm fluid in the middle ear. To prevent infection:
  • Keep your child away from other kids who have infections.
  • Take care of nasal allergies and teach your child to blow the nose gently.
  • Do not expose your child to cigarette smoke.
  • Avoid giving a bottle of milk or formula to a baby who is lying on his or her back, because the nutrient-rich liquid can flow into the eustachian tube during swallowing and pool there, creating a breeding ground for infectious organisms. Prop the child’s head up on pillows.
Earphones, Headphones and Cellphones!
Sounds over 140dB can cause pain, and prolonged exposure to noise over 85-90dB can result in permanent hearing loss. There are certain preliminary studies that say that people who use cellphones for more than an hour can develop hearing loss in the long term.
If you experience fullness or warmth in the ear where the phone is constantly used, it is probably time for a checkup with your doctor!
Dr Anita Krishnan is ENT Consultant, Apollo Hospitals, Bangalore.