Middle and Inner Ear Disorders

 

The middle ear consists of the eardrum (tym­panic membrane) and an air-filled chamber con­taining a chain of three bones (ossicles) that con­nect the eardrum to the inner ear. The fluid-filled inner ear (labyrinth) consists of two major parts: the cochlea (the organ of hearing) and the semi­circular canals (the organ of balance). Middle and inner ear disorders produce many of the same symptoms, and a disorder of the middle ear may affect the inner ear and vice versa.

Middle ear disorders produce symptoms such as discomfort, pain, and a sense of fullness or pressure in the ear, as well as a discharge of fluid or pus, hearing loss, tinnitus (noise in the ear), and vertigo (a whirling sensation). These symp­toms may be caused by an infection, injury, or pressure in the middle ear resulting from a blocked eustachian tube (the tube that connects the middle ear and back of the nose). When an infection is the cause, additional symptoms such as fever and weakness may affect the whole body.

Inner ear disorders produce symptoms such as hearing loss, vertigo, tinnitus, and congestion. These disorders can have many causes, such as infection, injury, tumors, and drugs; sometimes the cause is unknown.

Text A. Acute Otitis Media

 

Acute otitis media is a bacterial or viral infection of the middle ear.

Although this disorder can develop in people of all ages, it's most common in young children particularly those between the ages of 3 months and 3 years. Usually, this disorder develops as a complication of the common cold. Viruses or bac­teria from the throat can reach the middle ear through the eustachian tube or occasionally through the bloodstream. Viral otitis media is usually followed by bacterial otitis media.

Symptoms

Usually, the first symptom is a persistent, se­vere earache. Temporary hearing loss may occur. Young children may have nausea, vomiting, diar­rhea, and a temperature of up to 105 F. The ear­drum becomes inflamed and may bulge. If the ear­drum ruptures, discharge from the ear may be bloody at first, then change to clear fluid and fi­nally to pus.

Serious complications include infections of the surrounding bone (mastoiditis or petrositis), infection of the semicircular canals (labyrinthitis), paralysis of the face, hearing loss, inflammation of the covering of the brain (meningitis), and brain abscess. Signs of an impending complica­tion include a headache, sudden profound hear­ing loss, vertigo, and chills and fever.

Diagnosis and Treatment

A doctor examines the ear to make a diagnosis. If pus or some other discharge is draining from the ear, a sample is sent to a laboratory and ex­amined to identify the organism causing the infec­tion.

The infection is treated with antibiotics given by mouth. Amoxicillin is often the first choice of antibiotics for people of all ages, but penicillin in large doses may be prescribed for adults. Other antibiotics can also be used. Taking cold medi­cations containing phenylephrine can help keep the eustachian tube open, and antihistamines are useful to people who have allergies. If a person has severe or persistent pain, fever, vomiting, or diarrhea, or if the eardrum is bulging, a doctor may perform a myringotomy, in which an opening is made through the eardrum to allow fluid to drain from the middle ear. The opening, which doesn't affect hearing, heals on its own.

Notes:

air-filled воздушный

tinnitus звон в ушах

draining дренирование

Text B. Earache

An earache is a pain that originates or appears to originate in the outer or middle ear. Earaches may result from inflamma­tion caused by infections or from tumors or other growths in the outer or middle ear. Even a mild inflammation of the outer ear canal can be very painful, and inflammation of the external ear's cartilage (perichondri­tis) can produce severe pain and tender­ness.

Infection of the middle ear (otitis media), the most common cause of earaches in children, produces painful inflammation. Blockage of the eustachian tube leads to pressure in the middle ear, putting pressure on the eardrum, which results in pain. Rapid pressure changes during an airplane flight cause a transient version of this type of earache; swallowing relieves the pressure and pain.

Pain that feels like an earache may actu­ally come from a nearby structure that shares the same nerves to the brain; this type of pain is called referred pain. Struc­tures that share nerves with the ear include the nose, sinuses, teeth, gums, jaw joint (temporomandibular joint), tongue, tonsils, throat (pharynx), voice box (larynx), wind­pipe (trachea), esophagus, and salivary glands in the cheek (parotid glands). Often, the first symptom of cancer in any of these structures is pain that feels like an earache.

Treatment depends on the cause of the pain. Otitis media is treated with antibiotics to prevent the infection from becoming seri­ous. If the ear doesn't seem to be affected, a doctor examines the structures that share nerves with the ear and treats them as needed. Analgesics such as acetamino­phen can reduce the pain.

Note:

swallowing глотание, глотательный