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Author: admin, 19.07.2015. Category: How To Stop Ringing In Ears Home Remedies

Children & Adults The ear canal tends to have a slight anterior bulge and it is usually easier to see the posterior part of the drum than the anterior part (Ill explain ant and post parts later). Quick recap of ear anatomy You can see that only the malleus is the only bone normally in direct contact with the eardrum. Almost too good to be true (but good for illustration) Books will show you a picture like this claiming this is what youll see in the normal eardrum. Normal The normal tympanic membrane should appear pearly grey with a light reflex generally concave and you should be able to make out the malleus Tip: If you can make out the malleus, then you can figure out whether something is worth worrying over by noting its relation to it. The malleus looks like an arm This is the same picture as before but Ive outlined the malleus. The malleus looks like an arm Heres the picture again just to make sure you can make out the arm. And yet another normal An annulus fibrosus or more commonly referred to as the eardrum margin. Glomus Tumour This small blurry red lesion at the tip of the malleus handle is a vascular lesion called a glomus tumour. Acute Otitis Media First describe what you see using the method I outline previously: Eardrum shape Eardrum colour Light reflex Anything that shouldnt be there You should have noticed Bulging eardrum (cant see the malleus well + margin isnt very clear + it looks bulging) Inflammation – looks red and there is an injection of blood vessels in the eardrum itself.
Eustachian Tube Dysfunction Okay, in all honesty, I didnt expect you to get the diagnosis here. Eustachian Tube Dysfunction Features Retracted eardrum – you can see the bones clearly Notes My ears have been popping for two weeks and occasionally hurt.
Eustachian Tube dysfunction Chronic blockage of the Eustachian tube is called Eustachian tube dysfunction. ETD & Children Young children (especially ages 1 to 6 years) are at particular risk because they have very narrow Eustachian tubes.
Cholesteatoma Features Pearl shaped sac or disc – yellow in colour Retracted ear drum (so you can see the anatomy easily) Notes Must not miss this one! Tympanosclerosis Features White patches on the eardrum Nothing else really Notes Deposition of calcium into the drum itself in response to trauma or infection This is not normally of any consequence unless it is severe, which can lead to a mild conductive hearing loss. Safe vs Unsafe Perforations You need to be able to distinguish between safe and unsafe perorations.

The canal may be partly straightened by pulling the pinna backwards and upwards during examination. The only bits you really should be able to label is 1 = pars flaccida (=attic) 5 = light reflex 6 = eardrum margin and treat 2,3 and 4 as the malleus. Shape of the eardrum – bulging or retracted Colour of the eardrum – red (infection), yellow (glue ear), brown (blood), presence of blood vessels (injected?) Light reflex present or not?
This represents a resolving middle ear effusion, as air gradually re-enters the middle ear. Recognising the retracted eardrum is important and this is how to do it: Mild retraction may be difficult to identify. In fact, the patient would come in complaining of his ears popping and sometimes pain and together with this picture, you should get the diagnosis. Treatment includes pinching your nose and blowing - this forces air up the tube and pops the ear drum back into place. The eustachian tube becomes congested and swollen so that it may temporarily close; this prevents air flow behind the ear drum and causes ear pressure, pain or popping just as you experience with altitude change when traveling on an airplane or an elevator. The problem occurs when the dead cells accumulate in the middle ear and can not be expelled.
In this picture, you should have notice the eardrum is retracted: Malleus clearly visible Margin clearly visible Looks sunken Do you know which ear it is? SAFE PERFORATIONS A safe perforation is exactly what it sounds like: a hole in the tympanic membrane. In infants pull the pinna more horizontally backwards as the shape of the ear canal is different.
So, when looking at a normal eardrum (which is partly translucent), you should be able to make out the malleus but its unlikely youll see anything else.
The impression the malleus makes on the eardrum looks like (to me) an arm – with an upper arm, a bent elbow, a forearm, and a blobby bit at the end like a hand.
Even if you cant quite clearly see the malleus, you can usually make out the elbow bit in the normal eardrum. This can occur when the lining of the nose becomes irritated and inflamed, narrowing the Eustachian tube opening or its passageway.

Since children in daycare are highly prone to getting upper respiratory tract infections, they tend to get more ear infections compared to children that are cared for at home. The main risk of safe perforations are that they may allow infection to enter the middle ear But there are rarely more serious sequelae. Um umbo - the end of the malleus handle and usually marks the centre of the drum Lr light reflex –is usually seen antero-inferioirly At Attic also known as pars flaccida. Anterior – this is the area the elbow is point towards Posterior – this is the area opposite the elbow. Interestingly, the anatomy of the Eustachian tube in infants and young children is different than in adults. As this ball of dead cells accumulates it produces enzymes which cause the destruction of bone. Eardrum colour – nothing to say really ?okay You might think there is an injection of blood vessels, but what your looking at is blood vessels in the ear canal NOT on the eardrum (compare with previous pic if you dont believe me). If you can see these other things, it is likely the eardrum is not normal but retracted (more about that later) This eardrum is not normal, its retracted. There is another EASIER way you can figure out whether something is in the anterior or posterior segment. Other abnormalities – presence of fluid levels and bubbles In summary, what is a non red bulging eardrum with fluid?
Thus, bottle-feeding should be performed with the infants head elevated, in order to reduce the risk of milk entering the middle ear space. When youre looking down an earhole, just figure out whether the lesion is at the face end of the patient or not. The horizontal course of the Eustachian tube also permits easy transfer of bacteria from the nose to the middle ear space. The clever ones amongst you will have figured out that the picture above is in fact the right ear drum.

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