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Another less common result of recurrent ear infections is cholesteatoma which results from abnormal migration of the eardrum skin into the middle ear and area behind the ear called the mastoid.
Both chronic otitis media and cholesteatoma usually require surgical management in addition to medical treatment. Cholesteatoma is a difficult problem to cure and there is a substantial risk of the disease occurring again. There are two general types of hearing loss: Conductive hearing loss and Sensorineural hearing loss. Conductive hearing loss is caused by any disruption in the passage of sound from the external ear via the middle ear to the oval window.  Possible causes are impacted wax,  tympanic membrane perforation, otitis media, middle ear effusion, ossicle problems including otosclerosis. As far as possible, a brief case history was taken to ascertain the possible cause of hearing loss. A total of six thousand, four hundred and twenty-eight hearing-impaired patients aged 680 years were identified from 1999 through 2004. As can be seen in Table I, out of a total number of 6,428 patients seen, 5,734 (89.9%) were diagnosed as having hearing-impairment (>25dB).
The proportion of hearing-impaired people in different age and sex categories for two degrees of severity is shown in Table 2. The major causes of sensorineural hearing loss are Noise, Fever, Presbycusis, Sickness, Meningitis, Mumps, Meniere’s disease with 24% unknown, (Table 5). A total of 6,428 patients within the age range of 6 to > 80 years who reported with hearing problems were seen. Studies of this nature normally report on the prevalence of hearing-impairment among the general population as was reported in several studies in Britain [14], Italy [3], Australia [4] and Sweden [5].

The present study has shown that there were more women who reported with hearing problems than men. It is thought that malaria infection may cause deafness either by local action or by microvascular changes in the end arteries of the coclear or in a general way by lowering resistance to diseases and thus enhancing the effects of other infections [6]. The present study was on the number of patients who reported to the Ear, Nose and Throat clinic at KATH with hearing problems. We are grateful to the Ponto-Pidden Moller Foundation for the supply of the necessary equipment for the Audiological Evaluation and Ms Ruth Owusu-Ansah our Secretary.
To enhance your browsing experience, please upgrade to a more current browser such as Firefox, Safari or update to The Latest Internet Explorer version. Type of hearing loss was determined according to Cahart [10] as Conductive, Sensorineural and Mixed Hearing Loss. With regard to mild hearing-impairment it can be seen that there is a slight preponderance of women over men at all age ranges except the 46 – 65 age band where the number of men with a mild hearing loss were slightly higher. Again, the Causes of conductive hearing loss among the patients studied are wax, foreign bodies, Otitis Media, Eustachian tube malfunction, trauma, otitis externa etc. We could not report the prevalence estimates for the generalisation of our findings, since data were generated in the hospital setting. Even though it was not a population based data, it gives us an idea about hearing problems in Ghana, and the need for resources in the health care system to address the problems. Report on the first informal consultation on future programme developments for prevention of hearing impairment.
Without proper treatment, serious complications such as acute mastoid infection or brain infection may result.

If the hearing bones (ossicles) are damaged, they can usually be repaired at the same time. We also found that the 6,428 patients seen for assessment constitute 8% of the total number of the seventy-five thousand, seven hundred and forty (75,740) outpatients seen at the Ear, Nose and Throat clinic at KATH, during the period under investigation. The same pattern was observed with people with mild-moderate hearing loss with more females having this severity of hearingimpairment across all age bands except in the 6-25 age range where men were slightly more than females. The infection is usually treated with antibiotic ear drops, but surgery is usually needed to remove the cholesteatoma permanently. In cases of cholesteatoma, a second surgery may be needed several months later to complete the hearing reconstruction. Mixed hearing loss was due to mainly a long standing Otitis Media, trauma due to accidents or slaps on the ear.
Most patients will need to keep water out of the ear with ear plugs or a cotton ball with Vaseline. Uimonen [13] discussed fully the advantages and disadvantages of the four frequencies and other approaches for determining the presence of hearingimpairment and rehabilitation resources, and concluded that the four-frequency formula is more appropriate. Another feature is that, the total number of patients with sensorineural hearing loss is greater than the total number of patients with other types of hearing loss (Conductive and Mixed) at higher ages.

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