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Author: admin, 17.03.2016
Ear infections occur behind the ear drum in the middle ear space and cause a conductive hearing loss. Getting Technical with Ear Infection and Hearing Loss:  How Exactly Sound is blocked when an ear infection causes fluid buildup? The ear drum vibrates in response, which sets the middle ear bones (malleus, incus, and stapes) into motion. The stapes press against a window in the cochlea which causes stimulation of hair cells sending a signal up the auditory nerve and into the brain to process the sound.
When fluid or infection is present in the middle ear, sound cannot appropriately travel through the system causing the conductive hearing loss. A conductive hearing loss means the inner ear (cochlea and nerve of hearing) are functioning normally and the hearing loss is a result of the infection sitting in the middle ear space. Hearing back to normal:  Once the fluid and infection are cleared out, hearing will more than likely return to normal.
Historically, patients have generally had excessive ear wax or embedded ear wax removed using syringing or candling.
Binocular glasses and suction is used by trained audiologists to clean your ear canal and remove wax. The audiologist will wear binocular glasses ?tted with a bright light to see your ear canal up close.
Ear suction is carried out with a small sucker attached to a low-pressure suction machine that works like a gentle vacuum cleaner.
Servicing Abbotsford, Drummoyne, Canada Bay, Five Dock, Concord, Cabarita, Ryde, Balmain, East Ryde, Rozelle, Gladesville, Rodd Point, Hunters Hill, Lane Cove, Riverview, Longueville, Birchgrove, Chiswick, Woolwich, North Ryde, Pyrmont, Haberfield, West Ryde, Rodd Point, Putney, Denistone, Meadowbank, Glebe, Forest Lodge, Stanmore, Camperdown, Leichhardt, Croydon, West Pennant Hills, Beecroft, Cheltenham, Carlingford, North Rocks, Parramatta, Epping, Cherrybrook, Castle Hills, Dural, Round Corner, Galston, Baulkham Hills, Kellyville, Pennant Hills, Wahroonga, Thornleigh, Normanhurst, Hornsby & Asquith. Mr Neel Raithatha is a private ear wax removal specialist in Leicester and co-founder of CLEARWAX which provides national training for ear professionals in performing the latest Endoscopic Ear Wax Removal procedure, including Endoscopic Ear Suction (i.e. Similarly to Microsuction, Endoscopic Ear Wax Removal is a ‘dry’ technique requiring no water being pumped into the ear like when having ear syringing or ear irrigation performed. Depending upon the type (hard or soft) and amount (occluding or semi-occluding) of ear wax the entire procedure should take no longer than 10-15 minutes to perform per ear. To learn more about ear wax, its causes, symptoms and treatments please select from the below tabs.
Ear wax cleans the ear canal by trapping and capturing dead skin (keratin), small foreign objects (e.g. Ear wax lubricates the layer of skin lining the ear canal preventing it from drying out and becoming cracked. In most people ear wax will naturally migrate outwards of the ear canal and fallout taking with it any debris it has collected. There are many over-the-counter ear wax drops that are available at your local pharmacy to help soften, loosen and sometimes even dissolve the ear wax.
After applying the ear wax drops the affected ear needs to be facing upwards for around 5 to 10 minutes to allow the ear wax drops to enter the ear canal and penetrate the ear wax to soften and loosen it.
Up until recently, ear syringing (or irrigation) was the standard and conventional method used to remove ear wax (if using ear wax drops was not successful) and clear blocked ears. There is a growing reluctance amongst GPs and practice nurses, however, to perform ear syringing due to the obvious clinical risks involved. It is important to note that ear syringing should under no circumstances be performed in individuals with a known perforation, cleft palate, foreign object in the ear canal, and mastoid cavity following a mastoidectomy. The use of microsuction to remove ear wax and clear a blocked ear is generally performed in hospital outpatient’s clinics by ENT doctors and ENT nurses if all other ear wax removal treatments have either proven to be unsuccessful or unsuitable.
As mentioned earlier, microsuction is generally performed by ENT doctors and ENT nurses using expensive and large ENT binocular operating microscopes in hospital outpatient’s department.
Similarly to microsuction, endoscopic ear wax removal can be noisy and there is a very small risk, as with all other ear wax removal treatments, that some people may report tinnitus or increased tinnitus if they already experienced it pre- ear wax removal.
Serous otitis media, better known as middle ear fluid, is the most common condition causing hearing loss in children. Because children need hearing to learn speech, hearing loss from fluid in the middle ear can result in speech delay. Since the words sound distorted to the child, pronunciation of these words by the child will also be distorted.
Additional antibiotics may be prescribed, if fluid is still present at the follow-up visit. Other tests should be taken in addition to the hearing tests: impedance tympanometry, better known as a tympanogram, should be obtained to measure the movement of the eardrum when pressure is applied to it. After the specialist confirms that fluid is present behind both eardrums, further medical treatment is often advised. Surgery which drains fluid involves a small incision in the eardrum, so that the fluid can be gently removed and a tube can be inserted. The procedure, medically termed a myringotomy and tubes, or tympanostomy and tubes, is performed on children under general anesthesia. In addition to the insertion of a longer lasting tube, a careful search for underlying causes of Eustachian tube function should be sought, particularly in a child who has recurrent infections and requires a second set of tubes. One way of estimating the size of the adenoids is to obtain a soft tissue X-ray of the back of the nose, called a nasopharyngeal X-ray.
Research indicates that, in children with persistent ear infections and fluid problems, an adenoidectomy at the time of tube insertion may improve Eustachian tube function. Most children will eventually outgrow their problems with fluid by late adolescence or the early teens.
Short term complications from the insertion of tubes, such as a minor ear infection, can generally be cleared up with antibiotics and drops.
If a child has had tubes in place for six months, and suddenly the ear begins to drain, this may indicate a cold, or entry of water in the ear. If there appears to be a polyp around the base of the tube, it should be removed if possible, or the tube itself should be taken out. Some ear, nose and throat specialists advocate removing the tubes in the operating room, and patching the eardrum at the time of removal.
When tubes fall out or are rejected spontaneously, the eardrum almost always heals behind the tube. The proportion of permanent perforations increases directly with the number of tubes inserted in the past and the length that the current tube is left in position. There are instances, after the tube has fallen out or is removed, when the drum may not heal without surgical intervention.
Before performing surgery, there should be reasonable expectation that the fluid problems have been cleared and that the patient is beyond the age of having Eustachian tube problems: the so- called maturity of Eustachian tube function. If the opposite ear has persistent infections and fluid problems, it may be advisable to deter the repair of the perforated eardrum until the opposite ear clears fluid and appears to have matured its Eustachian tube function.
One significant exception to this situation would be if the perforation is marginal, at the edge of the eardrum. A combination of decongestants and antibiotics will usually clear up the infection and allow the fluid to drain.


If fluid is still not cleared after medical treatment has been completed, surgical drainage and the insertion of a ventilating tube is often indicated. Once the eardrum is anesthetized, the eardrum is opened, and the fluid is removed with aspiration and suction. During the time the tube is in the ear, and pending confirmation that the drum itself has healed, water precautions are necessary. When fluid develops in one ear only, without the patient having a prior history of ear problems and no evident cause, such as a recent severe cold, the implications may be more serious. After all potentially serious causes for fluid in one ear have been eliminated, a tube is placed in the ear. The objective of permanent tubes is to bypass the poorly functioning Eustachian tube completely. These individuals should be very carefully examined for all other treatable underlying problems, such as chronic sinusitis, nasal obstruction from a deviated septum or chronic allergies. Patients who have had cancer of the nasopharynx, or other areas of the head and neck, may require radiation as part of their treatment.
After radiation, fluid often builds up in one or both ears, due to the radiation-induced swelling and inflammation of the Eustachian tube.
It may be prudent after radiation to wait several months for all inflammation to subside before inserting tubes.
Fluid in the ear can occur after surgery of the head and neck, particularly radical operations on the maxillary sinus and palate for cancer.
Consultation between the surgeon and the radiologist is often useful in determining the appropriate post-operative timing for the insertion of tubes. DISCLAIMER: The Ear Surgery Information Center offers and maintains this web site to provide information of a general nature about the conditions requiring the services of an ear surgeon. All other information contained within this web site is © 2016 Ear Surgery Information Center. Children are not little adults, with their consult, investigations and treatment needing to be tailored to their specific ages.
If you are seeking an ear, nose, throat or hearing loss doctor in Singapore, look no further.
Otosan Ear Cone arose from the rediscovery of a traditional ear hygiene method, called auricular thermotherapy, a gentle technique with ancient origins. Otosan Ear Cone therefore helps to prevent the build up of wax plugs and supports their removal, contributing in this way to restoring ear pressure, for example, after spending time in the mountains, flying or scuba diving. Its purifying effect helps to solve hearing conditions such as buzzing, whistling, background noises, transmission loss and blocked-ear sensation.
Today, with the addition of propolis, Otosan Ear Cone develops an efficient protective action for the ears since the heat created regenerates local blood flow, providing a feeling of well-being and general physical relaxation. Study Shows That Hearing Aids Improve Brain Function!Published on February 15, 2016 brain function and hearing loss According to a recent study by Jamie Desjardins, PhD, an assistant professor in the speech-language pathology program at The University of Texas at El Paso, hearing aids improve brain function in people with hearing loss. Get Ready For Tinnitus Awareness WeekWhy not come along and join us week commencing 8th February & help us raise awareness for tinnitus. Hay fever (allergic rhinitis) is most common in springtime when large amounts of allergy-producing pollens are in the air, but can happen at any time in response to a variety of allergens, including house dust and animal hair or fur.
Conductive hearing loss occurs when sound is not able to be carried from the ear to the brain due to something blocking the path.  In the case of an ear infection, it is the fluid buildup in the middle ear that causes the hearing loss. Additionally, there is no need to apply ear wax drops for several weeks beforehand prior to undergoing Endoscopic Ear Wax Removal, as is the case with both ear syringing and ear irrigation.
An oto-endoscope is a more advanced medical ‘ear torch’ than the conventional otoscope used by Audiologists and ENT doctors to examine the ear. We commence by carefully examining your ears, taking a video to show you the type and amount of ear wax you have, before carefully cleaning and removing it all from your ears. It can be described as being either soft or hard, with the type of ear wax you have being genetically inherited. This is because the layer of skin lining the ear canal that secretes the ear wax has the unique property of moving sideways towards the entrance of the ear canal as it grows and sheds. The sensation of a blocked ear is due to the ear wax creating a “plug” inside the ear canal. Using ear wax drops that are either slightly cooler or warmer than room temperature can cause short-term vertigo due to the ‘caloric’ effect. Ear syringing is usually performed in GP surgery’s by a practice nurse and involves gently pumping water (either via a bulb-type syringe or electronic ear irrigator nozzle) into the ear canal at different angles to flush, dissolve, and rinse the ear wax out of the ear canal. Although old-fashioned, high-pressured ear syringes have since been replaced by modern directional jet pressure-controlled ear syringes and electronic irrigation machines, whereby the water flow pressure can be regulated and controlled using a foot pump, the procedure is still performed ‘blind’ with no direct vision. Also, it is sometimes reported that ear syringing can lead to tinnitus, or exacerbate it in people who already experience it.
Its major advantage over all other ear wax removal treatments highlighted above is that ear wax is removed safely under direct vision at all times.
Subsequently, many people have to wait weeks or months for an appointment if being referred by their GP for microsuction ear wax removal.
In fact, endoscopic ear wax removal has been clinically found to be less painful, more comfortable, quicker and easier to perform than microsuction, even when using an ENT microscope (Pothier et al. There is also the small chance of slight bleeding due to grazing and scratching of the layer of skin lining the car canal with the suction probe, although compared to microsuction this risk is somewhat reduced given there is a far greater degree of operating space available. Normally, the space behind the eardrum which contains the bones of hearing is filled with air.
Mark Levenson was elected by his peers for inclusion in Best Doctors in America® from 2001 to 2002 and 2015 to 2016.
The information is provided with the understanding that ESIC is not engaged in rendering surgical or medical advice or recommendations. Their spectrums of diseases do overlap with adults, but often with different presentations, progression, severity and specific cause. Conductive hearing loss is a common problem that can occur with pathologies in the external and middle ear. We provide a range of treatments for different conditions related to the ear and its balance, the nose, and sinus, the throat and mouth, and the head and neck. Enhanced with innovative safety and comfort devices, the Otosan Ear Cone is a natural, practical, safe and effective device, which, through beneficial heat and a chimney effect, helps to eliminate impurities and excess earwax from the ear.
It is recommended for adults and children, and especially for people working in dusty environments, for those suffering from excess earwax and people who use external hearing aids. Each pair has an opening into the nose to allow air in and out, and to drain the mucus that is produced in the linings of the sinuses to keep them clean.
Sinusitis can also block the Eustachian tube, which connects the middle ear to the back of the nose, causing temporary loss of hearing and sometimes earache.
The cold virus causes the nasal linings to swell, and mucus production to increase, preventing effective drainage of the nose.
This technique of ear wax removal is not only more effective and safer than ear syringing and ear irrigation, but was also found to be quicker, more comfortable and easier to perform than Microsuction when compared in a clinical study1.


Furthermore, unlike ear syringing and ear irrigation which are performed 'blindly', Endoscopic Ear Wax Removal is performed under direct supervision at all times making it a much safer technique. The oto-endoscope is comfortably positioned into the opening of the ear to provide a ‘wide’ high resolution view of the entire ear canal. Therefore ear wax doesn’t usually cause people too many issues, but in some cases ear wax can build-up and become impacted.
The caloric effect is when the balance (vestibular) organ in one ear is out of sync with the balance organ in the opposite ear due to an inhibition in its function (cooler air or water) or excitation in its function (warmer air or water).
Repositioning your head back to the centre or sitting back up after the allocated time will allow the ear wax drops to drain out of the ear canal, hopefully removing some of the ear wax at the same time. Prior to ear syringing, it is recommended that ear wax drops are applied 2 or 3 times a day for atleast 10-14 days in advance to help soften the ear wax and aid its removal. There is also still the risk of perforating the eardrum by applying excessive pressure, especially if the eardrum has been previously operated on or is fragile due to a healed perforation in the last 12 months. The procedure is undertaken through an ENT binocular operating microscope (to provide magnification, depth perception and light source) and a sterile suction probe that is connected to a gentle suction machine.
Subsequently, like ear syringing, sometimes people report tinnitus or increased tinnitus if they already experience it pre-microsuction. Secondary trauma of the eardrum caused through the oto-endoscope, suction probe and other ENT instruments is also possible, albeit rare. Any information in the publications, messages, postings or articles on the web site should not be considered a substitute for consultation with a board-certified otolaryngologist (ear, nose and throat specialist) to address individual medical needs. We manage holistically conditions of snoring, allergic rhinitis, hoarseness, gastroesophageal reflux laryngitis, and laryngotracheal airway narrowing and stridor.
It also helps to eliminate any residual water in the ear canal after swimming in the sea or a pool.
Sinusitis occurs when these openings become blocked by excess mucus, as a result of infections such as the common cold or allergies like hay fever. Bacteria can happily breed in this mucus, sometimes leading to a severe infection with a thick yellow or green discharge. Some people are simply just genetically more predisposed at secreting ear wax at a quicker rate than it can naturally migrate out of the ear.
The mismatch in signals sent to the brain via the two balance organs then confuse the brain into thinking you’re moving when you are still and stationary, leading to vertigo. This process generally needs to be repeated 2 or 3 times a day for anything between to 10-14 days. In addition, where an unknown and undetected perforation is present behind the ear wax plug, ear syringing can inadvertently force both ear wax and water through the perforation in the middle-ear cavity and trigger an infection. Other instruments, such as cerumen spoons, Jobson-Horne and miniature crocodile forceps can also be used in conjunction with the suction probe to safely remove ear wax. There is also the small chance of slight bleeding due to grazing and scratching of the layer of skin lining the car canal with the suction probe.
In addition, when using the suction probe cool air currents are generated within in the ear canal, and similarly to the ear wax drops, ear syringing and microsuction methods of ear wax removal there is a risk of short-lasting vertigo due to ‘caloric’ effect, as described previously. Individuals' particular facts and circumstances will determine the treatment which is most appropriate. Sensorineural hearing loss and tinnitus from aging, noise, drugs, congenital or genetic deafness can also be helped by medication, hearing aids or hearing implants. A low-pressure sterilized suction probe (alongside other ear wax removal tools if required) is then used to safely and gently vacuum the ear wax to clean and clear your blocked ear. It is thought that water-based ear wax drops are more effective at dissolving ear wax than oil-based ear wax drops. Even so, if there is excessive or impacted ear wax then ear wax drops alone may not successfully remove the ear wax. This could also be said to be true if a grommet (ventilation tube) has been surgically inserted through the eardrum.
Secondary trauma of the eardrum caused through the suction probe and other ENT instruments is also possible, albeit rare. An oto-endoscope is a more advanced medical ‘ear torch’ than the conventional oto-scope used by Audiologists and ENT doctors to inspect the ear.
Endoscopic ear wax removal may sometimes be difficult to perform on people with small ear canal entrances, but there are some oto-endoscope with very small diameters available (e.g. Once the cold clears, the fluid will generally drain out of the ear through a tube that connects the middle ear to the nose: the Eustachian tube. The good news is that rapid advances in medicine and technology now ensure that no patient needs to continue living in silence with hearing loss. Furthermore, unlike oil-based ear wax drops, there is no known risk of damage to the inner ear caused by water-based ear wax drops if there is an unknown perforated eardrum gone undetected behind the impacted ear wax (if a perforated eardrum has previously been diagnosed then it is advised that ear wax drops not be used). Furthermore, ear syringing is not appropriate for anybody who has had a middle-ear infection (otitis media) in the last 6 weeks since it can increase the chance of it returning.
In addition, when using the suction probe cool air currents are generated within in the ear canal, and similarly to the ear wax drops and ear syringing ear wax treatments there is a risk of short-lasting vertigo due to ‘caloric’ effect. It can either be rigid or flexible and uses a small diameter fibreoptic telescope to provide an incomparable 'wide' high resolution view of the ear canal. However, water-based ear wax drops are more prone to causing irritation and can sometimes lead to an infection. Similarly, ear syringing should be avoided in anybody who is currently suffering from an outer-ear infection (otitis externa) since it can increase its severity whilst also being extremely painful for the individual. Nonetheless, the use of microsuction compared to the other ear wax removal treatments is quicker and safer and doesn’t require weeks of instilling ear wax drops (although applying sodium bicarbonate ear wax drops the day before to slightly soften the wax is sometimes advisable).
Subsequently, it can be comfortable and safely rested into the ear canal opening using one hand to visualise the whole ear canal and eardrum, with minimal manipulation of the patient’s head or ear as would be the case with either a microscope or an oto-scope. Although efforts are made to maintain quality advertisements, ESIC does not endorse or recommend the content or claims made in the advertisements.
In addition, compared to oil-based ear wax drops, they can cause ear wax to swell and expand more therefore leading to a complete ear wax plug and exacerbation of the blocked ear sensation.
Even in normal ears, there is always the chance of infection post-ear syringing, albeit small, especially if the water being used has not been adequately sterilised. This allows the other hand to gently remove the ear wax by using the sterile suction probe in conjunction with other ENT instruments, if required. Additionally, as like with ear wax drops, the temperature of the water needs to be carefully controlled at body temperature (37?C) to avoid short-term vertigo due to the ‘caloric’ effect which has been described earlier.




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