The ear is the organ of hearing and allows us to distinguish many environmental sounds. The understanding of speech and appreciation of music involve the complex processing of the sounds the ear is exposed to.

The outer, middle and inner ear have distinct functions but are intimately associated such that each part depends on the other for the smooth transition of sound. It is important to understand the anatomy and function of the outer, middle and inner ear in order to appreciate how the ear works, what can go wrong to cause illness and how it can be treated.

Glue Ear and Recurrent Ear Infections

This is very common in children and can also be seen in adults. The underlying problem is Eustachain tube not functioning efficiently. This tube connects the area behind the eardrum to the back of the nose, allowing equalisation of pressure between those two areas. This is the tube that opens and closes and is felt as popping when in an aeroplane. As a result of the Eustachian tube dysfunction, negative pressure and thick fluid builds up behind the eardrum. This fluid can cause hearing loss and can also become repeatedly infected.

Hearing loss in children can cause inattention, the need to have the TV loud, poor performance in school and speech delay. The repeated infection can result in fever and pain in addition to eardrum perforations

Treatment for glue ear include the following:

• Watching and waiting for 3 months – some children may grow out of the condition
• Low dose antibiotics for six weeks
• Grommets – small temporary ventilation tubes placed in the eardrum under general anaesthetic. This surgery is done as a daycase.

Ear drum (tympanic membrane) perforation

Holes may be found in the tympanic membrane (eardrum) for several reasons. They commonly occur as a result of infections or trauma. They can cause hearing loss and persistent ear discharge particularly when the ear gets wet. Treatment options include keeping the ear dry and treating each infection as and when they occur. Surgical options involve patching the eardrum. I specialise in endoscopic ear surgery, which involves using small telescopes in the ear during the surgery. This gives a better view of the surgical field, avoids external wounds and therefore results in quicker healing.

Hearing Loss

Several types of hearing loss occur in adults and children. Glue ear is a common cause of hearing loss in children. Adults can also get glue ear. Longstanding ear disease and inherited conditions may cause hearing loss. In addition, many adults experience hearing loss as they get older. Difficulty in hearing should always be thoroughly investigated with a full history and examination. A hearing test (pure tone audiogram) should always be performed in order to determine the type of hearing loss and if it may be helped with surgery. Surgical procedures that may help hearing loss include; grommets, tympanoplasty, ossiculoplasty and stapedectomy.

Hearing implants can be life changing and again depend on the type and severity of the hearing loss. These include bone conduction hearing devices (bonebridge and bone anchored hearing aids BAHA), cochlear implants and middle ear implants (soundbridge)