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The Not So Normal Ear
This paper has been recommended by Digital Recordings as suggested reading for their AUDIO-CD product.
Ear Problems
The marvellous human ear that functions so well for so many people throughout
their lives, also has the potential of not working well, particularly if it is abused by a
significant number of damaging agents. Let's consider some of the problems that
can be encountered in the not so normal ear.
Some problems related to the ear:
Hearing loss. This is the situation in which the listener is not able to hear until
the intensity of sound has been increased beyond that which is normally required.
Hearing loss can be temporary or permanent. Hearing loss can involve the
mechanical, or "conductive" portion of the outer and/or middle ears, or the "sensori-
neural," or electrical portion of the inner ear, the eighth nerve or the brain. Hearing
losses can be mild, moderate, severe, or profound in nature.
Speech discrimination (word recognition) difficulties. Some types of damage to
the ear may cause not only hearing loss, but also a problem in understanding what is
heard, even when it is loud enough to hear comfortably. This problem is usually,
but not always, associated with sensorineural hearing loss where the malfunction is
in the inner ear, the eighth nerve, or the brain.
Recruitment. Recruitment is a narne that describes a significant problem in
tolerating louder sounds. A person with a hearing loss may have such a severe
tolerance problem, that once sound has been amplified just enough to overcome
their hearing loss, they found it too loud to tolerate. This problem is usually, but not
always, associated with sensorineural hearing loss where the malfunction is in the
inner ear.
Tinnitus. Tinnitus is the presence of a noise that is perceived as being in the
head or in the ears, even when no noise is actually present. Tinnitus can be ever-
present, or transient in nature. It can be very quiet, or extremely loud. It may sound
like a whistle, hum, buzz, wind, or have other characteristics. This problem is
usually, but not always, associated with sensorineural hearing loss, especially with
the malfunction in the inner ear. Excessive exposure to intense noise is the most
common causal factor. Tinnitus may just be a nuisance, or it can be quite
distracting, or it can routinely interfere with sleep, or it can lead to suicide ...
The Outer Ear
Most of the problems encountered with the outer ear are transient in nature, and
frequently relate to mechanical blockage of the ear canal. The ear canal can be
blocked, or occluded, by such things as excessive accumulation of cerwnen
(earwax), swelling of the lining of the ear canal from a skin infection or space
occupying lesion such as a cyst, or the presence of a foreign object.
Sometimes a child is born without normal outer ear structures, even though the
nerve function of the ear may be normal.
In all cases, a problem in the outer ear requires medical attention, preferably from a
good ear specialist (usually called an otologist, or ENT doctor). The physical
structures of the ear can be easily (and permanently) damaged; home remedies
should be avoided. This is particularly true of the removal of excessive ear wax. It
is extremely common for clinics to see patients who have attempted to clean their
ears improperly, frequently with cotton swabs. Your grandmother was right; never
put anything smaller than your elbow (or at the very least, your finger) in your ear
canal.
Most of the conductive hearing problems in the outer ear can be corrected with the
appropriate medical and/or surgical attention.
The Middle Ear
Middle ear problems can be of varied causes, but the two most commonly
experienced are middle ear "Infections," and abnormalities of the bone structure in
the middle ear.
It is common for the Eustachian tube to block. Many people have experienced a
"muffled" sensation when they sniff hard when their nose is runny. Usually the
Eustachian tube pops open in a few minutes, and everything is back to normal. This
can also occur when flying, especially when landing. If the Eustachian tube does
not open, fluid begins to collect in the middle ear space; once fluid is against the
back of the eardrum, it cannot move well, and temporary hearing loss occurs. The
fluid can be quite benign, or it can become infected. These conditions should be
treated medically and/or surgically by a good ear specialist.
Diseases of the bones, the ossicles, in the middle ear are not uncommon. The best
known is otosclerosis, where bony growth fuses the three bones together, or to the
wall of the middle ear so that mobility is impaired.
Most of the conductive hearing problems in the middle ear can be corrected with the
appropriate medical and/or surgical attention.
The Inner Ear
The performance of the inner ear can be affected by numerous malfunctions. By far
the most common cause of permanent hearing loss where the damage is in the inner
ear, is excessive exposure to intense noise. We live in a very noisy world. We
abuse our ears unmercifully, both in the work enviromnent, and at home or with
recreational pursuits. Loud music, power tools, snowmobiles, firearms, chainsaws,
motorcycles, monster trucks ... The list of ways to abuse our ears is constantly
growing, and many of us are not intelligent enough to recognize the fact that we are
causing irreparable damage to our hearing. If you fit in this category, enjoy
yourself, because you will soon no longer be able to enjoy activities that require
hearing.
You use seat belts. You use eye protection. You use safety shoes. You use a hardhat. You use gloves. Why not ear protection?? Ask your audiologist for a specific recommendation for the type of noise you encounter. There is no medical or surgical correction for this sensorineural hearing loss. A hearing aid might help somewhat. You blew it! You live with it! No longer enjoy music. No longer enjoy hearing birds. No longer enjoy hearing streams or brooks. No longer enjoy hearing nature sounds. No longer easily hearing firiends talking. Or your kids or grandkids. Or the telephone. Or the telephone ring. Or television without blasting everyone else out of the house. No longer do your job? ... The inner ear can also be damaged by head injury, and disease processes such as Meniere's disease. These require medical/surgical attention. The Eight Nerve Eighth nerve problems, though not rare, are also not that common. They can be serious, or even life-threatening. The two most common problems that can affect the functioning of the eighth nerve are head injury, and tumours along the nerve. If diagnosed early, medical/surgical attention can be quite effective. If hearing loss, and/or speech discrimination problems, and/or balance problems are noted, seek help from an audiologist and an ear doctor. The Brain
There are many types of head injuries and disease processes that can affect brain function. Some are more successfully treatable than others. If hearing loss, and/or speech discrimination problems, and/or balance problems, and/or headaches, and/or auditory processing problems are evident, seek medical attention.
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