Treatment by cause in case of deafnessOtolaryngologist Moon Tae-hyun

What causes deafness?

In the case of patients who come to the ENT department with deafness or a feeling of fullness in the ears, the symptoms that express themselves such as "the ear is blocked" and "it feels like they are in the water" are ambiguous, and the physical examination findings are unclear for each patient. There are also a number of mechanisms by which the actual deafness occurs.

There are two main causes: ear causes and non-ear causes. Ear problems are divided into problems in the outer ear, problems in the middle ear, and problems in the inner ear. Cases that occur outside the ear include intracranial problems such as nasal cavity, nasopharynx, temporomandibular joint, allergies, sinusitis, and enlarged adenoids.

How is the cause of deafness diagnosed?

First of all, an otoscope and endoscope are used to check for problems in the outer ear, and then check if there is a problem with the eardrum and middle ear. After that, a hearing test will be performed to check for problems with the inner ear. If there is no problem so far, the diagnosis will be made through the process of checking for problems other than the ear, such as nasopharyngeal, temporomandibular joint and muscle abnormalities, and psychiatric problems.

When to have problems with the outer ear and what is the treatment?

This is when the ear canal is filled with a foreign body, or if there is inflammation or otocular dynastie* symptoms. Acute otitis externa is the most common, which is caused by the habit of frequent cleaning of the ears with a cotton swab. The main symptom is pruritus and pain inside the ear, and the first priority is to visit an ENT to remove the inflammatory residue.

*Ear color: The ear is clogged with earwax

Inflammation of the ear canal begins with the habit of digging the ear, and since earwax protects the inside of the ear with an acid film, repeated removal of it habitually damages the skin of the ear canal and makes it vulnerable to infection, which can lead to chronic recurrence. Therefore, in order to prevent recurrence after the visit, habit correction is prioritized.

Otomycosis, a fungus in the outer ear, is also a cause of high frequency. When otomycosis develops, the itching is so severe that it is difficult to sleep. The caveat is that otomycosis also does not heal well and there is a high possibility of recurrence.

As for treatment, otomycosis also requires correction of the habit of repeated ear possession as in the treatment of otitis externa, and continuous treatment through outpatient visits. Medications include antibiotics, antifungals, and oral steroids to treat pruritus and pain. In addition, there are ointments to use and apply. The main treatment is the use of antimicrobial liquid and the method of use is to keep the liquid at a temperature similar to body temperature and then put it in the ear until the ear canal is full.

Finally, otoxyembolism, which is a buildup of earwax inside the ear, can also cause deafness. In the case of otolaryngosis, it cannot be treated with other departments, and only an otolaryngologist can remove earwax with fine instruments, so you must visit an ENT for treatment. This is also caused by the destruction of the acidic environment inside the ear, so it is necessary to keep the inside of the ear moist with vinegar solution and ointment application after hospital treatment.

When do you have problems with the middle ear and what is the treatment?

Middle ear problems , which are the main causes of deafness (50%), have a wide variety of causes, including hypocanal insufficiency, exudative otitis media, adhesive otitis media, chronic otitis media, perforation of the eardrum, and barometric trauma. The most common cause is auditory canal hypofunction. The auditory canal is a tube that runs from the middle ear to the nose, and when auditory canal hypofunction occurs, it is not possible to regulate the normal pressure.

Hypotonism is a very common factor, accounting for 30% of all causes of deafness. It is most common in children with a history of frequent otitis media, and it often occurs when there is a finding of eardrum depression. It can even affect your hearing, so you need to treat it. Treatment options include Valsalva exercises* and, if there is no remission, ear tube balloon dilatation.

*Valsalva exercise: Holding the nose tightly and applying pressure

Although less common, exudative otitis media can also cause deafness. The main accompanying symptoms are pulsatile tinnitus, nasal congestion, runny nose, and postnasal drip*, and CT scan can be seen as exudate pooling and inflammation. As a treatment for exudative otitis media, if there is no remission after the use of drugs such as antibiotics, steroids, and nasal decongestants, and conservative treatment such as nasal irrigation and nasal spray, endoscopic sinus surgery and ventilation tube insertion are performed.

*Postnasal drip: A condition in which secretions accumulate in the throat or discharge from the back of the nose passes into the throat

What happens when there is a problem with the inner ear and what is the treatment?

Tinnitus, sudden hearing loss, Meniere's disease*, and senile hearing loss may occur. Acute low-frequency hearing loss can cause cold symptoms such as fever and diarrhea. At clinical observation, the ear canal and eardrum appear normal, and nasal swelling appears. Hearing loss occurs in the low frequencies during the audiometry, in which case the patient is reactive to steroid preparations.

After prescribing steroid medication and sufficient rest, the hearing will return to the normal range at the time of examination after 2~3 days. This sudden hearing loss may improve on its own, but if it becomes more severe, the hearing loss may worsen and harden, so it is recommended to visit an ENT doctor for treatment as early as possible.

*Ménière's disease: A disease in which symptoms such as dizziness with a sense of rotation and hearing loss, tinnitus (ringing in the ears), and a feeling of fullness (a feeling of fullness in the ears) occur at the same time

What happens when extra-ear problems occur and what is the treatment?

In addition to problems inside the ear, temporomandibular joint disorders can also cause deafness. In the case of temporomandibular joint disorder, tenderness is felt when the jaw is touched, pain is felt in the muscles around the neck, and the eardrum and middle ear are normal, and there is no hearing loss. Anti-inflammatory drugs, muscle relaxants, and blood circulation agents will be prescribed for treatment, and even after hospital treatment, the habit of relaxing the jaw joint with self-massage may be helpful.

The back wall inside the nose is called the nasopharynx. If you have a tumor in your nasopharynx, you may also feel deafness. In the case of nasopharyngeal tumors, it can be observed similarly to exudative otitis media, but since exudative otitis media in adults is not common, the nasal cavity is first checked to determine whether there is sinusitis, and then the nasopharynx is checked to determine whether there is a nasopharyngeal tumor.

If there is a nasopharyngeal tumor, this can lead to obstruction of the auditory canal or inflammation of the auditory canal, which leads to inflammation of the ear. It can easily occur if you have repeated ear infections in the past while smoking, and the main symptoms include purulent nasal drip, postnasal drip, fever and chills. Antibiotics and anti-inflammatory drugs are prescribed first, and then an MRI is ordered to determine whether the disease is benign or malignant and further treatment is required. In the case of a benign lump, it can be simply removed, but in the case of a malignant tumor, if a nasopharyngeal tumor is detected, aggressive and prompt treatment is required.

What causes deafness?

In the case of patients who come to the ENT department with deafness or a feeling of fullness in the ears, the symptoms that express themselves such as "the ear is blocked" and "it feels like they are in the water" are ambiguous, and the physical examination findings are unclear for each patient. There are also a number of mechanisms by which the actual deafness occurs.

There are two main causes: ear causes and non-ear causes. Ear problems are divided into problems in the outer ear, problems in the middle ear, and problems in the inner ear. Cases that occur outside the ear include intracranial problems such as nasal cavity, nasopharynx, temporomandibular joint, allergies, sinusitis, and enlarged adenoids.

How is the cause of deafness diagnosed?

What causes deafness?

In the case of patients who come to the ENT department with deafness or a feeling of fullness in the ears, the symptoms that express themselves such as "the ear is blocked" and "it feels like they are in the water" are ambiguous, and the physical examination findings are unclear for each patient. There are also a number of mechanisms by which the actual deafness occurs.

There are two main causes: ear causes and non-ear causes. Ear problems are divided into problems in the outer ear, problems in the middle ear, and problems in the inner ear. Cases that occur outside the ear include intracranial problems such as nasal cavity, nasopharynx, temporomandibular joint, allergies, sinusitis, and enlarged adenoids.

How is the cause of deafness diagnosed?