The Eardrum Moves When the Eyes Move
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Perforated Eardrum
Vinod K. Anand, MD, FACS Nose and Sinus Clinic Perforated Eardrum A perforated eardrum is a hole or rupture m the eardrum, a thin membrane which separated the ear canal and the middle ear. The medical term for eardrum is tympanic membrane. The middle ear is connected to the nose by the eustachian tube. A perforated eardrum is often accompanied by decreased hearing and occasional discharge. Paih is usually not persistent. Causes of Eardrum Perforation The causes of perforated eardrum are usually from trauma or infection. A perforated eardrum can occur: if the ear is struck squarely with an open hand with a skull fracture after a sudden explosion if an object (such as a bobby pin, Q-tip, or stick) is pushed too far into the ear canal. as a result of hot slag (from welding) or acid entering the ear canal Middle ear infections may cause pain, hearing loss and spontaneous rupture (tear) of the eardrum resulting in a perforation. In this circumstance, there may be infected or bloody drainage from the ear. In medical terms, this is called otitis media with perforation. On rare occasions a small hole may remain in the eardrum after a previously placed P.E. tube (pressure equalizing) either falls out or is removed by the physician. Most eardrum perforations heal spontaneously within weeks after rupture, although some may take up to several months. During the healing process the ear must be protected from water and trauma. Those eardrum perforations which do not heal on their own may require surgery. Effects on Hearing from Perforated Eardrum Usually, the larger the perforation, the greater the loss of hearing. -
Eardrum Regeneration: Membrane Repair
OUTLINE Watch an animation at: Infographic: go.nature.com/2smjfq8 Pages S6–S7 EARDRUM REGENERATION: MEMBRANE REPAIR Can tissue engineering provide a cheap and convenient alternative to surgery for eardrum repair? DIANA GRADINARU he eardrum, or tympanic membrane, forms the interface between the outside world and the delicate bony structures Tof the middle ear — the ossicles — that conduct sound vibrations to the inner ear. At just a fraction of a millimetre thick and held under tension, the membrane is perfectly adapted to transmit even the faintest of vibrations. But the qualities that make the eardrum such a good conductor of sound come at a price: fra- gility. Burst eardrums are a major cause of conductive hearing loss — when sounds can’t pass from the outer to the inner ear. Most burst eardrums are caused by infections or trauma. The vast majority heal on their own in about ten days, but for a small proportion of people the perforation fails to heal natu- rally. These chronic ruptures cause conductive hearing loss and group (S. Kanemaru et al. Otol. Neurotol. 32, 1218–1223; 2011). increase the risk of middle ear infections, which can have serious In a commentary in the same journal, Robert Jackler, a head complications. and neck surgeon at Stanford University, California, wrote that, Surgical intervention is the only option for people with ear- should the results be replicated, the procedure represents “poten- drums that won’t heal. Tympanoplasty involves collecting graft tially the greatest advance in otology since the invention of the material from the patient to use as a patch over the perforation. -
Anatomy of the Ear ANATOMY & Glossary of Terms
Anatomy of the Ear ANATOMY & Glossary of Terms By Vestibular Disorders Association HEARING & ANATOMY BALANCE The human inner ear contains two divisions: the hearing (auditory) The human ear contains component—the cochlea, and a balance (vestibular) component—the two components: auditory peripheral vestibular system. Peripheral in this context refers to (cochlea) & balance a system that is outside of the central nervous system (brain and (vestibular). brainstem). The peripheral vestibular system sends information to the brain and brainstem. The vestibular system in each ear consists of a complex series of passageways and chambers within the bony skull. Within these ARTICLE passageways are tubes (semicircular canals), and sacs (a utricle and saccule), filled with a fluid called endolymph. Around the outside of the tubes and sacs is a different fluid called perilymph. Both of these fluids are of precise chemical compositions, and they are different. The mechanism that regulates the amount and composition of these fluids is 04 important to the proper functioning of the inner ear. Each of the semicircular canals is located in a different spatial plane. They are located at right angles to each other and to those in the ear on the opposite side of the head. At the base of each canal is a swelling DID THIS ARTICLE (ampulla) and within each ampulla is a sensory receptor (cupula). HELP YOU? MOVEMENT AND BALANCE SUPPORT VEDA @ VESTIBULAR.ORG With head movement in the plane or angle in which a canal is positioned, the endo-lymphatic fluid within that canal, because of inertia, lags behind. When this fluid lags behind, the sensory receptor within the canal is bent. -
Petubes Patient Handout.Pdf
Division of Pediatric Otolaryngology Information on Tympanostomy Tubes Tympanostomy tubes are small plastic or metal tubes that are placed into the tympanic membrane or ear drum. How long will the tube stay in place? Tubes usually fall out of the ear in 6 months- 2 years. If they remain in longer than 2 to 3 years they are sometimes removed. What is involved with Tympanostomy tube placement? This surgery is usually done under general anesthesia. The eardrum is examined using a microscope. A small hole is made in the ear drum called a myringotomy, fluid is removed, and the tube is placed. Tube in the eardrum What medical conditions are treated with tubes? Recurrent middle ear infections or frequent acute otitis media Otitis media with effusion or fluid in middle ear associated with hearing loss Eustachian tube dysfunction causing hearing loss or eardrum structure changes What is the Eustachian tube? This is the canal that links the middle ear with the throat. This tube allows air into the middle ear and drainage of fluid. This tube grows in width and length until children are about 5 years old. Reasons that the Eustachian tube may not work properly: Viral illness, exposure to allergens or tobacco smoke may lead to swelling of the eustachian tube resulting in fluid buildup in the middle ear. Children with cleft palate and craniofacial syndromes like Down’s syndrome may have poor eustachian tube function. How will Tympanostomy tube help my child? They allow air to re-enter middle ear space They reduce the number and severity of infections They improve hearing loss cause by middle ear fluid Why is adenoidectomy sometimes done with the Tympanostomy tubes? Adenoidectomy is the removal of the adenoid tissue behind the nose. -
Audiometric Findings with Voluntary Tensor Tympani Contraction Brandon Wickens1 , Duncan Floyd2 and Manohar Bance3*
Wickens et al. Journal of Otolaryngology - Head and Neck Surgery (2017) 46:2 DOI 10.1186/s40463-016-0182-y ORIGINALRESEARCHARTICLE Open Access Audiometric findings with voluntary tensor tympani contraction Brandon Wickens1 , Duncan Floyd2 and Manohar Bance3* Abstract Background: Tensor tympani contraction may have a "signature" audiogram. This study demonstrates audiometric findings during voluntary tensor tympani contraction. Methods: Five volunteers possessing the ability to voluntarily contract their tensor tympani muscles were identified and enrolled. Tensor tympani contraction was confirmed with characteristic tympanometry findings. Study subjects underwent conventional audiometry. Air conduction and bone conduction threshold testing was performed with and without voluntary tensor tympani contraction. Main outcome measure: Changes in air conduction and bone conduction thresholds during voluntary tensor tympani contraction. Results: Audiometric results demonstrate a low frequency mixed hearing loss resulting from tensor tympani contraction. Specifically, at 250 Hz, air conduction thresholds increased by 22 dB and bone conduction thresholds increased by 10 dB. Conclusions: Previous research has demonstrated a low frequency conductive hearing loss in the setting of tensor tympanic contraction. This is the first study to demonstrate a low frequency mixed hearing loss associated with tensor tympani contraction. This finding may aid in the diagnosis of disorders resulting from abnormal tensor tympani function. Tensor tympani contraction -
Let's Talk About . . . Otosclerosis
LET’S TALK ABOUT . OTOSCLEROSIS diagnosed with otosclerosis. Pregnancy can cause Key points otosclerosis to advance more quickly. • Otosclerosis affects the bones of the middle Otosclerosis is rare, affecting about 3 in 1,000 ear that conduct sound. people. Research suggests between 25 to 50% of people with otosclerosis have a family history of the • It is one of the most common causes of conductive hearing loss in young adults. condition. • How quickly, or to what extent, hearing will The word otosclerosis comes from Greek. It means be affected is unpredictable. abnormal hardening of body tissue (sclerosis) of the ear (oto). • If otosclerosis goes into the inner ear, you may be troubled by ringing in the ears, dizziness and balance problems. How do we hear? • Hearing aids are usually the preferred first treatment choice. To understand why otosclerosis causes hearing loss, it is important to have a basic understanding of how we hear. For hearing to function normally a What is otosclerosis? sound has to travel through all three parts of the Otosclerosis (oh-toe-skler-OH-suhs) a complex ear: outer, middle and inner. The first two are air disorder of abnormal bone growth in the middle ear. filled; the latter is fluid filled. It most often happens when the tiny stapes (“STAY- The outer ear is made up of the part you can see peez”) bone knits with surrounding bone. on the side of your head (pinna) and the funnel- Otosclerosis usually results in slow, shaped external ear canal. The pinna gathers progressive conductive hearing loss. sound waves (vibrations) and channels them When the stapes is unable to vibrate, hearing through the ear canal to the eardrum (tympanic becomes impaired. -
Cochlear Implants Answers to Your Questions
Cochlear Implants Answers to your questions 1 Welcome This guide is designed to give you the information you need when considering a cochlear implant for yourself or someone important in your life. It will help you understand how hearing works, hearing with a cochlear implant and answer some common questions about getting a cochlear implant. YOU’RE NOT ALONE Hundreds of millions of people around the world experience some form of hearing loss. While many can be helped by a hearing aid, more than 75 million people still find the most powerful hearing aids inadequate. DID YOU KNOW? More than 170,000 people around the world have received a Nucleus® cochlear implant. 2 3 How do our ears work? The ear is an amazingly complex but efficient hearing system. The ear is made up of three sections: The whole process only takes OUTER MIDDLE INNER a fraction of a second. Ossicles How do we hear? 3 1 Sound waves are guided down your ear canal by the pinna. Pinna 1 4 2 The sound waves hit your ear drum and it vibrates. 2 Cochlea 3 The small ossicles vibrate with the ear drum, transferring the sound across the middle ear to the cochlea. Ear Drum 4 The fluid inside the cochlea picks up the vibrations and carries them to the thousands of tiny hair cells. These hair cells change the movement into OUTER MIDDLE INNER electrical impulses which are sent The outer ear consists of the pinna The middle ear consists of the ear The inner ear consists of a complicated along the auditory and the ear canal. -
The Middle Ear and Mastoid
The Middle Ear and Mastoid Overview Tympanic membrane perforation Many things can cause a tympanic membrane perforation, or hole in the eardrum. It can be caused by trauma. This includes sticking things in the ear (like a Q-tip, bobby pin or pencil), getting slapped on the ear or being close to an explosion. Ear infections (acute otitis media) are another common cause. A severe ear infection may lead to a hole if the pressure of the pus behind the eardrum causes it to rupture. Repeated mild ear infections can also cause a hole in the eardrum. Ossicular chain dislocation Ossicular chain dislocation, or separation of the middle ear bones, may happen with a skull fracture. The eardrum may or may not have a hole. It may also happen when a hole in the eardrum is caused by penetrating trauma, such as a Q-tip injury. The most common type of problem is separation of the joint connecting the incus to the stapes. The second most common is separation of the joint connecting the malleus to the incus. Fracture of the arch stapes may also occur. Ossicular fixation may occur several months after the fracture if new bone grows at the fracture line. Chronic otitis media and cholesteatoma A patient with a hole in the eardrum can get chronic otitis media. This means that there is a hole in the eardrum, long-standing infections, and drainage from the ear canal (otorrhea). The infection slowly wears away the middle ear bones. Chronic otitis media also can lead to a cholesteatoma. A cholesteatoma is a skin cyst behind the eardrum. -
Repair of a Perforated Eardrum (Myringoplasty)
The Children’s Hospital Repair of a Perforated Eardrum (Myringoplasty) Information for parents and carers What is a perforated eardrum? A perforated eardrum means there is a hole in the eardrum. This may have been caused by infection or injury to the eardrum. Sometimes, a hole in the eardrum will heal itself. However a hole in the eardrum may cause recurrent infections with a discharge from the ear. If your child has an infection, they should avoid getting water in their ear. If the hole is large, your child may experience some hearing loss. A hole in the eardrum can be identified by a doctor or nurse specialist using an instrument called an auroscope. If the hole in the ear drum is causing discharge or deafness, your child’s surgeon may recommend that it is repaired. What is a myringoplasty? A myringoplasty is an operation to repair the perforation in the eardrum. The operation can successfully close a small hole nine times out of ten. The success rate is not as good if the hole is large. What are the benefits of the operation? The benefits include: • preventing water from entering the middle ear, which would cause ear infection • fewer ear infections • a possible improvement in hearing, but repairing the eardrum alone seldom leads to great improvement in hearing. An operation may be carried out on the ossicles (bones of hearing) at a later date, if necessary. page 2 Copyright © 2010 ENT•UK What are the risks? This is a simple and safe operation. However, all operations will carry some risks. -
Ear Problems and Treatments (PDF)
Ear problems and treatments “I knew from a young age that I couldn’t hear as well as I was supposed to – sometimes my Reception class teacher would think I was misbehaving when I didn’t follow her instructions, but I simply couldn’t hear what she was saying. I had two operations to insert grommets (ventilation tubes) in my ears, when I was eight and 10, to drain a build-up of fluid from the middle part of my ears and help prevent ear infections. The second operation eventually worked and, for the first time in my life, I could hear sounds clearly – the difference was amazing.” Tori Jeffery, West Yorkshire This leaflet tells you about the common ear conditions that can cause hearing loss or balance problems (or both) – and the treatments available. If you’re at all worried about your hearing or balance, see your GP. Contents • How our ears work ...................................................4 • Different types of hearing loss ........................................6 • Outer ear conditions ................................................. 7 • Excess ear wax ................................................... 7 • Otitis externa..................................................... 8 • Exostosis.........................................................9 • Middle ear conditions ................................................9 • Otitis media ......................................................9 • Glue ear ........................................................ 10 • Chronic suppurative otitis media (CSOM)...........................11 • -
The Eustachian Tube – Function and Dysfunction
ENT and Allergy Associates Leslie R. Berghash, M.D., F.A.C.S. Of Florida John T. Lanza, M.D., F.A.C.S. Caring For Our Patients Since 1963 Camysha H. Wright, M.D., F.A.A.O.A. www.entaaf.com THE EUSTACHIAN TUBE – FUNCTION AND DYSFUNCTION The eustachian tube is a narrow, one and a half inch long channel connecting the middle ear with the nasopharynx, the upper throat area just above the palate, in back of the nose. The eustachian tube functions as a pressure equalizing valve for the middle ear which is normally filled with air. When functioning properly the eustachian tube opens for a fraction of a second periodically (about once every three minutes) in response to swallowing or yawning. In doing so it allows air into the middle ear to replace air that has been absorbed by the middle ear lining (mucous membrane) or to equalize pressure changes occurring on altitude changes. Anything that interferes with this periodic opening and closing of the eustachian tube may result in hearing impairment or other ear symptoms. Obstruction or blockage of the eustachian tube results in a negative middle ear pressure, with retraction (sucking in) of the eardrum membrane. In the adult this is usually accompanied by some ear discomfort, a fullness or pressure feeling and may result in a mild hearing impairment and head noise (tinnitus). There may be no symptoms in children. If the obstruction is prolonged the fluid may be drawn from the mucous membrane of the middle ear creating a condition we call serous otitis media (fluid in the middle ear). -
Pathway of a Sound Wave
Pathway of a Sound Wave 1. The sound waves arrive at the pinna (auricle), the only visible part of the ear. 2. Once the sound waves have passed the pinna, they move into the auditory canal (external acoustic meatus) before hitting the tympanic membrane (eardrum). 3. Once the sound waves reach the tympanic membrane, it begins to vibrate and they enter into the middle ear. 4. The vibrations are transmitted further into the ear via three bones (ossicles): malleus (hammer), incus (anvil), and the stapes (stirrup). These three bones form a bridge from the tympanic membrane to the oval window. 5. Once sound passes through the oval window, it enters into the cochlea in the inner ear. 6. Hair cells in the organ of Corti (within the cochlea) are stimulated which in turn stimulates the cochlear branch of the vestibulocochlear nerve. 7. The cochlear nerve then transmits electrical impulses to the auditory region of the brain in the temporal lobe. Pathway of a Sound Wave 1. The sound waves arrive at the pinna (auricle), the only visible part of the ear. 2. Once the sound waves have passed the pinna, they move into the auditory canal (external acoustic meatus) before hitting the tympanic membrane (eardrum). 3. Once the sound waves reach the tympanic membrane, it begins to vibrate and they enter into the middle ear. 4. The vibrations are transmitted further into the ear via three bones (ossicles): malleus (hammer), incus (anvil), and the stapes (stirrup). These three bones form a bridge from the tympanic membrane to the oval window.