To determine the cause of earache, the
ear is inspected (see ear, examination
of). Analgesic drugs may relieve the
pain, and antibiotic drugsmay be given
for infection. Pus in the outer ear may
be removed by suction. Pus in the mid-
dle ear may be drained by myringotomy.
ear, cauliflowerSee cauliflower ear.
ear, discharge fromAn emission of
fluid from the ear, also called otorrhoea.
It may be due to outer-ear infection (see
otitis externa). It may also follow perfo-
ration of the eardrum (see eardrum,
perforated), usually due to middle-ear
infection (see otitis media). Rarely, after
a skull fracture, cerebrospinal fluidor
blood may be discharged.
A swab may be taken of the discharge
and analysed to identify any infection.
Hearing testsmay be performed. X-rays
of the skull are taken if there has been a
head injuryor serious middle-ear infec-
tion is suspected. Treatment usually
includes antibiotic drugs.
ear, disorders ofThe earis suscepti-
ble to various disorders, some of which
can lead to deafness. In rare cases, the
ear canal, ossiclesin the middle ear, or
pinnaare absent or deformed at birth.
Rubellain early pregnancy can damage
the baby’s developing ear, leading to
deafness. Most cases of congenital sen-
sorineural deafnessare genetic.
Infection is the most common cause
of ear disorders; it may occur in the ear
canal, leading to otitis externa, or affect
the middle ear, causing otitis media.
This can lead to perforation of the
eardrum (see eardrum, perforated). Per-
sistent glue ear, often due to infection,
is the most common cause of childhood
hearing difficulties. Viral infection of the
inner ear may cause labyrinthitis.
Cauliflower earis the result of one
large or several small injuries to the
pinna. Perforation of the eardrum can
result from poking objects into the ear
or loud noise. Prolonged exposure to
loud noise can cause tinnitusand/or
deafness. Pressure changes associated
with flying or scuba diving can also
cause minor damage (see barotrauma).
Tumours of the ear are rare. Acoustic
neuromais a noncancerous tumour of
the acoustic nervethat may press on
structures in the ear to cause deafness,
tinnitus, and problems with balance.
In cholesteatoma, skin cells and debris
collect in the middle ear. Obstruction of
the ear canal is most often the result of
earwax, although in small children, an
object may have been pushed into the
ear (see ear, foreign body in).
In otosclerosis, a hereditary condition,
a bone in the middle ear becomes fixed,
causing deafness. Meniérè’s diseaseis
an uncommon condition in which deaf-
ness, vertigo, and tinnitus result from
the accumulation of fluid in the inner
ear. Deafness in many elderly people is
due to presbyacusis, in which hair cells
in the cochleadeteriorate.
Certain drugs, such as aminoglycoside
drugsand some diuretic drugs, can
damage ear function.
eardrumThe circular membrane that
separates the outer earfrom the middle
ear. The eardrum vibrates in response to
sound waves, conducting the sound to the
inner ear through the ossicles.
eardrum, perforatedRupture or ero-
sion of the eardrum. Perforation of the
eardrum can cause brief, intense pain.
There may be slight bleeding, a dis-
charge from the ear (see ear, discharge
from), and some reduction in hearing.
Most commonly, perforation occurs as
a result of the build-up of pus in the
middle ear due to acute otitis media.
Perforation may also be associated with
cholesteatoma. Another cause is injury,
for example from insertion of an object
into the ear, a loud noise, barotrauma,
or a fracture to the base of the skull.
Diagnosis is confirmed by examina-
tion of the ear (see ear, examination of).
Hearing testsmay also be performed.
Analgesic drugsmay relieve any pain
and antibiotic drugsmay be prescribed
to treat or prevent infection. Most per-
forations heal quickly. If the perforation
has failed to heal after 6 months,
myringoplastymay be needed.
ear, examination ofThe ear may be
examined to investigate earache, dis-
charge from the ear (see ear, discharge
from), hearing loss, a feeling of fullness
in the ear, disturbed balance, tinnitus, or
swelling of lymph nodes (see glands,
swollen) around the ear.EAR, CAULIFLOWER EAR, EXAMINATION OF
E