Middle ear disorders
What should I know about the middle ear?
The middle ear is an air-filled cavity that includes three bones: the hammer (malleus), the anvil (incus) and the stirrup (stapes).
These bones enable sound waves to travel from the eardrum to the fluid-filled inner ear.
What are the symptoms of a middle ear disorder?
The main symptom of a middle ear disorder is hearing loss. Other symptoms may occur, including: ear pain (otalgia), fluid or discharge from the ear (otorrhoea) and tinnitus.
Middle ear disorders usually only affect one ear, but in some cases both ears are affected.
None of these symptoms are specific to a given middle ear disorder. An ENT specialist must perform an examination to fine-tune the diagnosis.
How is a middle ear disorder diagnosed at the American Hospital of Paris?
The first step in diagnosing a middle ear disorder consists in the ENT specialist taking a detailed patient history. The doctor will ask you about your medical and surgical antecedents and identify your symptoms.
The second step is an otoscopy, or ear examination, on both ears. The doctor inserts an otoscope – a special tool with a magnifying lens and a speculum at one end – into your ear to thoroughly examine the ear canal and eardrum. In many situations, this step is sufficient for diagnosis.
In addition to the otoscopy, a screening test performed with a tuning fork (Weber test) may be performed. This can give insights into the nature of any hearing loss detected.
An audiometry is performed to measure hearing acuity and accurately quantify the hearing loss. This test is performed by an ENT specialist or an audiometrist in a soundproof room at the American Hospital of Paris.
In some cases it will be necessary to further fine-tune the diagnosis with a CT scan of the ears. Your ENT specialist will order the exam, which can be performed directly on site by the medical imaging department of the American Hospital of Paris.
What treatment options are available for middle ear disorders at the American Hospital of Paris?
Treatments vary widely depending on the type of disorder that is diagnosed. The information below does not replace the advice of a doctor.
- Acute suppurative otitis media is when the middle ear fills with pus. Treatment consists in antibiotics, sometimes combined with ear drops if the eardrum has been perforated.
- Otitis media with effusion is when noninfected fluid builds up in the middle ear. It is treated with medication. If treatment fails, a myringotomy (procedure to create a hole in the eardrum) or tympanostomy tubes may be proposed to the patient.
- Chronic otitis with rupture or retraction of the eardrum can be relieved with a surgical procedure known as a tympanoplasty.
- The most aggressive type of chronic otitis is caused by a cholesteatoma. Surgical treatment is the only choice, and consists in removing the cholesteatoma. If necessary, the small hearing bones that have been damaged by the disease are repaired with prostheses.
- Otosclerosis, also called otospongiosis, occurs when the third hearing bone, the stapes, fuses with other parts of the ear. If treated surgically, the procedure consists in replacing the stapes by a prosthesis. The alternative treatment is hearing aids.
With the exception of acute otitis media, hearing loss caused by a middle ear disorder can be improved with hearing aids. Depending on your personal situation, the ENT specialist will order the most appropriate hearing aid system: classic, Contralateral Routing Of Signals (CROS) or bone conduction. This solution is available whether or not the ear has undergone an operation.
