The main ear examination is done with the otoscope microscope (otomicroscopy).
The main test for the diagnosis of hearing problems is audiometry, which requires headphones, speakers or a bone vibrator through which the sound reaches the patient. For its execution a soundproof booth is needed, which the patient enters. The most conventional tests are tonal audiometry, suprathreshold and verbal.
Another important test is Tympanometry, which complements the above in order to find out the location of the hearing impairment and it is complemented by the study of the stapedial reflexes.
The Otoacoustic Emissions and Auditory Evoked Potentials Brainstem tests are objective tests. The first is used for the screening for congenital hearing loss or universal screening for hearing loss and the second is used for the diagnosis of deafness in infants or small children.
Deafness, also called hypoacusia, is the loss of the ability to hear normally. Depending on its time of onset, deafness affects the other capabilities of the patient to a greater or lesser extent and influences the development of their work and personal life.
Deafness can have very different causes but in adults it is usually a result of earwax and otitis. Given that hearing is fundamental for the development of language and speech, if deafness appears in children at an early age it will affect their communication skills and learning ability and it may degenerate into deaf-muteness if it is not diagnosed and treated promptly. In school-age children which suffer from hearing loss, it Is usually a result of seromucinous otitis, generally associated with colds and bronchitis, asthma and growths and can cause irreversible damage to the eardrum and long-term hearing. It can also be the cause of damage to the auditory nerve. In this age it interferes with learning and school and social integration, making it a priority to diagnose and treat it early.
Other common causes of deafness in adults are due to repeated exposure to noise (due to occupation, firecrackers, gunshots…), age and heredity, infections or chronic otitis and otosclerosis. In the cases of chronic otitis with or without a perforated eardrum and in otosclerosis, the treatment is always surgery, either myringoplasty, tympanoplasty or stapedectomy.
In each case a precise diagnosis of the cause must be made and surgical or medical or surgical treatment will be prescribed or the prescription of hearing aids. It should be noted that, in the last treatment, the patient must always first be reviewed by the specialist as treatments differ by each case.
Therefore, with deafness, an early and accurate diagnosis of the type of hearing loss is essential as it will allow us to start treatment in order to solve the problem or mitigate its consequences.
Noises in the ear
Noises in the ear, also known as tinnitus, are a common condition and are very distressing for the patent. The Otolaryngologist will conduct the relevant tests in order to diagnose the cause and begin an early treatment.
Protruding ears are an alteration of the shape of the outer ear. For cosmetic correction, a surgical procedure called otoplasty is required. It is an outpatient surgery which is performed with sedation and aims to make the ears stick to the skull symmetrically.
Otitis is the swelling of the ear and, depending on the part of the ear which it affects, it manifests itself in one way or another and can have greater or lesser importance.
When it affects the outer ear it is called external otitis and it is an infection of the skin of the ear canal as a result of swimming in pools during the summer, the insertion of swabs in the ear and scratching. It manifests itself primarily through intense pain, although there can sometimes be suppuration or clogging. It is sometimes due to fungi which causes intense itching.
If otitis affects the middle ear, it is usually associated with colds, allergies or smoking, and it most frequently manifests itself through suppuration and deafness, and the eardrum is usually perforated. In children it is very frequent, isolated and on a recurring basis and it is associated with adenoid vegetations. Seromucous otitis are also very frequent following a badly treated cod or in patients with allergies and smokers and in children due to adenoid vegetations. They then produce, as the main symptom, deafness and the otitis must be treated as well as that which causes it.
Chronic otitis must always be treated because they produce permanent deafness and serious effects such as eardrum perforation and cholesteatoma, a type of ear tumor which, if left to develop without treatment, can lead to severe problems.
Vertigo and dizziness
Vertigo is a disorder of the sense of movement which manifests itself as imbalance, instability, pressure in the head, feelings of nausea and of the spinning of objects, etc. which may or may not be accompanied by ear symptoms such as noises or hearing loss.
The causes are numerous and they can be found in the ear, neck or they can even be secondary to general illnesses such as hypertension or diabetes.
As vertigo or dizziness are disabling conditions, it is necessary for the otolaryngologist to conduct a thorough exploration through examination which can sometimes, through simple maneuvering (in benign paroxysmal positional vertigo) cure the patient. For others, they will decide on medical rehabilitative or even surgical treatment. Once the otologic origin of the vertigo is discovered the otolaryngologist will tell the patient the most likely cause and will direct them to the appropriate specialist.
This is the paralysis of the muscles of half the face that appears suddenly. The most frequent cause is Bell’s Palsy or frigore, but it can also be secondary to traumas, infections or tumors. Diagnosing and treating this on time usually leads to good progress.