ENT: What are the main ear diseases?

Ear Infections (Otitis)

Caused by bacteria or viruses, otitis, or ear infection, can be more or less problematic depending on whether it affects only the outer, middle, or inner ear. Children are particularly vulnerable.

The main symptoms of otitis are:

• continuous purulent and foul-smelling discharge (otorrhea), which may be yellow, greenish, or streaked with blood (depending on the infectious agent causing the disease and the area affected);
• pain;
• redness;
• discharge of a clear and odorless fluid;

Sometimes there is also hearing loss and fever. Ear infections are usually treated with antibiotics in case of bacterial infection, but the medication can be administered locally or orally. If there are no complications, the ear infection disappears within a week.

Boils

These are pus-filled pimples that can appear anywhere in the outer or inner ear canal, particularly on damaged skin (e.g., injured or abraded by the use of inappropriate instruments to remove earwax). The main symptoms are pain and itching. An inflamed boil can easily rupture, in which case the pus it contains escapes. This type of mini-abscess is not serious and usually resolves on its own. However, if the pain does not disappear and the symptoms of inflammation worsen, it may be necessary to consult an ear specialist to drain the pus. Sometimes antibiotic treatment is also necessary.

Acute External Otitis

This inflammation occurs easily in summer and is often the result of an accumulation of water in the ear canal that cannot be eliminated. This is why it mainly affects people who spend their holidays at the seaside or who frequent swimming pools.

The symptoms of this specific non-infectious otitis are:

• redness of the ear canal;
• itching;
• discharge of a clear and odorless fluid;

Other possible symptoms are fever and swollen lymph nodes. Treatment for summer otitis involves taking anti-inflammatories and possibly applying local medications to restore the balance of the ear. A maneuver by the ear specialist to drain the accumulated fluid may also be helpful.

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Ménière's Disease

Ménière's disease is a disease that affects the inner part of the ear, particularly the endolymphatic duct or labyrinth, a semicircular canal that contains not only the ear nerves that transform sound waves into electrical signals for the brain, but is also responsible for the sense of balance.

The symptoms of this unpleasant condition, which is similar to labyrinthitis (inflammation of the labyrinth, which, however, is usually caused by pathogens and heals without leaving any trace), are varied and may differ from one person to another. They include:

• dizziness;
• cold sweats;
• palpitations and tachycardia;
• lightheadedness, nausea;
• tinnitus ("ringing" or buzzing in the ear);
• sometimes disturbed or reduced hearing;

Unfortunately, there is no cure for Ménière's disease, as the exact causes are unknown. Symptoms can be controlled by anticholinergic drugs and an appropriate diet. Acupuncture and anti-stress relaxation techniques appear to be effective for many people.

Tinnitus

Tinnitus presents as a buzzing, whistling, or classic trill that you hear as if it were coming from inside your ear, which does not depend on external sounds and which, in some cases, can occur so frequently that it becomes unbearable. The causes of this curious hearing disorder are varied, from Ménière's disease to stress, and cervical osteoarthritis. Tinnitus can occur every day without interruption for months, then disappear spontaneously; there is no cure. But if tinnitus persists, it is important to consult an ear specialist to check the health of your ear.

Vestibular Neuritis

Vestibular neuritis is a viral infection of the inner ear. Symptoms include:

• vertigo and dizziness;
• sometimes nausea and vomiting;
• partial hearing loss;
• pain and a general feeling of malaise similar to the flu;

In rare cases, nystagmus (involuntary eye movement). Vestibular neuritis must be treated immediately with the appropriate medication prescribed by the doctor, from the onset of symptoms until they disappear.

Cholesteatoma

Cholesteatoma is an otological disease characterized by the abnormal production of epithelial cells in the middle ear, itself caused by a chronic infection, typically a poorly treated otitis media with perforation of the eardrum. The symptoms of this serious ear disease include otorrhea, pain, progressive hearing loss (deafness), and even, in severe cases, facial nerve paralysis. Cholesteatoma is only treated with antibiotics when it is a mild form or is detected early on. Otherwise, the solution is surgical removal of the excess tissue.

Presbycusis

Presbycusis is characterized by the gradual, progressive, and inevitable decrease in hearing that occurs in many elderly people, especially after age 65. Because the cause is aging, it is not possible to prevent the process, but hearing loss can be compensated for by removable hearing aids (classic hearing aids), or permanent bone conduction hearing aids. Symptoms may affect both ears or only one, and are generally characterized by the fact that the first sounds to "disappear" are the highest-pitched, such as some women's or children's voices, birdsong, the ringing of the telephone, etc.

Deafness

Unlike presbycusis, deafness can occur at any time of life, even dramatically. This very disabling condition can occur at birth or be the result of trauma or an ear disease, so another distinction must be made here as well. Deafness cannot always be cured. If the cause is damage to the auditory nerves, nothing can be done. In other cases, the placement of cochlear implants in children or adults or the surgical correction of congenital malformations makes it possible to recover, if not all hearing ability, at least part of it. Prevention is extremely important, both during pregnancy, by protecting oneself from the most dangerous infections through appropriate vaccination, and throughout life, by avoiding neglecting the symptoms of a "common" otitis that could turn into a threat to the integrity of the ears.

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