Articles on ear

Increase in Fungal Infections in Ear With Arrival of Monsoon

Dr. LOKESH KUMAR BHAMA
Fungal infection of ear canal, also called as Otomycosis. It is a superficial fungal infection of the external auditory canal. It is the most frequently encountered fungal infection in ear, nose and throat clinics. The organisms responsible for this clinical entity are usually fungi especially A. niger. The fungi are usually secondary invaders of tissue already rendered susceptible by bacterial infections; physical injury or excessive accumulation of wax in the external auditory canal.The fungus tends to grow in humid, dark and warm areas and ear canal is one of the best places, especially in the rainy season. Excessive use of antibiotic ear drops may also be a cause of fungal infection of the ear.The fungal infection of the ear canal usually presents with a itching, irritation, discomfort, pain and scanty discharge from the affected ear. Patients also complain of feeling a blockage in the ear due to collection of fungal material in the canal. Sometimes irritation is so severe that patients tend to insert pins or sharp material in the canal leading to further injury or bleeding from the canal.Pruritus and discharge are the most common symptoms which are usually unilateral but bilateral involvement is also been seen. There is greenish or black fuzzy growth on in the canal resembling wet ‘blotting paper with black dots’, which may fill up the entire canal.Careful drying and cleaning of external auditory canal is the first step in treatment, which is done preferably by suction evacuation by an ENT Specialist. The topical therapy with antifungal or other antimicrobial agents is also necessary.After cleaning the canal, antifungal drops are given. Because the infection can persist asymptomatically, the patient should be re-evaluated at the end of the course of treatment.

How to Find Which Hearing Aid Suits Me the Best?

Dr. Sivaprasad Reddy, Audiologist
Hearing aid is a digital electronic device that amplifies sounds to meet the reduced hearing power. Hence it has a bundle of amplifiers (channels) and they can be adjusted (bands) using a software by trained audiologists. Hearing aids come with a variety of special features and the price varies with the number of features. The best hearing aid may not be expensive at all, or cheaper, as predicted by some. Though there are different ways in which the best hearing aid is selected, the method described here is accepted and followed in best audiology clinics across the world.You can select the best hearing aid for you in 3 stages – Thorough hearing test, Detailed counselling basis your listening requirements and Experience the sound and features. Also, try and keep a room for knowing what special accessories are available with the hearing aids. Sometimes, you may need an accessory that connects hearing aids with your TV or mobile phone or even the class teacher.Role of a trained AudiologistAudiologist has an eye to see the detail in your audiogram. The audiogram values help us selecting the sound power, channels, vents in hearing aids, special features that can bend high pitch sounds. Some audiograms are so challenging that it needs discussion among 2-3 experienced audiologists.Audiologist is also trained to identify the listening needs and match them with correct features in hearing aids. Even the Identification of communication situations that cause you the most difficulty is a critical first step in solving your problems. Audiologist’s knowledge, expertise and access to multiple brands will make this easier and better for you.After successfully completing these 2 stages, it is the time test the proof of the pudding by wearing the hearing aids. The hearing aids are programmed and the required features are activated. Most of the times the demonstration and experience can be completed within the clinic premises. In some cases, because of special listening needs, the experience is given in the real-life situation.Special features in Hearing AidsIt is now proven that the hearing aid users are more satisfied with new programmable technology. Advanced programmable technology allows the audiologist to adjust the hearing aid to your specific hearing loss with more precision. The following description helps in knowing some new features in programmable hearing aids.Multiple ChannelsThe majority of today’s hearing aids have multiple channels. Each channel represents a portion of the frequency range important for understanding speech. One advantage of multiple channels is that features such as gain and compression can be programmed differently to reflect changes in the patient’s hearing across frequencies.Directional MicrophonesUsing two microphones it is possible to configure a hearing aid so that sounds from the side, and especially the back of the hearing aid user are amplified less than sounds originating from the front. The user can easily hear conversations coming from front and ignore the rest. Directional technology is available on all hearing aid styles except CICs (because of size constraints). Importantly, directional technology does not improve localization of sounds.Noise ControlWith digital hearing aids, it is possible for the hearing aid to analyze an incoming signal and differentiate speech from a noise signal. This can be accomplished simultaneously in several channels, hence, works better in hearing aids with more channels.Stop Whistling Acoustic feedback (whistling from the hearing aid) can be annoying, embarrassing, and in some cases, prevent the hearing aid wearer from using the correct amount of gain. Many of today’s hearing aids have an automatic feature that quickly detects acoustic feedback and cancels it.Wireless Hearing Aids (with Bluetooth)They have a special Bluetooth in them which can amplify the ‘streamed’ sound also. Sounds picked up directly from TV, mobile phone, music system etc (with the help of an accessory) and amplified by hearing aids with little distortion or interference from noise.Hearing Aid could be your Style StatementHearing aids are available in at least 4 different styles. The most popular ones are worn behind the ear – BTE (behind the ear) and RIE (receiver in the ear). They are available in a variety of colour options and can help you surely make a style statement.The less popular ones are worn inside the ear – ITC (in the canal) and CIC (completely in canal). They are tucked inside the ear and have few options to express your style. They also have several limitations in terms of feature availability.All said it is good to be realistic in having expectations even from these miniature and most sophisticated computerised devices. Hearing aids will not permit you to hear the flapping of hummingbird wings near a jet engine. Remember that it takes time to get used to hearing aids, especially if you're a new wearer. Keep in mind that background noise is almost always part of your environment, and adjustment to it is required. In time, you will tune out many of these everyday sounds. It's important not to become disappointed or frustrated while your brain begins to adjust to a whole new world of sound.

How Do I Clean My Ears?

Dr. Rajesh Kr. Bhardwaj
Our ears help us to hear as well as maintain balance.The External ear secretes a solution which is called wax. Wax is a protective secretion and prevents bacterial infection of the outer ear canal wall.This accumulation in the ear canal is not dust or dirt that gathers from the atmosphere over a period of time. No. It is our own protective secretion.The ear canal skin is magical in one way - it migrates outwards. During this process of migration the ear canal sheds the accumulated wax outside the ear canal. This is seen as dry debris that lies outside the ear.The only ear cleaning that you need to do is to take a moist cloth and brush off this debris. You do not need to do more.Please DO NOT INSERT EAR BUDS INTO YOUR EAR. Indiscriminate use of ear buds causes1. Ear wax to be pushed deep inside leading to blockage2. Damage to the ear canal skin leading to bleeding and infection3. Rupture of the eardrum in extreme cases - especially if a child shakes your hand while the ear bud is inside.Ear Bud going deep into the ear causing rupture of ear drumSo, the absolute NOs for ear care are1. Avoid using ear buds to clean ears2. Do not instil oil in the ears - this may lead to a fungal infection, especially during hot and humid months3. Avoid going to street vendors - their instruments are not sterile and they may cause an infection.street ear cleaner - courtesy -  johnnyvagabond.comIn case you experience ear blockage and feel that it is due to wax, kindly put some Over The Counter Ear wax softening drops for 5-7 days and then visit your nearest ENT Specialist - She will use sterile instruments and remove the wax in the most scientific manner.

Cough ,Cold and Ear Infection in Children

Dr. Vipul Mehrotra, Pediatrician
Because their immune systems are still developing, children are especially vulnerable to viruses and bacteria, and they tend to get sick more than grown ups. Most of the time, all kids need is a little symptom relief and comfort. Here's how you can help yours recover faster from colds, coughs, and earaches, plus how to tell when sickness indicates something more serious.Treating coldsBabies and kids typically get six to eight colds a year -- just think of all the stuff they're constantly sticking into their mouths and it's easy to understand why. The good news: These infections actually help strengthen their immune systems down the line. Meanwhile, to help her feel better:Saline drops in the nose can reduce congestion (follow package directions for dosage). This is especially helpful for babies too young to blow their noses. Put a cool-mist vaporizer in her bedroom -- moist air helps alleviate congestion.Give infant acetaminophen (babies older than 3 months only) to ease her discomfort. For babies 3 months or younger, don't give any medication without talking to your doctor first (it can mask a fever, which requires immediate medical attention in infants; for more info, see "Fevers", below).Call the doctor if-You suspect the flu in an infant younger than 3 months, go to the doctor right away (symptoms of flu include fever, fatigue, and listlessness); from 3 to 6 months of age, it's less urgent, so call your pediatrician and ask what the best course of action is. (Remember, symptoms of flu come on suddenly -- as opposed to cold symptoms, which come on gradually -- and they're more intense.) Your child shows symptoms of sinus inflammation or sinusitis (a bacterial infection of the facial cavities), both of which may cause a wet or phlegmy cough, bad breath, and thick yellow or green mucus. Sinusitis may also bring on a headache and fever. If your doctor diagnoses an infection, he'll likely prescribe antibiotics.Soothing coughs.A cough often develops with a cold, and can be persistent. There's usually nothing to worry about, and the best thing to do is let it run its course. To make your child more comfortable-Offer liquids to lubricate an irritated, cough-prone throat. For babies, nurse or bottle-feed more frequently. For children, give water, warm tea, or diluted juice (semi-frozen if you want, for its soothing chill).At bedtime, elevate your child's head with a wedge underneath his mattress. Always ask a pediatrician before giving a child under 3 years of age an over-the-counter cough preparation or decongestant. For all kids, avoid any medication that contains phenylpropanolamine, which may trigger seizures and increase the risk of stroke.Call the doctor if-Your child has a severe cough and a fever of more than 101 degrees Fahrenheit that lasts more than a day; you'll need to have your pediatrician rule out strep. (A rectal temperature is the most accurate reading.) Your child is wheezing and coughing to the point that he's having trouble breathing -- or he shows a loss of appetite and unusual lethargy. This could signal a more serious infection such as respiratory syncytial virus (RSV), which can lead to bronchiolitis, an inflammation of the small tubes of the lungs. Bronchiolitis can be life-threatening in some babies under 6 months, and in preemies up to 1 year.Your child has a hacking, barking cough -- usually at night -- which means he probably has croup, an infection of the larynx (the voice box). Call the doctor no matter the hour; he'll probably advise you to elevate your child's head and go out into the cool night air with him. If your child is struggling for breath, go to the emergency room. He likely will be given an injection of steroids -- a standard treatment that's safe in kids as young as 3 months -- and perhaps a nebulizer with medication to help open his airways.Your child's cough persists for a week or two and then worsens, with severe and prolonged coughing jags punctuated by gags and gasps and, occasionally, vomiting. This could be pertussis (a.k.a. whooping cough). In spite of its name, babies under 1 rarely "whoop." Nor do adults (kids do). Your doctor will probably prescribe antibiotics.Babies are especially vulnerable until they get the third of four diphtheria- tetanus-pertussis (DtP) vaccinations, usually at 6 months. Those under 3 months are at increased risk for pertussis-related apnea, in which they stop breathing altogether and need emergency help. The best prevention: Stay on schedule with baby shots and remain vigilant for signs of pertussis until full protection kicks in around 6 months. When kids hit 11 or 12, they'll need a booster shot.FeversA fever indicates that the body is working to fight an infection, and is usually not a cause for concern. How your child is behaving is actually a better way to tell how ill she is. If your baby has a fever but plays normally (rather than being listless and fussy), there's probably nothing to worry about. Same goes for toddlers and older kids. As long as your child acts like she normally does, all you need to do is comfort her by:Making sure she gets plenty of rest. Giving her lots of fluids. Infants and toddlers may be given a commercial rehydrating solution, such as Pedialyte or Rehydralyte. Sponging her with tepid water or placing her in a bath of lukewarm water. Giving her acetaminophen or ibuprofen to reduce her discomfort, as long as the doctor says it's okay. (Children under 18 should never be given aspirin; it's been linked to Reye's syndrome, a serious disease that affects the brain and liver.)Call the doctor if-An infant 3 months or younger has a temperature over 100.4 degrees Fahrenheit, even if she shows no other signs of illness. (Always use a rectal thermometer for babies this age since it provides the most accurate reading.) And be ready for a trip to the emergency room to rule out a serious infection -- in the early weeks of life, babies have a limited ability to fight illness because their immune systems are not fully developed.Your 3- to 6-month-old has a temperature of 101 degrees Fahrenheit or higher, as children this age have a greater (though still small) risk of a serious bacterial infection than older kids do. An older child's temperature hasn't improved in three days or reaches 103 degrees Fahrenheit or higher. A feverish child of any age develops other symptoms -- a rash, an earache, swollen glands, or trouble breathing. The pediatrician will want to make sure your child doesn't have a serious illness, such as pneumonia or meningitis. Your child suffers a febrile convulsion. These seizures are scary but not uncommon, and happen most often in babies between 6 months and 2 years. Have the doctor check your child the first time this happens to make sure it hasn't been caused by an underlying condition. Kids prone to febrile convulsions usually outgrow them by age 6 with no long-term effects.Ear infectionsBy age 3, 70 percent of children have had at least one ear infection. The vast majority occur when fluid accumulates in the middle ear and becomes infected (usually a bacterial infection), causing pain, swelling, and redness. If your baby seems uncomfortable and begins pulling on his ears, you may have an ear infection on your hands.About 80 percent of the time, the infection will clear up on its own in a few days, so you may not need an antibiotic. New evidence shows that antibiotics simply don't help most kids that much -- they end pain at best half a day sooner than if left untreated. Many experts think it's best to wait on antibiotics and manage the discomfort by:Giving your child acetaminophen or pain-numbing drops (which your doctor can prescribe) Applying mild heat to the ear-try a warm, moist washcloth.Call the doctor if-You suspect an ear infection and your child is 2 or younger. Your older child has mild pain in his ears for more than 24 hours; is in great pain; is running a temperature of 102 degrees Fahrenheit or higher; or younotice pus coming out of his ears, or the glands in his neck seem swollen.Your child gets one ear infection after another. If this is the case, talk to your pediatrician about whether ear tubes are a good option. These tubes are implanted surgically, and are designed to allow bacteria-friendly fluids to drain from the ear. Tube implantation should be a last resort, but chronic ear infections shouldn't be ignored since they can affect a young child's hearing and delay speech.Preventing ear infections-To lower your child's odds of getting an ear infection:Breastfeed. This is associated with a lower risk of ear infections.Feed upright. In young children, the ear's Eustachian tube goes in a straight line from the mouth to the nose to the ear, so when a child lies flat, formula or milk may drain through the tube into the middle ear and provide a meal for bacteria.Limit pacifiers. A study found that babies who didn't use pacifiers had one- third fewer middle ear infections. If your baby loves his, try giving it only at naptime and bedtime.Stop sniffles. Ear infections often follow colds, so cold-prevention tips matter: Remind kids to wash hands with soap and water after they cough or sneeze, and before meals.Don't smoke. Kids who are exposed to secondhand smoke get more ear infections; it irritates mucous membranes and damages tiny hairs in the middle ear.Stay up-to-date with vaccines. The pneumococcal vaccine, Prevnar (recommended for all healthy children under 2), mainly prevents bacterial meningitis, but also guards against seven strains of ear infection-causing bacteria. (Babies typically get four shots, between 2 and 15 months.)SummaryYour child is bound to get her share of coughs, colds, and earaches when she's little. They'll become less frequent as her immune system strengthens. Meanwhile, be watchful of symptoms and give her plenty of TLC.

How to Deal With #Insect Inside Ear

Dr. Vijay Chourdia
How to Deal With #Insect Inside Ear -If Suddenly one feels a #buzzingsound or an itchy feel in the ear& to horror, one feels a live insect in ear, which can be extremely annoying and is like a nightmare. Insects often get stuck when they enter our ears as they cannot fly or crawl out.first thing is to confirm if insect is there or not;for which pull pinna upward and backwards in adult and straight down in children below 3 yrs,throw light with torch,if a #mosquito it might come out with light.If other insect use gravity down position so it might crawl out.#Staycool,calm and no panic plz.Being too active may lodge the bug further in your ear or cause it to crawl further back, or cause #damage to the sensitive inner ear or eardrum.keep objects (like fingers) away from your ears to promote early exit of insect.sometimes there is no insect or might have come out and just sensation or feeling is persisting.Abnormal sensation can be sometimes due to eustachian dysfunction.If you are not able to understand&If the foreign object is an insect, tilt the person's head so that the ear with the offending insect is upward.Try to float the insect out by pouring #mineral,#oiloliveoil or baby oil into the ear.The oil should be warm but not hot. As you pour the oil, you can ease the entry of the oil by straightening the ear canal. Pull the earlobe gently backward and upward for an adult, backward and downward for a child. The insect should suffocate and float out in the oil bath,it will #Kill the insect by #drowning it. Don't use oil to remove any object other than an insect. Don't use this method for a child if ear tubes are in place or if you think the eardrum may be perforated. The emergency is over once the insect is dead. See your#ENTdoctor as soon as possible.one may also Squeeze droplets of #alcohol in ear canal,even though painful.The alcohol will evaporate but the smell will pressure the insect to come out.one may also,#Flush the ear with water – using a bulb or syringe (without the needle) if one is available to swish it out.Let the water slowly overflow and watch for the insect to be flushed out. Do not irrigate ear if you think your ear drum has been ruptured or has old hole in drum or has a tube or grommet.But do not try to remove an insect with cotton swab, tweezers or hair clip or#forceps or any other tool, as it will make the situation worse and can lodge the insect deeper into the ear canal, which can possibly damage the eardrum,middle ear leading to hearing loss and may lead to chronic disease and necessity of #tympanoplasty operation in future. we sometimes get such cases of damage hence please ask only a ENT specialist to remove and no one else must attempt removal even though tempting.Best thing is always visit ENT doc & get insect removed fully or if parts are left with.he will also clean debris or infection.believe me it will be cost effective and safe.Lastly plz ensure less entry of insects in house or office,avoid lying on ground, use insecticides regularly for insect control etc.

Say No to Earbuds

Dr. Sumanth T J
Since our childhood, we have been repeatedly told to keep our ears clean, using a ear bud. Are our elders right in suggesting so? Should we listen to their advice and continue using an ear bud ? You can read on to make an informed decision. What is wax? Wax is a natural secretion of the ears containing a mixture of dead skin cells and sebum (a lubricant secreted by the hair inside the ear). Its function is to trap the dust entering the ear and preventing it from going deep inside. Wax is produced only in the outer 1/3rd of the ear canal which is a hair bearing area. It is not a waste product but a very useful secretion. Freshly formed wax is transparent in colour and as it ages becomes brown or black. Over a few days,the wax is naturally pushed out of the ear canal and falls off during sleep or while taking a bath. The skin lining the ear is special in that it is the only skin in the body which can expel wax. Only a few people have the tendency to accumulate wax even when not using ear buds. What happens when we use an ear bud ?The wax which should be present only in the outer part of the ear, is pushed deeper inside from where it cannot be naturally expelled. So, over a period of time, wax starts accumulating in the ear and goes even deeper, eventually hitting the ear drum. This will lead to hard of hearing. If the wax stagnates for long, it can infect the ear drum leading to severe pain.How should the accumulated wax be removed? There are no home remedies to remove accumulated wax. Using wax solving ear drops also does not help as the wax absorbs the drops and swells up leading to further pain and loss of hearing. You need to visit an ENT specialist who will have appropriate instruments to remove the wax.Is wax removal painful? IF done using syringing or wax hooks, Many patients complain of pain and are apprehensive in going back for ear cleaning further complicating matters. With the advent of microscopes and endoscopes with magnification, wax removal is a breeze and can be achieved without pain or discomfort. So always visit an ENT specialist,especially one has has an endoscope or microscope.How often should the ears be cleaned?I suggest everyone to have their ears checked atleast once a year.

Earwax in Kids -- What's Healthy and What's Not?

Dr. Poonam.M. Sambhaji, Pediatrician
Earwax (also known as cerumen) is a natural substance which helps to keep the ear clean and healthy. It traps dirt, dust and other particles that could damage the eardrum were they to travel inside the ear. Normally, wax builds up, then dries out and moves to the outer ear, where it is expelled. What causes earwax to build up in the ear? Sometimes earwax accumulates faster than the body can expel it, and that's when earwaxcan build up.When is earwax a problem? When a child's ear canal is plugged with too much wax, it can pose the following problems Poor hearing due to the blockage. Ear discomfort EaracheNoises in the ear (tinnitus)Earwax is normal and natural. The build-up does not cause fever and sleep troubles which are associated with ear infections. If there's a large amount of wax, you may be able to see it just by looking into your baby's ears. How can I clean my baby's earwax? You can clean visible earwax on the outer rim of your baby's ears with a cotton ear bud. But the bud shouldn't go deep into your baby's ear. Do not try to clean your baby's ears with your fingers, a hair pin or a pen. You could do more harm than good with such sharp objects. If you are concerned that the earwax is affecting your baby's hearing or troubling her in any way, make an appointment with your doctor. The doctor might advise eardrops to help soften the earwax so that it comes out gradually on its own. If it does not come out on its own than visit your doctor for wax removal, which would be done under direct visualisation without hurting the ear drum.Putting warm oil into your baby's ear will not help get rid of the earwax. It can be dangerous.Happy Parenting DR POONAM M. SAMBHAJI CHILD AND NEWBORN SPECIALIST(All views are compilation from web as well as clinical experience. Some web articles may be used since I feel it gives compact and just the needed information to parents.)