The ear is critical to hearing and balance in our body. Ear symptoms include ear pain, itch, discharge, hearing loss, ringing in the ears and dizziness. Some patients may experience ear symptoms as a result of an underlying nasal, throat problem, dental, temporo-mandibular joint or cervical spine issue.
Otoscopy, microscopic examination and ear clearance, nasal endoscopy and hearing test maybe required during your visit for proper assessment and management.
Ear Conditions
Ear Procedures
Re-Positioning Manoeuvre
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At Adult and Child ENT Specialists, We are committed on providing Effective, Personalised & Holistic Care for all patients.
Ear Conditions
Wax Impaction
If you experience blocked ear sensation, tinnitus, itchy ears, decreased hearing or ear discomfort, you may be having impacted wax.
Risk factors include ear digging with cotton buds, insert ear-phones overuse, water sports, underlying skin conditions such eczema, may cause one to have excessive ear wax production.
Management with Dr Soon will include otoscopy and microscopic ear clearance.
Infections
A. Outer Ear Infections (Otitis Externa)
If you experience severe ear pain, a discharging ear, ear swelling associated with decreased hearing with tinnitus, you may be having an outer ear infection (otitis externa).
Risk factors include ear digging with cotton buds, insert ear-phones overuse, water sports, overuse of antibiotic ear drops or a misplaced foreign body in the ear
Management with Dr Soon will include otoscopy and microscopic ear clearance. You will need topical ear drops and oral antibiotics if you develop complications to the ear.
B. Middle Ear Infections (Otitis Media)
If you experience ear pain, decreased hearing, tinnitus, associated with a low-grade fever or headache, you may be having inflammation of the middle ear (otitis media).
Risk factors include recent upper respiratory tract infections, uncontrolled rhinitis, barotrauma. Underlying cause is due to eustachian tube dysfunction.
Management with Dr Soon include nasal endoscopy and hearing tests. Medications with oral antibiotics, nasal decongestants are given. Urgent decompression with myringotomy and grommet tube insertion, CT temporal bone maybe ordered if you experience complications of facial nerve paresis, mastoiditis/abscess formation.
C. Cholesteatoma
Cholesteatoma is a condition whereby skin from the outer ear canal has migrated into the middle ear. It is normally diagnosed after ear examination in adults presenting with chronic discharging ear with hearing impairment.
Management will involve microscopic ear toilet, hearing assessment, CT scan of the temporal bone and commonly surgery to eradicate the disease (mastoidectomy).
Hole in Ear Drum
If you experience sudden piercing ear pain with bloody discharge, or a discharging ear with decreased hearing and tinnitus (suppurative otitis media), your ear drum may have ruptured.
Risk factors include ear trauma from ear digging, barotrauma (flight, diving) or severe persistent ear infections
Treatment will involve microscopic ear clearance and hearing test to evaluate the degree of conductive hearing loss. A period of watching waiting, keeping the ear dry is advised. Surgery (myringoplasty) can be considered thereafter.
Hearing Loss
Hearing loss can occur suddenly overnight (a medical emergency) or gradually, chronic. There are two types of hearing loss: conductive (outer and middle ear conditions) or sensorineural hearing loss (inner ear conditions). Dr Soon will examine your ears and hearing tests will be pre-scheduled so that you will receive immediate results. Management will be advised accordingly.
Tinnitus
Tinnitus is described commonly as a constant buzzing sound which is heard more in quiet environments. If severe, it can disturb sleep or create anxiety. It can manifest as a single ear symptom or associated with hearing loss, ear fullness and vertigo.
Ear examination, hearing tests are commonly performed. Dr Soon will advise on the management accordingly. Imaging scans maybe ordered if severe, for pulsatile tinnitus or associated with headaches and balance issues.
Eustachian Tube Dysfunction
If you experience ear fullness, ringing or popping noises in the ear or more severe symptoms of reduced hearing or muffled hearing, you may be having eustachian tube dysfunction, a condition whereby the mucosal lining of the tube is swollen or does not open or close properly.
Nasal endoscopy is performed to check the post-nasal space (area around the opening of the eustachian tube) and hearing tests ordered to check middle ear pressures and hearing thresholds.
Treatment by Dr Soon often include management of nasal allergies. Procedures such as eustachian tube balloon dilation, myringotomy and grommet tube insertion maybe required if symptoms are recurrent, persistent or associated with hearing loss.
Vertigo
Vertigo is a condition whereby you feel that the room is spinning or swaying when they are not. It is commonly triggered by movement or turning of your head. You may feel nauseated and want to vomit. Acute symptoms are commonly treated with oral or injection with anti-emetics, positional maneuvers. It is important not to miss neurological, cardiac or cervical causes of vertigo as some of these medical conditions are emergencies. Common diagnosis in adults include benign paroxysmal positional vertigo, vestibular neuronitis, and less frequently labyrinthitis and Meniere’s disease.
Bell’s Palsy
This is a neurological disorder that causes sudden paralysis or weakness on one side of the face (drooling of the mouth, difficulty closing one eyelid, drooping eyebrow and mouth). You may also experience excessive eye tearing, problems with taste, facial pain or abnormal sensations. This is due to a problem (inflammation or swelling) of the facial nerve (cranial nerve VII). Causes include existing viral infection such as herpes simplex or varicella (chicken pox) or impaired immunity. You should see a doctor immediately. Treatment normally involves high dose oral steroids and eye care. You should notice an improvement of facial function after 2weeks and full recovery possible by 3-6 months.
Swellings around the Ear (Sebaceous Cyst, Pinna Pseudocyst, Keloid)
Swellings around the ear maybe cosmetically unpleasant, asymptomatic or give symptoms of pain, itch, discomfort. Common benign swellings around the ear include sebaceous cyst, pinna pseudocyst, keloid formation. Options of treatment will include removal or steroid injection for keloids.
Ear Procedures
Microscopic Ear Clearance
Microscopic ear clearance is a clinic procedure whereby Dr Soon will examine and remove any earwax, discharge or foreign body in the outer ear canal using a microscope. Under magnification and direct vision, and with the aid of fine ear instruments and suction, the outer ear canal and ear drum which lies posterior can be clearly visualised. The clearance is safe, quick and atraumatic.
Indication: Blocked ear sensation, discharging ear, hearing loss, history of foreign body/objects in ear, swollen ear.
Procedure is performed in the clinic.
Myringotomy and Grommet Tube Insertion
This surgery involves making a small incision on your ear drum to release the fluid in the middle ear. A ventilatory tube (grommet) is usually inserted in the same setting.
Indication: Acute middle ear infections (otitis media with effusion) with complications or chronic non-resolving otitis media with effusion.
Procedure is performed in the clinic (under topical or local anesthesia).
Ear Drum Repair (Myringoplasty)
This surgery involves patching up the hole in your ear drum
Indication: Ear drum perforations giving problems of recurrent infections or hearing loss.
Performed under general anesthesia with an artificial membrane or harvesting of temporalis fascia. Can be performed through your ear canal, or an incision is required on the ear or behind the ear.
Mastoidectomy
Mastoidectomy is a procedure to remove cholesteatoma and to reconstruct the surrounding structures which it has damaged. It is performed under general anesthesia with an incision behind the ear. Facial nerve monitoring is required during the surgery. Extent of surgery depends on preoperative CT temporal bone, hearing test results an intra-operative findings.
Eustachian Tube Tuboplasty
This surgery involves dilation of the eustachian tube to improve the patency of the cartilaginous Eustachian tube
Indication: Eustachian tube dysfunction with associated middle ear conditions resulting in hearing loss.
Performed under general anesthesia and trans-nasal. Other nasal procedures or grommet insertion maybe performed at the same setting.
Excision biopsy
This procedure involves complete removal of your ear swelling. Most can be performed under local anesthesia. Suture removal will be done in clinic and histology results discussed with you one week after surgery.
Incision and drainage of abscess
This procedure is required when pus has accumulated in a swelling around your ear or in your ear canal. Under local anesthesia, Dr Soon will make a stab incision over your swelling to drain the pus. Pus is taken for culture, cavity is cleansed, curettage and abscess wall sent for histology. The cavity is left open with dressing and healing by secondary intention. You will be prescribed antibiotics and will be required to return to clinic for dressing till the wound is cleaned. Elective excision at a later date maybe required in some cases.
Re-Positioning Manoeuvre
Re-Positioning Manoeuvre for benign paroxysmal positional vertigo (BPPV) encompasses a series of head movements which will be performed by Dr Soon to relieve your vertigo symptoms. The commonest manoeuvre, Epley’s manoeuvre is used to move the canaliths out of the canals so that they stop causing symptoms.
It is normal to feel giddy during the treatment. Some patients may throw up. It is advisable to bring along an accompanying person during your consult.