Your Middle Ear is Well Connected

“Your back bone connected to your shoulder bone, Your shoulder bone connected to your neck bone,Your neck bone connected to your head bone…….” from Gospel song Dem Dry Bones

Just as the lyrics of the above song tell us, every part of the body is connected to one another and as Dr Yeoh Thiam Long, Consultant ENT Head & Neck Surgeon, KPJ Ipoh Specialist Hospital emphasises, ear issues may originate from other organs, as in your nose, sinus and even the brain!

In particular with middle ear problems in children where fluid accumulates and the symptoms are not immediately apparent. As the middle ear is connected to the nose via the Eustachian tube and in children, this tube is shorter and more horizontal than in adults, children are more prone to ‘Acute Otitis Media’ (AOM) which is a painful type of ear infection. It occurs when the area behind the eardrum called the middle ear becomes inflamed and infected.

Symptoms which manifest may include fits of fussiness and intense crying (in infants); clutching the ear while wincing in pain (in toddlers) and complaining about a pain in the ear (in older children).

The eustachian tube can become swollen or blocked for several reasons such as allergies, a cold, the flu, a sinus infection, infected or enlarged adenoids, cigarette smoke, drinking while lying down as in infants fed from a bottle.

In cases where symptoms are not so obvious, parents need to be vigilant for signs that their children has fluid and infection in the middle ear; such as when they are not hearing properly or their motor speech or language development appears slow or when there are repeated ear infections which can lead to permanent hearing loss. It is important that they check with an ENT specialist if children show any signs of the above.

All AOM infections must be dealt with thoroughly to ensure there is no lingering inflammation and all fluid removed. When medical treatment fails, only then is minor surgery required to drain the remaining fluid.

In the case of adults showing up with ear infections, tinnitus (ringing in ears), blockages or pain in the ears, the ENT specialist will always first eliminate the possibility of Nasopharyngeal cancer which is quite prevalent. Various tools are used for the various tests including an otoscopy which looks at the fluid behind the eardrum, a nasal endoscopy to determine if there is a nasal infection or tumour and occasionally a tympanometry to assess the middle ear function. Only in extreme cases is surgery considered.

“When a child is crying excessively and the child is pre-verbal, and when all other signs are normal, it is wise to bring the child in for a consultation to eliminate the possibility of a middle ear infection”, said Dr Yeoh, “because a middle ear infection if left untreated can have serious consequences as evidenced by the problems detailed earlier”, he stressed.