Acoustic neuromas are benign tumors that develop very slowly, on the eighth cranial nerve inside the ear, and they can have a major impact on a person. It is known that only about five individuals out of 100,000 actually have acoustic neuromas, but those who do have them may experience symptoms such as facial numbness, vertigo, a slow diminution of hearing in one or the other ear, problems with balance, and possibly tinnitus.
In extreme cases, the tumor itself can grow to a size where it actually becomes life-threatening, so its early detection is very important. The issue with early detection is that, as mentioned, the development of such a tumor is generally slow, which makes the symptoms experienced very gradual in nature.
In many cases, these symptoms are actually just attributed to normal aging and don’t attract any real attention because they’re thought to be a consequence of diminishing capability. Individuals who experience any of the symptoms referenced above should seek medical attention at the earliest opportunity. This is so that if there is an acoustic neuroma in progress, steps can be taken to have it treated before it gets critical.
How Acoustic Neuromas Develop
The cranial nerve where a neuroma begins to develop is the nerve which joins the inner ear and the brain, and it has a profound impact on both hearing and balance. This is why the symptoms of an acoustic neuroma include side effects that are both hearing-related and balance-related. It’s common for people with an acoustic neuroma to have problems with steadiness in their daily routine, even walking around the household.
Hearing can be impacted by the development of tinnitus, and possibly also a direct loss of hearing. As an acoustic neuroma grows larger and larger, it will begin to crowd the brain itself, as well as those nerves which manage facial expression and facial sensitivity. If an acoustic neuroma goes completely undetected and is allowed to continue growing, it can eventually put so much pressure on the cerebellum or brainstem, that a life-threatening situation can occur.
Causes of Acoustic Neuromas
There are two main causes of acoustic neuromas, the first of which is a sporadic form, and the second being related to a syndrome known as neurofibromatosis type II or NF2. Neurofibromatosis II is an inherited condition in which noncancerous tumors grow in the nervous system, and most of the time these noncancerous tumors are acoustic neuromas. For this inherited type of acoustic neuroma, it is fairly common for them to begin development in both of the patient’s ears, before the age of 30. This is a rare disorder that only makes up about 5% of all acoustic neuromas, meaning that the overwhelming majority of acoustic neuromas are of the sporadic form. Unfortunately, doctors and scientists do not yet understand what causes the sporadic form, although at least one risk factor has been identified as exposure to unusually high levels of radiation, primarily in the area of the neck and head.
Treatment for Acoustic Neuromas
There are three primary approaches to treatment of acoustic neuromas: radiation therapy, surgery, and observation. You can think of observation as ongoing monitoring or watchful waiting. Since acoustic neuromas are not cancerous and grow only slowly, there is usually not an immediate or urgent need for any more drastic form of treatment. What happens after the observation period will depend on how rapidly the acoustic neuroma grows, and what kind of impact it’s having on an individual.
Surgical procedures will take one of three tracks. Translabyrinthine surgery calls for an incision to be made behind the ear, so that a portion of the middle ear as well as the bone behind the ear can be removed, and this approach is generally used on tumors bigger than 3 cm. Sub-occipital surgery operates on the back of the head, and can be used for any sized tumors, and unlike translabyrinthine surgery which causes total hearing loss, sub-occipital surgery holds at least the potential for preserving your hearing. Middle fossa surgery also holds out hope for preserving a patient’s hearing, as it removes a small bone piece over the ear canal, so that tumors of a smaller size can be removed.
Radiation therapy is recognized as state-of-the-art treatment for acoustic neuromas, as it sends high radiation dosages directly at the tumor, while also limiting damage or exposure to all surrounding tissue. There are two types of radiation therapy which are generally used in the treatment of acoustic neuromas. The first of these is multi-session fractionated stereotactic radiotherapy (FRS). This delivers small doses of daily radiation over a period lasting several weeks, and is generally the more successful of the two radiation approaches. The second method for radiation therapy is known as single fraction stereotactic radiosurgery (SRS). In this approach, hundreds of small radiation beams are directed at the tumor in one comprehensive session. While this has the advantage of requiring only a single treatment session, it has historically been somewhat less effective than the FRS radiation therapy approach.
People who aren’t usually affected by sinus problems such as inflammation and infections probably think that the worst time for sinus flareups is either the spring or summer, when seasonal allergies kick in as a response to increased pollen in the air, as well as other triggers. However, almost anyone who is subject to seasonal allergies and sinus issues can tell you the real truth of the matter: many of the worst symptoms associated with sinus infections actually occur during the winter.
That means that the whole catalog of sinus issues, i.e. congestion, facial pressure, post-nasal drip, headaches, stuffy nose, runny nose, and headaches, are all as likely as not to be more severe during the cold season. Below you will find some of the reasons why that is true, and why there’s really no respite from the effects of sinus infection, despite what the calendar might say.
Less Humidity in the Air
During the cold winter months, there is usually far less moisture in the air, and far less in the home or office setting as well. Part of the reason for this is that furnaces or other heating systems are running so frequently that they dry the air out. When the air becomes that dry, it has a tendency to irritate the lining of your throat and of your nose, which in turn will exacerbate any issues with your sinuses. The best way to manage this situation is to install a humidifier in your home or in your area at the office, that will supply moisture to the air, and cause much less irritation to your nose and throat.
Increased Presence of Mold
Surprisingly, there are a number of triggers which can worsen your allergies or sinus symptoms during the winter time, especially around holiday season. At that time, most people will actually bring into the household some of the very items that can lead to a worsening of sinus symptoms. For instance, the fragrances given off by scented candles, which are very common during the holidays, can actually cause significant irritation to your sinuses.
The same is true of many holiday decorations such as wreaths, plants, Christmas trees, poinsettias, and a whole host of other decorative but potentially irritating sinus triggers. All these have the potential to develop mold growth, which can cause noticeable problems for your allergies and sinus condition.
It’s also very possible that tree decorations and ornaments which you have stored in the basement for the past 11 months can develop mold, while just sitting in a damp area out of sight. The best prevention for eliminating mold on holiday decorations is to store them in plastic containers which are airtight, and will not allow moisture inside. Before you bring a Christmas tree into the household, you should shake it down vigorously so unwanted debris will fall off. The best way to avoid the irritation that comes from scented candles and similar materials is to stop using them entirely if you notice that they are beginning to irritate your nose and throat. You should also keep in mind that any of the symptoms you might potentially experience from mold growth or fragrances burning in the household, will be made worse by having all the windows and doors closed.
Increased Likelihood of Colds and or Influenza
It’s much more common for people to contract influenza or common colds during the wintertime than it is during the summer or spring. Because this is so, it often causes the lining of your nose to swell up, and an increased amount of mucus is produced by the nose as well. All of this contributes to reduced efficiency of drainage, and it also causes an accumulation of mucus. If mucus is allowed to build up at any specific site in the body, it will invariably trigger the development of bacteria, and once that happens, you can expect a sinus infection to follow shortly thereafter, with all the nasty associated symptoms.
The best way to protect yourself against contracting influenza is to make sure that you are vaccinated with the seasonal strain of flu vaccine. Good hygiene is a must during winter times for preventing colds, because that’s one of the most common ways for bacteria to be spread among people. That means it’s very important for everyone in the household to wash their hands frequently, and to make sure noses are covered up when sneezing, such as into the elbow. When everyone in the household practices good hygiene, the chances for contracting colds and/or the flu diminish significantly.
It is especially easy during the winter months for pet dander, allergens, dust, and debris to become trapped inside the household, where they can all become triggers for sinus symptoms. There are a number of ways that you can address this, in order to minimize the impact of all those miscellaneous trapped substances.
Rugs, for instance, are known to be very effective traps for all these kinds of materials, and that means they should be frequently vacuumed and/or shaken outside so that as much debris as possible can be removed from the household. Old furniture is another major trap for debris, so these pieces should also be scoured to whatever extent is practical, to remove debris. Air filters are obvious traps for dust and debris, and they should either be cleaned regularly or replaced entirely, so that clean air is always circulating in the interior. If you have pets, they should be groomed regularly, so that they can be kept free of all kinds of harmful material that could be become a trigger for your wintertime sinus symptoms.
The nasal fluid produced by your body is known as mucus, although it has many more colorful names which younger people are especially fond of using. Contrary to popular belief, nasal fluid is not an offensive fluid from the body, and is not something that should be thought of as poorly as it is. In truth, nasal fluiid is one of the body’s most important lines of defense, playing a critical role in the protection against infections and various types of irritants.
What Exactly is Mucus?
Everyone is aware that our noses are used to smell things, but that’s certainly not the only role they play in human health. Their role, which not many people actually consider, is as a protection against inbound irritants, and in this capacity, mucus is one of the most important agents involved in the protection process.
Most people recognize mucus as a runny, nasty-looking substance that often dribbles out of the nose, but in actuality, it’s a very complex substance that works hard to keep sinuses and the interior of the nose moist. There are components of mucus which determine its thickness, elasticity, and stickiness, all of which are important in its role as defender against incoming irritation. Most people produce between one pint and one quart of mucus each and every day.
What Mucus Does
The primary role of mucus is to trap incoming irritation such as animal dander, pollen, mold, smoke, and bacterial substances. By smoothing the lining of the nose and trapping all these types of foreign substances and debris, they are prevented from reaching the interior respiratory system where a great deal of damage could be done. The vast majority of mucus is simply swallowed, along with all the material that it may have trapped. Whatever those foreign substances were, they become neutralized in the gastrointestinal tract, and are then expelled from the body.
This is the more invisible component of mucus removal, and not the one people commonly associate with the process. The more visible process for mucus removal is blowing your nose into a handkerchief, and this of course removes all unwanted material without the need for having it processed in the interior of the body. However, as stated above, this occurs far less frequently than the swallowing process, where most unwanted debris is managed.
Normal Mucus Content
Most of the time, people don’t really think about mucus or what is contained in it, and this is perfectly normal, because it should be unnoticeable if everything in the body is as it should be. Healthy mucus is colorless and is typically quite watery and thin. In the absence of any disease or infections in the body, the cilia of the nose move very gently in tiny waves to move mucus, along with any trapped materials, toward the back of the throat.
These cilia have been compared to tiny brooms which sweep materials clear of nasal passages to keep the breathing process running smoothly. When sinuses are in a good state of health, they are typically empty, because these cilia are working constantly to remove mucus and trapped materials. The end result of this constant sweeping is that the mucus is ushered toward drainage openings into the nasal cavity, and from there it can either be expelled by blowing the nose, or it will simply be swallowed and processed in the gastrointestinal tract.
Indicators of Mucus Problems
There are several indicators which tell you there’s some kind of problem with mucus, often because it’s associated with an infection. Since mucus is normally clear, if you should observe that it becomes yellow, brown, green, gray, white, or even bloody, this could be a sign of a major infection from bacteria, virus, or fungus particles.
The reason for this color change is that the white blood cells in mucus produce enzymes to repel invaders when they encounter any kind of infectious organism. The enzymes produced by the mucus have a tendency to turn it green, and if that remains in place overnight, it can then change into several other colors as described above.
Another indicator of a problem with mucus is the amount that the body generates. Healthy people will generally have clear-colored mucus, and will not even notice any amounts that are produced by the body, since all the work is carried on in the background. Whenever you begin to cough up significant amounts of mucus, that is a likely indicator of an allergic reaction or some kind of infection.
The thickness of mucus is also a frequent indicator of ill health, because thick mucus can clog the throat and become noticeable as it impacts the voice. Thick mucus inhibits vocal cord movement, and the associated post-nasal drip may cause persistent coughing, as well as changes in taste or in smell.
There may also be a burning sensation in the throat because mucus is dripping down the throat, and since it’s naturally acidic, that can be an irritation to the lining of the throat. That’s why it’s very common for someone to wake up with a sore throat when there’s some kind of infection occurring in the body – mucus drainage, which has occurred during sleep hours, has caused noticeable irritation in the lining of the throat.
People who have hyperacusis hear things a little differently than people with relatively normal hearing. With this medical condition, ordinary sounds like running water, the ticking of a clock, or the timer alarm on your microwave not only sound extremely loud, but also can actually be painful. This doesn’t mean that their hearing is more acute, or that patients with this condition are able to hear more sounds than the rest of us – it just means that all normal sounds you may hear in a typical day are heard at a higher level of volume. This is not just a temporary inconvenience a with minor impact; it can literally have a profound effect on a person’s quality of life, because the condition doesn’t ever take a break – it’s there all the time.
How Does Hyperacusis Develop?
Scientists are not exactly sure what causes this condition to develop in any one person, but studies which have been conducted seem to point to exposure to one of several triggering conditions as a cause. One of the most prominent of these is noise related to a daily job routine: for instance, someone working in a factory with heavy machinery, or where a repetitive loud noise recurs throughout the eight-hour shift.
Traumatic head injuries are another possible cause of hyperacusis, with many of today’s hyperacusis patients having experienced some significant blow to the head in their past. Chronic ear infections are another culprit, because even though they can be cleared up with medication, the damage they do while the infection is rampaging can persist beyond the duration of the infection itself.
Migraine headaches are thought to be another possible cause of hyperacusis, since many current hyperacusis patients also experience migraines, or have had them in their medical history. There also seems to be a correlation between patients who have contracted Lyme disease or TMJ Syndrome in their past, although it is not known exactly what from those two conditions leads to the development of hyperacusis. Lyme disease is spread by a tick which can commonly be found in fields and woods, and may be brushed up against by a person. Temporomandibular Joint (TMJ) Syndrome is a disorder which causes pain in the muscles and joints of the jaw.
As far as the physiology behind the actual triggering of hyperacusis, that’s the part of the equation that scientists and researchers have yet to confirm. At present, it seems likely that the fibers of the ear which regulate sound have been somehow compromised, and that the auditory nerve has suffered significant damage. Another school of thought holds that the brain’s central processing system affects how the brain evaluates sound, and for some reason magnifies it beyond its true level. And naturally enough, since there are primarily these two major theories about what actually happens in hyperacusis, there is also another group of scientists who believe that a combination of those two is the real answer to the problem.
Relationship to Tinnitus
While most people have probably not heard of hyperacusis, the medical condition of tinnitus is probably much more well-known. While these two conditions are not at all same thing, they do have a relationship, in that both represent departures from the norm in the way that sounds are heard. People with tinnitus experience several different abnormal sounds in their hearing, sometimes even when there is no actual noise being generated in the surroundings.
This can be felt as a ringing noise, or some kind of whistling, hissing, or buzzing, and it’s easy to see how this can be so distracting that a person’s quality of life could easily be diminished. Although hard statistics are not available to support this, it is estimated that more than 60% of patients who have tinnitus also have hyperacusis. So in addition to hearing a persistent buzzing or whistling sound in the ears, a patient who experiences both of these medical conditions would also sense ordinary sounds at several times their true volume.
Having either one of these medical conditions could have a profound impact on your daily life, but just imagine being troubled by both of them at the same time! Patients who are known to suffer from both medical conditions generally find it extremely hard to just get through a normal day. As a result, there’s a strong tendency for such individuals to withdraw from life to a significant extent, and become socially isolated. This in turn, can easily slide into depression and add to the list of medical conditions the individual would have to deal with.
Treatment for Hyperacusis
Treating hyperacusis requires a two-pronged approach, but it does not really result in a cure for the condition. People who have hyperacusis are generally counseled so as to help lower their reactions to loud sounds, and a process known as acoustic therapy helps to retrain the ear to hear sounds at a more normal level. While there are no actual medical or surgical procedures at present which can offer significant help, some success has been achieved by the counseling/retraining program. Not surprisingly, the same approach has been used with tinnitus, with similar success.
Ear infections are simply inflammations of the middle ear, and they are generally triggered by bacteria which accumulate behind the eardrum. People of any age can be subject to ear infections, but children have them at a more frequent rate than do adults. By the time of a child’s third birthday, five out of six children will have had an ear infection at least once, and that makes it the single most common cause for children to be taken to a doctor.
One of the problems with this is that some children are just too young to verbalize what they are experiencing, and can’t really tell you that their ear hurts. In this situation, a parent should be on the lookout for symptoms that characterize an ear infection, such as pulling at the ears, balance problems, fevers, difficulty with sleeping, excessive crying, drainage from the ears, and non-responsiveness to quiet sounds.
Causes of Ear Infections
One of the most common causes of an ear infection in a child is an upper respiratory infection, a cold, or a sore throat. In the case of the upper respiratory infection, related bacteria can easily spread to the middle ear, and with a cold, the virus can be drawn into the middle ear as an offshoot of the main infection. In any of these cases, fluid begins to build up around the eardrum.
The reason that children are more susceptible to ear infections than adults relates to the fact that the eustachian tubes in a child’s ear are smaller than an adult’s, and that makes it more difficult for any fluids to exit the middle ear, even in the absence of any kind of infection. When those eustachian tubes become swollen by a cold or other illness, drainage may slow down to almost nothing, and blockage will be the likely result. Complicating matters, the immune system for a child is not nearly as developed or robust as an adult’s, and that makes it much harder for children to fend off the effects of any kind of infection.
Diagnosing a Middle Ear Infection
When you take your child to see a doctor about a possible ear infection, the doctor’s first question will be about your child’s recent medical conditions. Your doctor will try and find out if your child has had a sore throat or a head cold recently. Then the doctor will ask about any of the other common symptoms associated with an ear infection, to see if your child has been experiencing any of these. After gaining this kind of information, your doctor will probably use an instrument called an otoscope, which is a lighted instrument that can see inside the eardrum to determine whether it is red and/or swollen with an infection. If this is inconclusive, your doctor might then use a diagnostic test known as tympanometry to measure eardrum sensitivity at various points.
Treatment for Middle Ear Infections
One of the most common treatments for a middle ear infection is an antibiotic called amoxicillin, which is generally prescribed over a period of 7 to 10 days. If your child is experiencing an inordinate amount of pain or discomfort, your doctor may also recommend pain relievers such as ibuprofen or acetaminophen, and possibly even eardrops which can be delivered directly into the ear.
In cases where an ear infection cannot be definitively diagnosed, your doctor may want to adopt a wait-and-see attitude about the condition, to see if it worsens into an actual ear infection. This is more common in very young children, between the ages of six months and two years. However, even when the wait-and-see approach is adopted, your doctor will probably ask to have your child returned within three days to check on whether symptoms have worsened.
If definitive diagnosis is still lacking, it is likely that a program of antibiotic treatment will be initiated, to be sure it gets no worse. When antibiotics are prescribed, it’s very important that the child takes the prescribed dosage throughout the entire period of the prescription, so that bacteria do not have the chance to develop resistance to the medication.
Preventing Middle Ear Infections
There is no rock-solid way to prevent middle ear infections in children, and the best approach that can be adapted calls for limiting the risk factors which may trigger an ear infection. Vaccinating your child against influenza is one good track to take, and limiting your child’s exposure to children known to be sick is a good idea as well, although obviously this is not 100% enforceable.
Good hygiene for everyone in the household is important: for instance washing hands and sneezing into your elbow, to help prevent the spread of germs to your child. It’s not a good idea for anyone in the household to be smoking, and statistics bear out the fact that where at least one person at home smokes, there are more ear infections than in smokeless homes. One last method of limiting the risk factor for developing ear infections is to make sure that your infant is never put down for a long period of time, such as overnight, with a bottle in hand.
When it comes to the sinuses, the most common issue seems to be excess mucus. When the sinuses aren’t acting as they should and sinusitis (a sinus infection) is experienced, it generally leads to mucus overproduction and this can be a difficult issue to live with. However, as many will tell you, dry sinuses are an equally difficult problem.
During the colder months especially, we tend to look towards artificial sources of heat to stay warm. With a pellet stove, for example, we’ve found a solution that keeps costs to a minimum while also not getting too hot for any children or pets in the house. However, one of the biggest benefits of this system is also one of its greatest downfalls.
Back in the day, people would keep a pot of water on the stove to keep moisture in the air. Today, we’re doing the opposite because the stoves are sucking all the moisture from the room for every second they’re working away. For many, this lack of humidity dries the sinuses and causes all sorts of problems as a result.
Is This a Problem?
First and foremost, having dry sinuses is unpleasant so it quickly becomes uncomfortable. The longer the problem goes untreated, the bigger it becomes. Additionally, the sinuses need moisture because bacteria, fungi, and viruses are normally kept at bay by a protective layer of mucus. If this mucus has disappeared, the protection does the same and the sinuses are left vulnerable.
As you may know, this all leads to many problems, one of the biggest being a lack of smell. At first, people tend to attribute the loss of smell to something else because they can’t imagine that a stove (or any other source of artificial heat without the ability to keep moisture in the air) would cause the damage. Soon enough, a medical professional will assess their sinuses and find the problem.
Over the years, people have developed their own solutions for this issue and we have three of the most popular here today. If one doesn’t work for you, try another because the theory behind them is very positive!
- Anti-Fungal Tea: If you’re suffering from a dry nose or dry sinuses, your liquid intake should be increased anyway so long as the liquid is water or any other responsible drink. If you can get your hands on it, there’s also anti-fungal tea and this just might prove to be a fantastic addition to your diet.Known as calendula tea, it comes from the orange calendula flower and offers all sorts of advantageous properties. For example, it acts as an anti-inflammatory, anti-fungal, and antiseptic solution. Alone, the tea should start to improve your sinuses but it becomes even more valuable when partnered with some herbs of your choosing.Since all the ingredients are natural, you can have this tea two or three times in a single day and you should notice a change to your breathing as the day goes on. If this doesn’t work, play around with the herbs you’re using or move on to another suggestion.
- Steam Inhalation and Room Humidifiers: As we addressed earlier, they had a simple solution back in the day and it came from a pot of water. Therefore, why not take from their lead and do the same thing? Nowadays, the market holds some fantastic room humidifiers (and even whole home humidifiers!) to add moisture to the air.If you feel comfortable, you could even try steam inhalation in combination with a neti pot. Before we get ahead of ourselves, steam inhalation is where you hold your face as close to hot water as possible. With a towel over your head to increase the intensity, the idea is to inhale the steam without getting so close you harm yourself. To improve the results, add some essential oils whether this comes from tea tree oil, eucalyptus, lemon, or peppermint. As a starting point, this steam should make the walls of the sinuses a little softer (and looser).From here, you can finish with a neti pot and this is a small container used to rinse any debris you may have from the nasal cavity. With a simple saltwater solution, you leave your sinuses in a great position to become healthy once again.
- Anti-Bacterial Tincture: If you want to fight infection and improve your sinuses, we recommend echinacea and boneset as a two-herb tincture. With a little of the tincture added to water, this should allow you to fight active infection. If you’ve never made a tincture previously, there are plenty of guides online that’ll show you how to get it right.
Regardless of which solution you try first, we urge you to keep going even if you don’t see any results the first time. Over the many years of people suffering with this issue, all three of these solutions have fantastic support in the community so they’re worth your persistence. Typically, you’ll notice a change within a few days and you don’t have to contend with the loss of smell any longer!
Quite often, the term ‘sinuses’ is used in relation to certain medical conditions. However, there aren’t too many people who know the role of the sinuses or how they’re made up. Today, our goal is to answer both of these questions so you’re aware the next time the term is used in conversation!
Commonly shortened to ‘the sinuses’, the paranasal sinuses are small cavities filled with air inside the bones of the face; the bones of note are also found in the eyes and nasal cavity. With each sinus, it has a name that represents the bone in which it can be found.
- Frontal: With one per side, the frontal sinuses can be located in the forehead right above the nasal bridge and eyes.
- Maxillary: Found on each side, the maxillary sinus is inside the bone in the cheek.
- Ethmoid: With the ethmoid sinuses, they sit just under the corner of each eye where the bone lies. In many medical diagrams, they’ll show the ethmoid sinus as one sinus but it’s actually made up of several smaller sinuses in a honeycomb shape; it can only be seen properly in CT scan images of the face.
- Sphenoid: Again, the sphenoid sinus is located on both sides but this time behind the ethmoid sinuses. When looking head-on, they won’t be visible so a side view is required instead.
Physiology of the Sinuses
For each sinus, pink membrane will line the outside and it’s responsible for producing mucus to flush the sinus cavities. With a plate of bone and cartilage commonly known as the nasal septum, the two nasal passages are separated. However, the biology of each passage is the same starting with three small ridges of tissue which can be called a concha or turbinate. Depending on whether it’s referring to the upper, middle, or lower structure, they’re designated as superior, middle, or inferior.
When it comes to the draining, the majority of sinuses use the middle turbinate and the drainage occurs below this point. From here, it goes into the osteomeatal complex. For the system to work correctly, air needs to flow uninterrupted through both sides of the nasal passage since this allows for streaming between the nasal septum and turbinates (via the crevices).
For both the mucus and the airflow that started the process, they should end up in the nasopharynx which is a connecting part of the throat towards the back of the nose. As air continues its journey through the windpipes and into the lungs, the mucus takes a different journey and is swallowed instead.
Structures within the Nasal and Sinus Tract
As you probably know, the human body is quite simply amazing and evolution has allowed it to survive on a day-to-day basis using complex scientific principles. Therefore, it probably won’t surprise you to hear that there are some fascinating structures inside the nasal and sinus tract. Below, we have three very important examples:
- Adenoids: As a collection of tissue much like the tonsils, the adenoids are found behind the farthest nasal cavity accessible at the very top of the nasopharynx. While most body parts and important features of the body grow as we get older, this tissue actually starts larger and then disappears during puberty. However, discrepancies in this process can leave it in tact which has the potential to require surgery.
- Tear Duct: Often called the nasolacrimal duct, this is important for our eyes since, without it, tears would continue to build on the inside corners. When it’s in place and functioning as expected, the tears drain into the nasal cavity and this prevents excess moisture within the eyes.
- Eustachian Tube: As our last example, the eustachian tube is required for removing any build-ups that occur within the ears; with the system all interconnected, the opening is found towards the back of the nasopharynx sidewall.
The Role of the Sinuses
Ultimately, the sinuses have many responsibilities within the ear, nose, throat, and beyond but their main role is to produce mucus. When the system is working as it should, the mucus creates a lining on the inside of the nose and this keeps it free from bacteria, fungi, and viruses. If you were to experience dry sinuses, the lack of mucus would leave the nose vulnerable to these pollutants and this leads to irritation and illness.
Over time, cilia, which are tiny hair cells, gradually move the mucus backwards towards the throat where it’s swallowed. Therefore, the steady supply of mucus always takes the same journey while protecting your nose and remaining clean at all times.
After this main function, we should also note that the sinuses are also important for our voices and to lighten the skull. With everything having a purpose, we’re able to enjoy life without consciously worrying about replacing the mucus or producing the right amounts at the right times. As we learn more about the sinuses and how they work, we get an insight into just how fascinating the human body can be!
Single-sided deafness, or SSD, is a condition in which a person has good hearing in one ear, and non-functional hearing in the other ear. By ‘non-functional hearing’, it is meant that even with the help of some system of sound amplification, the bad ear cannot be made functional again. The most common reason for this is that a person with SSD has sustained damage to the inner ear, so amplification has no effect whatsoever on hearing ability in that ear.
Problems Presented by SSD
One of the most serious issues presented by single-sided deafness is the loss of spatial hearing. Spatial hearing allows a person to identify sounds both distant and nearby, in addition to all those that occur within 360° of the head area. Because our two-tiered auditory system is oriented to evaluate very specific information that can localize and pinpoint sounds, there is a big loss sustained when one ear is completely subtracted from that model.
It creates some difficulties for the brain, in terms of evaluating the information it receives and trying to assess what kind of information is missing. When the non-functional ear is in the acoustic shadow of the functional ear on the other side of the head, there can be significant difficulty with interpreting speech and other sounds, versus normal background noises.
This is especially true when speech or other distinctive sounds reach the non-functional ear first, and are not really ‘heard’ until the sound signal travels around to the other side of the head, to be received by the good ear. The net effects of this kind of sound reception are: a serious degradation in listening quality, difficulty with the interpretation of sounds and speech, and in a broader context, lowering of a person’s quality of life.
Another of the difficulties with single-sided deafness, alluded to above, is the condition known as ‘head shadow’ effect. What is meant by head shadow effect is a situation where sounds originating on the side of the head where the non-functioning ear is, are actually obstructed by the head itself in traveling to the other side of the head where the good ear is.
The main problem with this is that some kinds of sounds become very difficult to hear with the good ear. Low-frequency sounds are mostly unaffected in this scenario, because they have a long wavelength and they can move around the head more readily to the good ear. High-frequency sounds on the other hand, are characterized by much shorter wavelengths, and many of these are typically reflected by the head, and become altered before they reach the good ear.
Since consonant sounds occur largely in the high-frequency wavelengths, this can have a big impact on communication, because it is much more difficult to differentiate those sounds from background noises. Therefore, the biggest impact of this head shadow effect is on communication, and it causes a person with SSD to miss a great deal of what may have been said by someone, even if they’re standing close by.
Causes of SSD
One of the more common causes of single-sided deafness occurs is when surgery is necessary to remove a tumor growing in the ear. This kind of surgical removal sometimes causes such damage to the auditory nerve that a patient loses most or all hearing in that ear. If such tumors are not removed, they will continue to grow slowly, and will eventually cause damage to the ear anyway, including possible loss of hearing. However, surgical treatment can end up being just as harmful, if the auditory nerve becomes damaged.
A secondary cause of SSD is known as sudden idiopathic hearing loss, which is generally attributable to some kind of viral infection. In this scenario, a virus infects the cochlea, which eventually leads to swelling and permanent damage to the delicate structure of the cochlea. It happens fairly frequently that the ear cannot recover from this kind of damage, and the person is left with no hearing in that ear.
A third cause for SSD stems from some kind of blunt trauma to the head. In such cases, there can be a transverse fracture of the critical temporal bone, which has the effect of rendering the cochlea non-functional from that point forward. It is also possible for people to be born with hearing loss in one ear, while having perfectly good hearing in the other ear.
Solutions for SSD
One of the most effective solutions for SSD is known as a Contralateral Routing of Signal (CROS) configuration, in which a microphone is placed in the non-functioning ear, and transmits received sound signals over to a receptor in the good ear. The first of these configurations relied on a tiny wiring system for the transmission of sound between ears, but this has now been improved and refined with a wireless system that makes the whole arrangement less bulky and more effective.
There are now also two additional high-tech solutions which build upon the idea that sound received on the non-functioning side is somehow transported to the good side so that relatively normal hearing is possible. These two processes are known as bone conduction solutions and bone anchored solutions.
In the first, sound is actually transmitted through the bone of the skull to the other side of the head, and in the second, sound is transmitted by a subcutaneous implant which transmits sound through the skin to the good ear. As you might expect, these solutions can be relatively costly, but they can also be a very effective means of restoring normal hearing to someone who has completely lost hearing in one ear.
Noise-induced hearing loss is a condition which currently affects about 10 million Americans. It is the most common preventable cause of hearing loss which is due to damage of the ear’s sensory nerve. The prevalence of noise-induced hearing loss and the number of people affected have steadily grown right along with the development of society—as more and more of man’s creations create noise pollution which damage a person’s hearing.
Probably most people understand the damage that can result from being close to a gunshot, but far fewer people are aware of potential damage from more mundane causes like leaf blowers, lawnmowers, traffic sounds, car alarms, music concerts, and even the stadium noise at a sporting event.
The truth is, any loud noises which are received by the ears over an extended period of time, no matter where they came from, can cause significant damage to the inner ear. Eventually this can lead to dizziness, ringing in the ears, some degree of hearing loss, and even issues unrelated to hearing, such as high blood pressure and an irregular heartbeat.
What is Noise-Induced Hearing Loss?
Noise-induced hearing loss is the condition which results from having an excess of sound energy reaching the inner ear. When the excess sound energy is temporary, any hearing loss is also likely to be temporary and reversible. A good example of this would be attending a loud rock concert where sound undergoes a great deal of amplification, and excess sound energy reaches every person in attendance, regardless of where they’re sitting.
It is fairly typical for someone attending a concert like this to completely recover within the next day or two, because the excess sound energy has dissipated. If that noise were to persist over a longer period of time, however, it is quite likely that the damage to the inner ear would be irreversible, and the listener would be subjected to a permanent loss of hearing.
It is also possible for excess sound energy to be so profound as to rupture a person’s eardrums, rendering them more or less deaf. Still more problems can be created if a person’s eardrums are shattered and he or she also develops severe dizziness, which is usually an sign that there is a perilymphatic fistula, i.e. an inner ear hole, created between the middle ear space and the inner ear fluid. Surgery in such cases may eliminate the dizziness, but the hearing loss is likely to remain permanent.
Prevention of Noise-Induced Hearing Loss
Two of the best kinds of protection for the inner ear are the simple devices we know as earplugs and earmuffs. Earplugs are small-sized devices made of various materials, which can easily fit into the outer ear canal to block sound reception. Since they come in many different shapes and sizes, earplugs can be fitted to virtually anyone’s ears, and the fit is very important because there must be an airtight seal in the ear canal to block excess sound energy from reaching the inner ear.
Earmuffs on the other hand, are devices fitted to the head, and they cover the entire outer ear to prevent sound energy from reaching the ear canal. These devices usually have an adjustable band which allows for a tight fit, and as in the case of earplugs, a tight fit is very important so as to make a good seal against excess sound energy.
The choice of which of these devices to use for any given situation is contingent upon which kinds of sounds need to be blocked. Earplugs are much more effective in providing protection from noises in the low frequency spectrum, whereas earmuffs offer better protection against noises on the high end of the spectrum. Either one will reduce the sound energy that reaches the inner ear by between 15 and 30 dB of sound, and when the two devices are used in tandem, a person wearing them can expect to have twice as much protection than by using either one alone.
Treatment for Noise-Induced Hearing Loss
Anyone who suspects that they may have sustained noise-induced hearing loss should seek professional advice from a doctor who has been trained in ear and hearing disorders. This kind of doctor will be able to diagnose the specific condition affecting a person’s hearing, and can recommend the most effective kind of treatment program.
Unfortunately, there is no real cure for noise-induced hearing loss, because damage to the inner ear is irreversible. There are various devices available which can help restore hearing if only one ear has been affected, and there are also amplification systems such as hearing aids, which can be used in certain situations.
There’s also a great deal of very promising research being conducted by such organizations as the National Institute on Deafness and Other Communication Disorders. One of the specific areas being researched now is how using antioxidants may be able to prevent hearing loss due to noise-induced causes, and may actually be able to restore relatively normal hearing.
Early results have already demonstrated that vitamin D and aspirin can reduce the effects of hearing loss when they are used prior to the event which produces excess sound energy. Other research conducted on laboratory animals has shown that exposure to loud noises does not result in hearing loss when the animals are provided with vitamins A, C, and E before being exposed to a loud noise.
With a name that confuses many, cholesteatoma is a delicate and troublesome problem within the ear. Describing an abnormal skin growth behind the eardrum, the middle ear, cholesteatoma is normally caused by multiple infections. However, there are other causes to note including a dysfunction in the eustachian tube.
What is the Eustachian Tube?
Running to the middle of the ear from the back of the nose, this tube is essential for our hearing. Since it allows air to reach the ear, ear pressure is equalized efficiently and our hearing works as expected. Sadly, an issue can occur with a simple cold along with allergies, sinus infections, and chronic ear infections.
With a failure in the eustachian tube, the middle ear can experience a partial vacuum and, in turn, the eardrum, or certain sections of the eardrum, is pulled out of position. As you can see, each step of the process causes another problem and it ends with a growth or cyst in the middle ear.
When left untreated, willingly or unknowingly, the size of the cholesteatoma can change while causing severe damage to the delicate bones located in the middle ear. If left for too long, hearing loss is experienced and surgery becomes one of just a few select options. Fortunately, there aren’t any serious side effects when the issue is treated which means that permanent hearing loss and muscle paralysis in the face are both unlikely. This being said, there has been cases of all three when the cholesteatoma is allowed to keep growing.
Causes of Cholesteatoma
As we’ve seen, the main causes are problems with the eustachian tube and chronic infections but there are also small numbers of people who are born with a cholesteatoma. Ultimately, this is seen as a birth defect and should be picked up on soon after birth. If children experience numerous ear infections, cholesteatoma can also become a problem at a young age.
Symptoms of Cholesteatoma
With any health issue such as this, the key information comes in knowing the symptoms so it can be recognized early. With cholesteatoma, many are actually drawn to a foul odor before anything else and this is where the ear drains fluids. After this, you might feel building pressure or a sense of fullness in the ear where the sac enlarges over time.
As with ear infections themselves, cholesteatoma will cause discomfort whether it comes through an ache in the ear, a difficulty to fall asleep at night, or a slight loss of hearing. Finally, there may be muscle weakness on the side of the cyst in addition to dizziness. If you experience any of these symptoms, we advise you to visit your doctor as soon as possible. Even if it turns out to be a simple ear infection, this will still need treatment.
As you visit your doctor, they’ll examine the inside of the ear because the signs of a cyst can often be seen early whether it’s a congregation of blood vessels or excess skin cells. If they don’t find anything but are still a little worried, they may ask for you to attend a CT scan which will show the cyst or whatever it may be causing your discomfort.
As with any other cyst, a cholesteatoma is something that needs surgery for removal. Unfortunately, cysts don’t just go away on their own; in fact, they do the opposite and grow. While you’re waiting for surgery, your doctor might suggest ear drops, antibiotics, careful cleaning, and other forms of light therapy.
During surgery, most cases are completed under a general anesthesia with the main aim of removing the cyst. If the cyst is removed, this is great news but it might not be the end of the problem depending on how serious the issue was and the state of your ear now. Typically, a second surgery will be planned at the very least to check the cyst has gone. However, you may also require a reconstruction of the damaged bones in the middle ear; this will improve your hearing and reverse other symptoms experienced. Of course, this will be judged on a case-by-case basis as not all patients would benefit from reconstruction if the damage is too severe.
In terms of the logistics, you’ll be an outpatient and a certain percentage will stay in the facility overnight as a precaution. If the cholesteatoma was extremely damaging, you might be required to stay in hospital for a few days with a course of antibiotics. On the whole, you can expect to need one or two weeks away from work. In the months ahead, check-ups and evaluations will ensure the problem has gone for good.
Although we can’t provide any prevention tips for congenital cholesteatomas, we do advise visiting the doctor as soon as you notice any of the symptoms we’ve listed. Whether it’s yourself or your child, quick action is the best way to remove the problem and ensure the middle ear bones aren’t damaged. Despite cholesteatoma being a serious ear condition, it is treatable with the right steps.