Hearing problems

Ear infection

There are two types of ear infections: middle ear infection (otitis media) and external ear infection (otitis externa).

Otitis media
The middle ear is the space behind the eardrum, and is connected to the nasopharynx through the Eustachian tube, which allows fluid to drain out. This tube can clog up due to swelling of the mucous membranes, causing pus and fluid to accumulate and inflammation to occur. This leads to increasing pressure on the eardrum, causing a sharp, stabbing pain. Usually, a middle ear infection heals on its own within about 10 days. However, it is advisable to take paracetamol to suppress the pain.

Otitis externa
The ear canal runs from the auricle to the eardrum. An ear canal infection means that the skin here has become inflamed. The skin is normally protected by earwax, but can become irritated by ear picking, improper drying, cosmetic products or the use of earplugs. An ear canal infection can be effectively treated by using ear drops containing corticosteroids, and generally heals within 2 to 3 weeks.

Tinnitus

Tinnitus is also known as tinnitus. People with tinnitus perceive sounds without an outside sound source. This can be anything: ringing, whistling, buzzing, squeaking, humming and even a combination of these. About 3% to 4% of the Dutch suffer from such complaints.

People who suffer from relatively soft tinnitus sounds can live with them quite well during the day. Environmental sounds then drown out the sounds in the ear. Only when things get quiet, such as when they go to sleep, may they be unable to do so because the tinnitus sounds are too obvious.

The exact cause of tinnitus is often unknown, although there are factors often associated with it such as hearing damage, stress or certain medication use. Therefore, tinnitus is not a disease, but a symptom. If the underlying cause can be identified, tinnitus can be reduced or even disappear. If this is not the case, then a tinnitus masking device may provide relief.

Learn more on our Treating Tinnitus page.

Ménière’s disease

In Ménière’s disease, people have problems with their balance, leading to vertigo and nausea. There is also often hearing impairment.

The exact cause is still unclear, although it is known that the balance organ and cochlea are connected. Ménière’s disease is likely related to a disruption of fluids in these organs.

Ménière’s disease has attacks followed by periods of relative calm. As the disease progresses, hearing loss often develops. Because no cause is yet known, little can be done about it. Treatment, often by a psychologist or social worker, consists mainly of accepting and dealing with this disease. However, a hearing aid or tinnitus masker can sometimes help to remedy or reduce tinnitus and hearing loss.

Hyperacusis

People with hyperacusis have a low sound tolerance threshold. They are hypersensitive to sound, and experience normal sounds as unpleasantly loud or sometimes even painful. About 3% of the Dutch population suffers from hyperacusis.

Hyperacusis can have several causes. The most common is logically noise, but it can also occur with various conditions or certain medication use.

Hyperacusis, like tinnitus, is not a disease but a symptom. When the cause disappears, the hypersensitivity will also disappear. Usually, however, this is not the case and it is a permanent problem. The only option then is to learn to cope with it as best you can. Often people with hyperacusis benefit from professional help from a psychologist or social worker.

Bridge angle tumor

A bridge angle tumor is a benign tumor in the area behind the ears called the “bridge angle. The tumor usually originates in the internal auditory canal where it grows slowly toward the brain stem and cerebellum. It is estimated that approximately 320 patients are diagnosed with a bridge angle tumor each year in the Netherlands.

Usually, a bridge angle tumor occurs on one side of the head, and therefore people experience the hearing loss there. In addition, symptoms such as balance disorders, dizziness, tinnitus and headaches may occur. In some cases, people also experience problems with the face, for example, the cheeks become numb. The problems of a bridge angle tumor occur because it presses on 3 important cranial nerves: the auditory nerve, the balance nerve and the facial nerve.

Fortunately, there are several methods of treatment. In “wait and scan,” there is no (immediate) intervention, but the tumor is closely monitored. It is also possible to operate or irradiate, which is especially the case with larger and faster growing tumors. A combination of these treatments is also possible.

Otosclerosis

Otosclerosis is excessive bone growth around the riser in the middle ear. It is a progressive hearing disorder that causes a person to slowly become hearing impaired. The bone growth in the inner ear causes the stirrup to become stuck, so to speak. As a result, the mobility of the bone chain gradually decreases. Sound vibrations are then less well directed toward the cochlea, resulting in hearing loss, also called conductive hearing loss. Otosclerosis is not painful.

The exact cause of otosclerosis is unknown. It can occur after a viral infection, but can also be hereditary. It is more common in white people than in non-white people, and also more common in women than in men, but why is not known.

Otosclerosis cannot be cured, but a hearing aid can reduce the effects of hearing loss. Surgery may also be helpful. The riser is then replaced with a prosthesis. In about 90% of cases, hearing recovers (almost) completely after surgery.

Usher’s syndrome

Usher’s syndrome is an inherited disorder in which both hearing and vision are affected. It thus causes deafblindness. It is estimated that about 600 people in the Netherlands suffer from Usher’s syndrome.

The symptoms of Usher syndrome are the condition Retinitis Pigmentosa, which causes night blindness and tunnel vision, hearing loss and often balance problems. The disease is passed through the parents’ genes, but it is recessive, meaning both parents must carry the Usher gene to pass it on to the child. However, this in turn does not mean that the parents then also have Usher’s syndrome, it is merely the presence of the gene.

There is no cure for Usher’s syndrome. The loss of retinal pigment appears to be inhibited with vitamin A palmitate, but there is no other concrete treatment. There are, however, various aids that make daily life easier for people with Usher, such as a guide dog, hearing aid or cochlear implant.

Glue ears

Glue ears are especially common in young children. They occur when too much and too long fluid remains in the ears, causing it to become thick and gluey. The cause is often a chronic middle ear infection with fluid accumulation. In this process, the Eustachian tube becomes blocked and if this blockage persists for some time then the middle ear becomes filled with thick, sticky fluid.

Glue ears in themselves are not painful; they merely produce an oppressive sensation. However, when the accumulation of fluid leads to inflammation, it can be very painful. Children with gluey ears hear less well, and if they suffer from this more often it can lead to language and speech disorders. Generally, however, glue ears cause only temporary hearing loss and there is no permanent hearing damage.

In most cases, glue ear goes away on its own within 3 to 6 months. Sometimes, when a learning disability develops, for example, an eardrum is placed to correct the problem. In some cases, the doctor removes the child’s nasal tonsils.