Ear Wax Removal
Ear wax is a naturally occurring substance. Its function is to protect the ear from dust, and to moisturise the skin of the ear canal. For some reason, many people seem to think that the wax is being produced unnecessarily, and seek to remove it by using cotton buds and other items such as hairclips.
Unfortunately, doing this often has the reverse result – the wax is simply pushed deep into the ear, and then accumulates, causing blockage and hearing loss. This then necessitates removal by a doctor.
Do not attempt removal of impacted wax yourself. You may cause serious, permanent damage to your ear.
A grommet is a tiny plastic or titanium tube that is inserted into the eardrum via a tiny incision, to drain fluid or to allow for equalisation of pressure, or both. Children with recurrent otitis media benefit because grommets because the number of episodes and severity decrease following insertion.
The surgery is done under general anaesthetic, as a day procedure. No cuts are required, and everything is done through the ear canal.
Grommets are usually short-term solutions, until the child’s Eustachian tube has matured sufficiently. However, this may take several years, and multiple sets may be required over that time. A grommet usually falls out on its own after 12 – 18 months.
There are usually no major sequelae to grommets, but some patients may develop a discharge from the ear. In this case, consult your ENT.
Reconstruction of the ear drum is referred to as tympanoplasty. Sometimes it is combined with reconstruntion of the ossicles of the ear, or ossiculoplasty.
The procedure is usually done under general anaesthesia, through an incision inside or behind the ear. Occasionally, it may be done by means of an endoscope, which means there will be no incision. The material used to graft the eardrum comes either from the covering of the muscle behind the ear, the cartilage of the ear itself, or from the fat of the earlobe.
Tympanoplasty is a very safe operation, but carries several risks. These included worsening of the hearing, injury to the facial nerve and dizziness. The risk however, is very small.
You may have a dressing and bandage post-operatively. Patients are usually discharged the day after the surgery.
A mastoidectomy is an operation performed to remove infected air cells of the mastoid process. This is the bone behind the ear, and its infection is often associated with acute and chronic otitis media. Mastoiditis can be lethal, and urgent intervention is required.
Mastoidectomy is also performed electively for conditions such as cholesteatoma and chronic otitis media.
The procedure is done under general anaesthetic, via an incision in the ear or behind the ear. The bone is drilled away using a special surgical drill, disease is cleared, and the ear reconstructed if possible.
A dressing and bandage is applied post-operatively, and patients are usually discharged the next day.
Major complications include worsening of hearing, facial nerve injury, dizziness and tinnitus.
Not all hearing can be rehabilitated using hearing aids. Sometimes, the auditory nerve and brain are working normally, but the modes of getting sound to them are damaged ie the eardrum, ossicles or cochlea.
In these cases, it is sometimes possible to restore hearing using a cochlear implant. Implant surgery is highly specialised, and patients are selected using strict criteria. The surgery is done in conjunction with Dr MRI Ahmed at Netcare Garden City hospital.