HOW TO PROTECT YOURSELF FROM EAR INFECTIONS

 INTRODUCTION

Earaches tend to be more common in childhood but can affect all ages. Sometimes an ear infection may start seemingly out of the blue and it’s not always possible to prevent them, but an understanding of what causes ear infections and steps we can take to protect our ears can help reduce your chances of getting an ear infection or suffering complications from one.

The ear is made up of three main parts: the outer ear, the middle ear, and the inner ear. We will be focussing on how to protect the two parts that are most commonly affected by ear infections – the outer ear and the middle ear.

OUTER EAR INFECTIONS

The outer ear is the part that we can see on the outside (the pinna) plus the ear canal. The technical term for an outer ear infection is Otitis Externa. Some people call it swimmer’s ear as outer ear infections are commonly caused by water that has remained in the ear after swimming or bathing. The moisture can become a breeding ground for fungi or bacteria. 
Outer ear infections may also occur if the ear is scratched or irritated and bacteria is introduced by putting your fingers or foreign objects into the ear.
Common symptoms of an outer ear infection include itchiness, pain, tenderness, redness and swelling. Sometimes there may be a smelly discharge.

HOW CAN WE PROTECT OUR EARS FROM OUTER EAR INFECTIONS?

You can protect your or your child’s outer ears with these tips:

• Don’t forget to wash your ears to protect against bacteria or fungi being introduced into the ear canal.

• Make sure to dry your ears after swimming or showering to protect the ear from a moist breeding ground for infection. If you have very narrow ear canals that don’t dry easily then you may wish to further protect your ears from moisture by wearing earplugs while swimming.

• Avoid putting foreign objects into the ear to protect your ear from any scratches or irritation and protect against introducing pathogens into the ear canal.

MIDDLE EAR INFECTIONS

The middle ear is the air-filled space between the eardrum and the oval window of the inner ear. It contains three tiny bones called ossicles, which vibrate along with the eardrum to transmit sound to the inner ear. The middle ear is connected to the nasal cavity and back of the throat with the Eustachian tube, which helps protect the middle ear by keeping the air pressure in the middle ear the same as the air outside the body.

Middle ear infections often occur due to a cold or other upper respiratory tract issue spreading to the ear and causing a build-up of fluid in the middle ear space, which may be unable to drain through the Eustachian tube if it is blocked by congestion and swelling in the nasal passages and throat. The technical term for a middle ear infection is Otitis Media. Some people refer to it as glue ear. 

Otitis Media with Effusion (OME) refers to a middle ear fluid build-up without symptoms of infection such as pain, discharge, or fever. This may be due to fluid and mucous continuing to build up after an initial infection has subsided. The ears may feel blocked and hearing may be reduced or muffled due to the fluid blocking the eardrum from moving properly. 

Acute Otitis Media (AOM) refers to an abrupt middle ear fluid build-up as a result of a bacterial or viral infection. Symptoms may include eardrum redness, swelling, earaches, fever and reduced hearing. The eardrum may also perforate and lead to discharge from the ear.

Children are more prone to middle ear issues because their Eustachian tubes are shorter and flatter compared to an adult’s, which tends to slope down more and be more effective for drainage.

HOW CAN WE PROTECT OUR EARS FROM MIDDLE EAR INFECTIONS?

Some people are more prone to middle ear infections than others due to their anatomy or other predisposing factors, and prevention may involve seeing an Ear Nose and Throat specialist for individualised care. The following are some general tips that can help protect your or your child’s ears from middle ear infections:

• Middle ear infections are often caused by bacteria such as Streptococcus pneumoniae or viruses such as influenza, so make sure you are up to date on vaccinations to protect yourself as much as possible, including the pneumococcal vaccine and the annual flu shot.

• Wash your hands with soap and water regularly to protect against bacteria and viruses.

• Try to avoid coming into contact with people who are sick with colds or other upper respiratory tract infections.

• Avoid smoking or exposure to second-hand smoke to protect yourself against upper respiratory tract issues caused by cigarette smoke.

• Stay on top of managing any allergies to protect yourself against congestion and other respiratory issues. Avoid triggers where possible and keep any allergy medications up to date.

EXTRA TIPS TO PROTECT BABIES:

• Breastfeeding exclusively until a baby is 6 months old and continuing breastfeeding until 12 months can protect babies from all kinds of infections, including middle ear infections.

• Be mindful with bottles and pacifiers as their use while laying down can increase the chance of getting middle ear infections. The use of pacifiers beyond 12 months of age also increases the risk of middle ear infections.

• Daycare centres can, unfortunately, expose babies and children to a lot of germs. Make sure vaccinations are up to date and protect them where possible by cleaning their hands with soap and water and trying to keep dirty objects from going into their mouths. 

WHEN TO SEE YOUR DOCTOR

If the only symptom has been an earache then it could be given a day or two before seeking medical advice, as some ear infections resolve on their own after a few days. It is important though to book in to see the doctor for their help to protect your ears if the earache persists if running a fever, if there is a discharge of blood or pus from the ear, or if your hearing is affected.

Appropriate treatment of outer and middle ear infections will protect your ears from complications. If there appears to be a recurrent or chronic issue, then referral to an Ear Nose and Throat (ENT) specialist might be worthwhile to investigate why the issue is not resolving and which extra measures may be necessary to protect your ears and hearing. If ear infections are not treated appropriately then there may be a risk of permanent injury to the ear or hearing, as well as the risk of the infection spreading to other parts of the head.

Often a hearing assessment by an audiologist may also be recommended as part of your doctor’s investigation process. These assessments will look at the function of each part of the ear to determine how well it is functioning and to rule out certain issues, which helps your doctor to determine the best management options to protect your ears.

SUMMARY

Hopefully, some of these general tips will help to protect your or your child’s ears from a painful ear infection. Your doctor would recommend additional measures based on the specific issue, so seeking medical advice is the best way to protect your ears if an earache persists or if you have any other symptoms. 

If you would like to get an idea of whether past ear infections have done any permanent harm to your ears, it would be worth booking in to see a qualified audiologist at Attune Hearing for a comprehensive hearing assessment to check the function of the ear. This would also give you a hearing baseline for future comparisons, which is helpful to your doctor and audiologist if any future ear infections or changes occur. Contact Attune Hearing on 1300 736 702 or book an appointment online today. 

Does my child have hearing loss?

 

Development of hearing 

Our sense of hearing starts developing as early as the second month of pregnancy. By 18 weeks of pregnancy, babies are thought to hear their very first sounds. Babies in the womb at around week 25 or 26 have been shown to respond to voices and noise.  In their fluid filled environment though the sounds are likely to be muffled and therefore responses to sound are difficult to measure.

Once the baby is born, it is difficult to tell sometimes if they are hearing however hearing tests are done to determine any difficulties. In the first couple of months babies’ responses are very subtle and difficult to observe. They may startle to loud sounds, wake to some sounds, stir in their sleep or show other body responses such as eye widening or body tensing. The sounds they respond to are usually sudden loud or sharp sounds such as a door banging, someone sneezing or a toddler squealing. Babies of this age are unable to turn to their names and rarely respond to softer sounds.

By 4-6 months of age babies begin to develop the ability to turn towards the direction of sound but only if it is on the same level of the ear. They can be soothed from crying by the sound of a voice and their eyes can often shift towards the source of a sound. Over 6-month-old babies can turn well to the direction of sound and will listen when you speak to them. They will begin to understand some simple words and will begin to babble. More complex sounds such as musical toys and TV jingles will be more interesting to them.

By 10-12 months old your child should be responding to sounds from any direction. They should be able to turn to their name and recognise familiar sounds around them. They should be babbling and starting to form words such as mum, dad and no.

What signs should I look for if I suspect my child has a hearing loss?

If you suspect your child has a hearing loss the best thing you can do is contact an Audiologist to perform a hearing test. It is advised that you do not try assessing the child’s hearing yourself as this may lead to unnecessary anxiety. You can observe your child’s responsiveness to sound which may be useful information for the Audiologist.

• Are they responding to a variety of sounds at home? Observe your child at different times during the day. Look for signs that they can hear a favourite TV jingle from another room or the crackle of you opening a biscuit packet from a distance. Ensure the child is not too distracted or tired or that the house is not too noisy.
• Is their speech developing appropriately? This is often the first obvious sign of late onset hearing loss or temporary hearing loss. Discuss with your maternal and child health nurse, GP or speech pathologist to determine if there is a speech delay.
• Do they have recurrent ear infections, throat infections or colds? This is the most common reason for hearing loss in children under the age of 7. Fluid or mucous builds up in the normally air-filled space in the middle ear and results in a temporary hearing loss similar to listening under water. This is often temporary and can be fixed surgically if it is a persistent issue. Your child would need to see an Ear, Nose and Throat doctor for management.
• Is there a history of hearing loss in the family from a young age? There are certain hearing losses that are hereditary. These hearing losses often are diagnosed in childhood and can progress to worsening hearing as an adult. Genetic tests are currently available for some of the genes which are known to cause hearing loss.
• Did my baby have a newborn hearing test? In all states in Australia, newborn hearing screening tests are offered to babies before discharge from hospital. If your baby was born at home or overseas, they may have missed the screen. You can contact your closest Audiology department or ask your GP for details of where you can arrange a hearing test.
• Could there be other reasons my child is not responding to sound? Sometimes children with developmental delays or physical delays may not show clear responses to sound. Children with Autism Spectrum Disorder often show little interest in environmental sounds. Extremely premature babies may be delayed with their responsiveness and babies or children with physical disabilities may not be able to turn their heads in response to sound.

Types of hearing loss in children

Conductive hearing loss

This is the most common hearing loss in children and is a result of a build-up of fluid or mucous in the middle ear space. This occurs when there is a blockage in the eustachian tube which connects the nose and the ear. This eustachian tube usually acts to equalise the air pressure in the middle ear cavity. The eustachian tube can become blocked with a cold or as a result of enlarged tonsils and/or adenoids which sit at the base of the nose. If the eustachian tube stays blocked for long enough the mucous can build up in the middle ear cavity and can remain there until the eustachian tube is able to clear the blockage.In many cases the child presents with hearing loss as a result of this fluid in the ear. It can be in one or both ears and can fluctuate depending on how blocked the ears are. The degree of hearing loss can range from a very mild dulling of sound to a more serious deficit resulting in speech sounds being reduced to a whisper. The hearing loss is generally temporary with the hearing nerve remaining intact. The fluid can resolve on its own or may need medical treatment, some even require minor surgery with grommets to aerate the middle ears. If the conductive hearing loss is due to structural abnormality of the middle ear, in some cases it may not be surgically corrected. Special hearing aids are suitable for these children to access hearing to develop speech and language.

Conductive hearing loss is most common in younger children but can happen at any age. Tell-tale signs of conductive hearing loss could include:

• Pulling/tugging/banging ears
• Recurrent ear infections
• Sensitivity to sudden loud sounds (eg vacuum, hand dryer)
• Constant colds/snotty nose/snoring
• Slower than expected speech development
• Balance issues
• Learning delays in school aged children

Sensorineural hearing loss

Less common than conductive hearing loss but current statistics suggest 1 in 1000 children in Australia have a sensorineural hearing loss. These hearing losses are defined as losses due to an impairment in the nerve of hearing or cochlea. Hearing loss can be in one ear or both ears and can vary in degree from very mild to no hearing at all. The cause of sensorineural hearing loss is not always known. The most common causes are genetics, ototoxic medications administered as newborns, illnesses such as meningitis, maternal CMV, jaundice, chromosomal abnormalities and extreme prematurity. Children can be born with the sensorineural hearing loss or it can be acquired later in childhood.

Mixed hearing loss

A mixed hearing loss is where a child has a combination of a conductive hearing loss and a sensorineural hearing loss. Often the conductive hearing loss is temporary and can resolve or be medically treated. In some cases, particularly if the child has a syndrome involving structural abnormalities such the child has hearing loss at the nerve but also some conductive loss due to a malformation of the middle ear.

 Auditory Neuropathy Spectrum Disorder

ANSD is a very rare condition where the cochlea shows response to sound but the signal to the brain becomes disrupted and this results in a hearing impairment. This nerve disruption or dyssynchrony is more common in very premature babies, those with high jaundice at birth and in some genetic conditions.

How can I check if my child has a hearing loss?

Audiologists are university trained specialists in hearing assessment. You are best to see a Paediatric Audiologist especially if your child is under 7 years of age. Different age groups require different modes of assessment and sometimes several techniques are used to obtain an accurate result. All Audiologists should perform middle ear function tests and some form of hearing assessment to gain a good understanding of your child’s hearing and middle ear status. They may refer your child for further medical advice depending on the result.

What happens if my child has a hearing loss?

If a child has been diagnosed with a hearing loss it will depend on the degree and type of hearing loss as to how the hearing loss is managed. If the hearing loss is medically treatable the Audiologist will refer you to an Ear, Nose and Throat specialist to determine if grommet surgery or similar is warranted. If the hearing loss is more permanent, then the impact on the child’s development will be determined. If it is thought that the hearing loss is likely to delay a child’s speech development or learning, then hearing aid fitting may be recommended. In cases where children have severe or profound hearing losses or ANSD, cochlear implantation may be an option.

In all cases the development of speech and language is of the utmost importance to the Audiologist. Their job is to accurately diagnose and manage hearing losses in children. Speak to your GP, maternal and child health nurse or paediatrician if you are unsure of Audiological services in your area. Attune Hearing is Australia’s only accredited hearing healthcare provider, offering hearing services to those who need help on their hearing journey.

How Humans Prefer Pitch And Music When Hearing

It is more or less easy to predict what kind of movies will please most of the public, and it is not complicated to do the same with books or video games. However, with music it seems that this does not happen so much: we all have musical pieces in mind that, although they do not look anything like what we usually prefer to hear, they catch us. That is why it is interesting that favourite songs, in all their variety, produce a similar effect on the brain of the listener. In fact, music can define, in a way, how we are and how we think as there are different ways human prefer pitch and music when hearing.

What happens in our brain when we listen to our favourite music?

Specifically, strong electrical connections are established between the auditory areas of the brain and the hippocampus, a part related to memory and emotionality. That means that the neuronal processes that a Beethoven fan experiences are very similar to those that occur in the head of an AC/DC fan when both are listening to what they like, no matter how different the vibrations reach the eardrums.

The finding would also help explain why completely different pieces of music can trigger very similar emotional states in different people and the role of music in remembering memories. In addition, it is further evidence of how closely related memories and emotions are when recovering them.

However, the fundamental findings on the study of “how humans prefer pitch and music when hearing” is that it shows how our brain is able to turn around any series of sound stimuli to awaken moods to some extent unpredictable, related to the listener's musical taste. In this sense, it has also been seen that we are able to make music something pleasant by identifying ourselves with what we hear by relating it to our memories and thus helping to give them a satisfactory meaning or use it to better regulate our emotions.

Of course, every moment has its potential "ideal music" and we probably would not get the same results if we force someone to listen to their favourite song longer than desired, for example, or at a time when they don't feel like listening to anything.

However, in most cases there seems to be the paradox that very complex and changing processes (the adaptation of the brain for the enjoyment of virtually any musical piece) result in a stereotypical and predictable activation pattern. It is a test of the brain's ability to reach the same results from different starting situations, and memory plays a fundamental role in this process.

Beyond the laboratory experiments, it is clear that the sensation of listening to music of our liking is unique and to some extent indescribable. However, if we lift the hood of our nervous system and observe what happens in it during this experience, we will realize that after such subjective sensations there is a network of neurons acting meaningfully.

Do you find yourself struggling to listen to lyrics/words or do you find it hard to listen to certain pitches over others? At Attune Hearing, our Audiologists can conduct a Full Diagnostic Hearing Test to determine exactly where your hearing difficulties lie. Call on 1300 736 702 or visit the website today to get back to listening to your favourite sounds again.

Can Hearing Loss Cause Headaches?

If you or a loved one are suffering from hearing loss, you might have noticed that headaches can be one of the many symptoms going hand in hand with a decline in hearing abilities. There is a range of explanations for this correlation. For one, a feeling of pressure in the ear from a build-up in fluids behind the eardrum or the ringing or buzzing sound experienced by those suffering from tinnitus can be causes for severe headaches.

A new hearing aid could also result in temporary headaches. When you are experiencing hearing loss, your auditory system and brain don’t receive as much stimulation as they once had with normal hearing. Those who first receive a hearing aid, therefore, might experience more or less severe headaches. Their brains simply need some time to adjust to the new influx of information. These symptoms, however, disappear within about a week. If you’re worried that your hearing aid might be the cause for ongoing headaches, don’t hesitate to make an appointment with your audiologist.

The Link Between Hearing Loss And Migraine

But it can also go the other way around: Did you know that migraine is said to be a possible cause for hearing loss? Studies indicate that migraine sufferers are twice as likely to suffer from sudden sensorineural hearing loss. Other studies suggest that changes in the cochlear system and our auditory pathways are associated with migraine. It is quite possible that migraine could be accompanied by a compromise of blood supply of the auditory system, and in doing so, causes a temporary hearing loss.

Hearing loss and headaches can also be symptoms of a range of other health conditions. Ménière's disease for one can cause severe headaches, specifically migraines and a sensation of clogged ears, resulting in sounds seeming distorted and far away.

If you’re experiencing signs of hearing loss and headaches or migraine, don’t waste time and make an appointment with a specialised audiologist at Attune Hearing, as it’s always smart to keep a close tab on your hearing health.

How Do You Measure Sound Frequency?

Sound waves are waves of pressure that oscillate between stretching or compressing the medium they move through, which is in our case air, at a certain frequency.  The higher the frequency these waves oscillate at, the higher in pitch the sound is heard when the wave reaches the eardrum. Our brain’s perception of these pitches relies on how many of the compressions our ears can sense in a second. High-frequency sounds, such as a whistle being blown, oscillate at a high frequency and are heard as high pitch sounds by our ears. On the other hand, low-frequency sounds, such as plane taking off, oscillate at a low frequency and emit low-pitched sounds. The human hearing range is an impressive thing—we can hear both in intensity (loudness) and frequency (pitch). The ear is capable of hearing a lot, but surprisingly, it can’t hear everything. Sounds that are on the higher end of the frequency spectrum quickly fade from our hearing range. For example, dog whistles emit a sound at such a high frequency that human ears cannot hear it. Unfortunately, unlike a dog’s ears, our ears haven’t evolved to hear at such a high frequency. Although these sounds are often unthought-of, they are crucial to many processes and professions. Understanding pitch is a necessity to those in music, music engineering, acoustics, and psychoacoustics. So, how do you measure something that might not even be heard? Firstly, let’s understand the unit of measurement used: the Hertz.

The Unit of Measurement

The unit used to measure pitch is Hertz (Hz). Hertz is a measure of cycles per second. When sound waves oscillate, they change in pressure. A sound wave cycle consists of a sound wave reaching high pressure, dropping to low pressure, and then reaching high pressure again. The amount of time a sound wave does this in one second is measured, and this number is called the Hertz. Everyone knows the annoying high pitch sound of a mosquito, but did you know that mosquito is emitting a 400 Hz to create its flight tone? That’s 400 sound wave cycles in one second. Going back to the dog whistle, this emits between 16,000 and 22,000 Hz, which is just out of range for humans.

How are Hertz measured?

Scientists and engineers typically use oscilloscopes to measure frequency. An oscilloscope creates a graphical representation of a waveform. To measure the pitch of a sound, the sound is transmitted by audio cables or a microphone to the device. The oscillator then displays the sound on the screen in moving waves that are a visual representation of the sound. The user then adjusts the setting until the waveform is stationary. The adjustments they make indicate the Hertz of the sound.

Understanding frequency, pitch, and Hertz is critical to understanding how sound and our hearing works. With age, our hearing abilities often diminish, and this includes our sense of sound frequency. If you think your ears might not be picking up all of your surrounding sounds and frequencies, it’s a good idea to consult a professional.

Attune is an independent provider of hearing healthcare in Australia. Established with a formidable medical alliance, Attune provides high-quality services and shows a great understanding of hearing-related conditions. If you’re worried about your hearing, call today on 1300 736 702 to schedule an appointment with an expert.

Hearing Loss Symptoms

Hearing loss depends on the severity of ear damage and is treated according to its severity. However, the symptoms for identifying hearing loss are generally the same. These include:

• Having to listen to the sound from television and radio at a much higher level than others.

• Difficulty keeping up with a conversation

• Difficulty hearing people over the phone

• Often asking people to repeat themselves

• The ringing of the ears

• Hearing muffled speech and sounds 

• Social isolation from fear of being judged for poor listening skills

• Constant pain in one side of the ear 

• The feeling of pressure build-up in the ear

• Not able to hear female and young children’s voices.

• Unable to differentiate certain consonants.

• Inability to hear songbirds and timers on devices. 

People with high-frequency hearing loss may also develop these symptoms:

Permanent hearing loss can occur due to several reasons including:

Old age - causing the degeneration of the ear structure.

Genetics - you are more likely to suffer ear damage due to genetic ear sensitivity

Result of an illness - severe meningitis can damage the cochlea (inner ear)

Being around loud noises - exposure to loud sounds, such as concerts, can damage the inner ear cells. People working in loud workplaces such as construction or factory sites are also more likely to suffer from ear damage.

Temporary hearing loss can also occur, however these generally only last from a few hours up to a few days. These are usually defined as a Temporary Threshold Shift (TTS). Common reasons for temporary hearing loss include:

A buildup of earwax - blocks the ear canal from receiving sound waves. Earwax removal can restore hearing.

Ear infection or abnormal bone growth - obstruct sound waves. Infections can generally be cured of medications while abnormal bone growths or tumours near the ear may require a small operation.

Exposure to loud noise - Frequent exposure to loud noises make it harder for the ears to recover from TTS. If constant exposure continues, the ear may not be able to recover from TTS and suffer from permanent damage.

If you fear you are suffering from hearing loss, it is best to get your ears tested straight away. Take this short quiz to determine if you need a hearing test. Attune takes a holistic medical approach and conducts a range of comprehensive tests to determine the cause, type and level of hearing loss. As a patient, if you fall into any of these categories, Attune will be able to provide you with a range of free services to diagnose your hearing. Visit our website or call on 1300 736 702 to book an appointment!