EAR CONDITIONS

Painful ears (otalgia) – may be the result of aural disease or referred pain from head or neck.

Otitis externa

Painful inflammation of the skin that lines the external auditory meatus. Common, often associated with swimming.

Acute otitis media (OM)

Painful infection (bacterial or viral) of the middle ear.

Chronic suppurative OM

Persistent drainage from the ear, associated with tympanic membrane perforation and often a degree of conductive hearing loss.

Serous/secretory OM (glue ear)

Non-suppurative fluid in the middle ear. An important cause of childhood hearing loss.

Irrigation may be required to remove wax from the auditory canal. However, the procedure is not without risk and there are circumstances in which it should not be carried out.

HEARING SCREENING

All parents in England are offered hearing screening for a new child at 0–5 weeks. Subjective hearing tests in children are not guaranteed to be exact, and the value of screening tests is often questioned.

HEARING IMPAIRMENT

The biggest single cause of hearing impairment is age. Slight age-related hearing loss (presbycusis) begins in most people at 30–40 years, and by 80 years of age most have significant impairment. Another common cause is loud noise (acoustic trauma).

Assessment/detection Adults who think they have a hearing loss should be tested as soon as possible and referred as appropriate to an ENT specialist or audiologist. Some simple tests can be carried out in general practice, but formal audiometry is preferable. Ask ‘Do you have a hearing problem?’ on new-patient questionnaires and during health checks for older people.