FLUID IN THE EAR (Middle Ear Ventilation Problems)
The ear passage is a tunnel at whose end is a thin
wall called the ear drum. On the other side of that ear drum is a space
called the middle ear which normally contains air. The air gets there
through a tube called the eustachian tube, which is normally closed, and
which opens during yawning or swallowing , often causing a
clicking sound. When the tube stops functioning, a vacuum develops in
the ear. Nature responds to the vacuum by secreting fluid. The fluid may
be as thin as water or so thick that we occasionally call it a glue ear.
The degree of hearing loss caused by fluid varies.. Occasionally, when
there is a vacuum in the ear, the ear drum will be sucked in. When
vacuum persists for years, chronic infection, damage to bone, or
perforations of the ear drum may result.
The tube that lets air into the ear is partially made out of gristle
(cartilage). In children, this cartilage is very soft and when a
small vacuum develops in the ear, it tends to collapse the cartilage in
the same way that a wet straw collapses when you try to drink through
it. The cartilage firms up with maturity. Heredity seems to
determine the mechanics of the muscles that serve to pull the tube open.
Finally, there is a membrane factor, referred to as "allergy" which is
poorly understood, but is operating at a biochemical level. Children’s
adenoids are said to have some mechanical affect on the way the tube
opens, but their role in the this process in quite unclear at this time.
Ear ventilation problems generally begin at about nine months of
age, and gradually get worse until about six to eight years. By
puberty the ears improve, and most chronic ear ventilation problems have
almost always vanished. In adults, the tubes
malfunction during inflammatory conditions like infection or allergy.
Those predisposed to such problems will experience the most
difficulty when challenged by environmental pressure changes, such as
flying or SCUBA diving.
Treatment varies. Decongestants are frequently offered to
improve a borderline tube. Adenoidectomy is said to improve the
mechanics of the eustachian tube opening. Artificial middle ear
ventilating tubes break the vacuum in the ear responsible for the
complications. Ear ventilating tubes mimic the solution nature sometimes
uses...a hole in the ear drum. As long a s the hole..natural or
artificial..is kept perfectly dry, the ear will rarely get infected.
Artificial tubes usually last about nine months, though the range can be
from two weeks to two years!