Download Middle ear dysfunction and hearing loss

It helps to understand how the ear works before describing what can cause problems for the ear. The ear is
made up of 3 main parts: 1) the outer ear, 2) the middle ear, and 3) the inner ear. The outer ear extends from
the flap of skin on the outside of your head up to the ear drum. The outer ear acts like a funnel to quickly send
sounds to the ear drum.
Outer Ear
Middle Ear
Inner Ear
The ear drum is where the middle ear starts. Behind the ear drum is the middle ear space, which is normally
filled with air. The opening of the eustachian tube is in the middle ear space. This tube connects the middle
ear space with the upper part of the throat. The tube opens and closes many times during the day; for example,
it opens when we swallow or yawn. Sometimes you can hear it open, or "pop". When it opens, it lets fresh air
into the middle ear from the air around us. It helps to make the pressure in the middle ear equal to the pressure
of the air outside the ear. This is why our ears pop when we change altitude, like when we travel over a
mountain or take off and land in an airplane.
Three tiny bones inside the middle ear are named for their shapes: the malleus (hammer), the incus (anvil),
and the stapes (stirrup). These bones connect to form a chain. The first bone, the malleus, is connected to the
ear drum. The last bone, the stapes, is connected to another tiny membrane called the oval window. The oval
window is the beginning of the inner ear, or cochlea. When sound hits the ear drum, the tiny bones jiggle in
the air and the last one pushes on the oval window. Inside the cochlea are over 15,000 tiny nerve endings,
called hair cells. They are surrounded by fluid. The hair cells change the sound waves into electrical impulses
that travel up the auditory (hearing) nerve to the brain.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our
aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health
concerns or specific treatment options should be discussed with your physician.
Copyright © 2003 St. Jude Children's Research Hospital
Revised 06/03
www.stjude.org
Page 1 of 3
A dysfunction is anything that keeps the middle ear from working correctly. If the eustachian tube does not
open enough, the pressure in the middle ear changes. This is called eustachian tube dysfunction. It is the most
common kind of ear dysfunction in children. If the eustachian tube stays closed for a long time, no air can get
to the middle ear. This is middle ear dysfunction. When this happens, fluid sometimes fills the middle ear
space. The fluid can become infected if it remains in the middle ear. When this happens, your child may pull
at her ears, complain of ear pain, hold her head at a tilt, become irritable, and possibly run a fever. If your
child has any of these symptoms, tell her doctor or nurse.
Yes. When the middle ear is not working correctly, sound cannot travel as well to the auditory (hearing)
nerve. This causes what is called conductive hearing loss. This type of hearing loss is usually temporary. The
hearing usually returns to normal with medical treatment. A hearing evaluation will find how much hearing
loss is being caused by the dysfunction. The amount of hearing loss varies from child to child and may even
change from day to day. An ear infection is a health problem that requires medical attention. If it is not
treated, it may result in permanent hearing loss and communication problems. The doctor will decide what
treatment is right for your child based on the results of the hearing test, the ear examination, and any history
of ear problems.
Yes. Children learn speech and language by listening to the people around them. If a child has conductive
hearing loss for an extended time, speech and language development may be delayed. It can also cause
listening problems in daycare or school, as well as at home. Sometimes hearing problems make it harder for
the child to pay attention. Hearing test results should be shared with your child's daycare workers or teachers,
so they will understand your child's behavior. Some children have chronic eustachian tube or middle ear
dysfunction, but since they never have an active infection, they do not have any of the symptoms listed
earlier. If you have concerns about your child’s hearing, speech, language, or school performance, tell her
doctor or nurse. One of these staff members can arrange for a hearing evaluation.
 Get medical attention for the problem as soon as possible. Be sure to follow the directions on any
medicines the doctor gives you and finish the medicine.
 Create the best possible listening environment at home, daycare, and school.
 Minimize background noise (television, radio, etc.)
 Get your child's attention before speaking.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our
aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health
concerns or specific treatment options should be discussed with your physician.
Copyright © 2003 St. Jude Children's Research Hospital
Revised 06/03
www.stjude.org
Page 2 of 3
 Get close to your child and let her see your face when you are talking.
 It will help your child in school if she sits near the teacher and away from any sources of
noise (hallways, air conditioners, overhead projectors)
 If you are concerned about your child's speech or language, discuss the problem with her doctor or
audiologist. A speech/language evaluation may be needed.
 Follow her doctor's recommendations for treatment and follow-up. This might include re-testing your
child's hearing to make sure that it has returned to normal.
If you have questions about middle ear dysfunction and hearing loss, call Rehabilitation Services at 595-3621.
If you are inside the hospital, dial 3621. If you are outside the Memphis area, call toll-free 1-866-2ST-JUDE
(1-866-278-5833), extension 3621.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our
aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health
concerns or specific treatment options should be discussed with your physician.
Copyright © 2003 St. Jude Children's Research Hospital
Revised 06/03
www.stjude.org
Page 3 of 3