EAR, NOSE & THROAT
Disorders of the Hearing Bone
Disorders of the ear can occur in the hearing bones formally known as Ossicles. There are three total bones in your ear. The common names for them are the Anvil, Stirrup, and Hammer, which are names given to the bones based on shape. The scientific names are Incus, Stapes, and Malleus respectively. The hearing bones make up the majority of the middle ear. The mastoid bone is another structure of the ear that is susceptible to disorders. The mastoid bone is not included as a bone in the ear because it is not a bone at all. It is a spongy looking structure that rests behind the ear. Disease of the ossicles and mastoid bone are severe and can affect hearing.
One of the most common disorders of the ossicles is Otosclerosis. When you break down the word, Oto- means ear and -Sclerosis is an abnormal hardening. The ossicles are bones, but they have some flexible that allows for vibrations from sound waves. It is because of these vibrations that we can process sound. The bone cells just like skin cells die and regenerate. In Otosclerosis, the bone cells abnormally remodel the ear causing the bones to become stiff. It may be best to break down how sound travels through the ear.
The Art of Sound
Sound travels in waves. For us to hear, those waves have to be converted into signals that are sent to the brain. The vibrations start in the outer ear and travel through the ear canal where they hit the eardrum. Vibration by the eardrum causes the ossicles to vibrate which in turn vibrates the cochlea, which is filled with fluid. During this process, sound waves are converted from air to liquid and the hairs in the cochlea begin to move from the waves of the fluid opening up channels that allow chemicals to enter. These chemicals create an electric signal that is carried by the auditory nerve to the brain to interpret the sound. The ossicles are a crucial factor in our ability to hear. If the ossicles are stiff and unable to vibrate then, the cochlea will not vibrate, preventing chemicals from entering and creating signals for the brain.
According to the National Institute of Health, more than 3 million people have Otosclerosis. It is considered an inherited disorder. Otosclerosis may only affect one bone out of the three. With even one bone being stiff, the cochlear vibration will not happen. Hearing loss is an unfortunate result of otosclerosis. There is currently no cure or treatment for this disorder. Hearing aids can be used in the early stages of otosclerosis but eventually, they will no longer be helpful.
The mastoid bone is another important structure of the ear. The mastoid bone sits behind the ear but is affected by abnormalities in the ear. Even though the name is mastoid bone, it is not a bone at all. It is a porous-looking structure that is made of air sacs. It is not solid like bones at all. The mastoid bone must receive air from other structures of the ear to function properly. When the Eustachian tube does not drain properly, it may cause infections that will lead to an infection of the mastoid bone.
Mastoiditis is an infection of the mastoid bone. Untreated ear infections cause mastoiditis. The bacteria in the middle ear travel to the air cells of the mastoid. A middle ear cyst known as cholesteatoma can also cause mastoiditis by blocking drainage of the ear. In more severe cases, the infection can spread to the brain and cause other complications. The more serious complications include meningitis, hearing loss, and brain abscess. Symptoms of mastoiditis include fever, ear drainage, tenderness of the ear, and swelling or redness. Unlike otosclerosis, mastoiditis does not usually cause hearing loss except in extreme cases. It is uncommon because the mastoid bone does not directly affect the structures of the ear.
The best way to treat mastoiditis is antibiotics. In more severe cases, surgery may be needed to drain the mastoid bone and remove the infected parts of the bone. In some instances, tubes have to be inserted to assist in the drainage of the Eustachian tube. Ear infections are a common diagnosis in children. Subsequently, mastoiditis is also typically found in children. Many children are susceptible to ear infections due to Eustachian tube dysfunction. It is uncommon for adults to have ear infections and therefore even more of a rarity to see mastoiditis in adults. When mastoiditis is diagnosed early, it can be easily treated.
Mastoiditis and Otosclerosis are two disorders of the hearing bone that affect two separate parts of the ear. They are both considered bone disorders despite the fact the mastoid is not bone. Osteosclerosis is more of a disorder whereas mastoiditis is viewed as a disease. Even though the ossicles and mastoid bone are anatomically close together, they have different functions. As an adult, you may not experience mastoiditis, but it is something to be aware of in children. With otosclerosis being an inherited disorder, it may start as early as age 11 or may not start until age 30. With any signs of hearing loss or discomfort, it is best for you to see a physician, preferably an ENT specialist who can do the proper testing and achieve the right diagnosis.
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