You and Your Ears - by Dr David Delvin

It's an unfortunate fact that as you get a little older, your ears tend to give you more trouble.  This is because - like almost everything else in the body - the areas are subject to a bit of 'wear and tear' as the decades go by.

The biggest cause of 'wear and tear' is "NOISE!"  People are subjected to far too much noise in today's society - and alas it often damages their ears and harms their hearing.  So, whatever age you are, do please do everything you can to protect yourself from excessive sound levels.  For instance:

  • If there are road works in your street, keep your distance from the pneumatic drills!
  • If anybody in the family wants to play the hi-fi at top volume, keep well away from the speakers.
  • If you go to a concert or a gig, consider getting seats which are well back from the musicians - even a classical orchestra can produce sounds which are loud enough to damage the ears.
  • If you happen to go in for shooting - as many people of retirement age do - then always, always make sure that you wear ear protectors (in Britain, shooting is a really common cause of deafness in the right ear - but very rarely in the left one!).
  • In any situation where there is a lot of noise - like a gym, for instance - don't be embarrassed about putting a couple of ear plugs in your ears.
  • If you have to spend a lot of time in noisy places, it's worth investing in a personal stereo - so that you can blot out the racket, and just have soft, soothing music in your ears.

SOME COMMON EAR CONDITIONS THAT YOU SHOULD KNOW ABOUT   

The reason for avoiding noise is, of course, to avoid deafness - which so often affects the over-50s.  But before we move on to deafness, let's have a look at half a dozen or so common ear conditions, any of which might affect you:

WAX  Earwax is a bit of a problem for millions of British people.  Everybody produces a bit of wax, but a lot of us have a genetically determined tendency to make lots of it.  Result:  you can't hear anything!

Fortunately, earwax is easily treated.  The excellent drops which you can buy from any chemist (such as Waxsol, Cerumol or Otex) will soften and dissolve it.  But if it has got very hard, then the only way to get rid of the wax is to get a doctor or nurse to syringe it for you.

Incidentally, please DON'T try and dig the wax out with hairpins or other objects.  Contrary to what many people think, it is not a good idea to stick things into the 'lughole'.  That is likely to damage the delicate tissues of the ear. 

EARACHE  Fortunately, this gets less common as you grow older.  It is usually caused by a germ - which gets into the interior of the ear after working its way up the tube which leads up from the throat to the cavity of the middle-ear region.

Initial treatment is usually with Aspirin, Paracetamol or Nurofen, plus warmth to the ear.  Many doctors give penicillin or other anti-biotics, but there is controversy about how soon they should be used.

OUTER EAR INFLAMMATION

Also known as 'otitis externa', this is pretty common in the retirement age group.  It causes itching and soreness, and a discharge from the ear.  It's commoner in people who have spent time in the tropics, and it tends to be made worse by swimming - particularly in pools in warm climates, where there may be the odd 'bug' in the water!

Otitis externa needs treatment by a GP or an ENT consultant.  Usually the doctor will clean out the ear and prescribe special drops.  Sometimes it's necessary to put a 'wick' into the interior of the ear to help it recover.  Most important, however itchy the ear, don't poke any hairpins etc into it!

SORE PLACES IN THE EAR

Lumps and raw spots on the ear are common, particularly in the over-50s - especially in those who have been exposed to a lot of sun during their lives.  If you get any unexplained lump or sore place on your ear and it doesn't clear up within a week, please do have it checked out by your doctor - because (to be frank) there is a risk that it could be a skin tumour.

TINNITUS

The word 'tinnitus' just means 'noises in the ear'.  It's NOT a disease - just a symptom of something wrong.  Incidentally,  many people think it's called 'tinnitis' - but it isn't; the spelling is 'tinnitus'.  

You can see that the important thing with tinnitus is to find out what's causing it.   Possible causes include:

  • An insect in the ear - very RARE in the UK!
  • Aspirin and similar drugs
  • Presbyacusis (see below) - this is the form of deafness often seen in the over-50s; it is often associated with tinnitus
  • Wax (see above)
  • Fluid in the middle part of the ear
  • Damage by noise
  • Damage from diving
  • Meniere's disease (see below)
  • Labyrinthitis - a common inflammation of the inner part of the ear (see below) 

However, in many cases, the cause of the noise cannot be found.  Where this is so, you'll need specialist medical help to come to terms with the noise and find ways of dealing with it – do try, new methods are being discovered all the time!

VERTIGO

The word 'vertigo' means the kind of giddiness in which things actually seem to spin round you.  It is often due to problems in the balance mechanisms of the inner part of the ear.  Possible causes include labyrinthitis and Meniere's disease (see below).

There is also something called 'Benign Positional Vertigo', which often develops in the second half of life.  What happens is that you move your head - and then you suddenly feel awfully giddy.  The cause is believed to be tiny 'stones' in the fluid of the inner part of your ear.  Fortunately, ENT surgeons have developed a way of curing the condition by carrying out a manipulation called 'Particle Reposition Manoeuvre'.

MENIERE'S DISEASE

People with Meniere's disease suffer recurrent attacks of deafness, tinnitus and vertigo.  These attacks are very upsetting - but (thank heavens) patients feel OK in the intervals between bouts.  The cause of Meniere's seems to be a disturbance in the fluids which circulate in the inner part of the ear.  

Initial treatment is with anti-vertigo drugs and (usually) salt restriction.  If these measures fail, there are surgical operations which can be tried - but alas the results are variable.

LABYRINTHITIS

This is a common condition, in which a person suddenly becomes very giddy, and may feel sick as well.  Sometimes they go a bit deaf for a while.  This disorder (which is also knows as 'vestibulitis') is thought o be due to a virus.  So not surprisingly, there are sometimes little outbreaks, in which several people develop the same symptoms.

Antibiotics will not help, but fortunately labyrinthitis usually gets better of its own accord, over a few weeks.

CATARRH

Catarrh in the back of the throat is notorious for causing all sorts of symptoms in the ears; deafness, 'popping', discomfort and sometimes slight giddiness.

The commonest cause is smoking.  Catarrh can't be treated with ear drops - because they wouldn't get through the ear drum.  So the most common way of treating it is with nose drops.

DEAFNESS

Deafness in the second half of life is very common.  Frequently, it's due to one of the causes mentioned above - like catarrh or ear wax.  Fortunately, these are easily cured.

BUT - the type of deafness which affects so many people over the age of 55 is - I'm sorry to say - not easily put right.  It's called 'presbyacusis', and it's due to 2 things:

  • Loss of hair cells in the delicate part of the ear called the 'cochlea'; and
  • Loss of fibres in the nerve that carries hearing impulses.

The effect of this degeneration is that high-pitched sounds are lost, to begin with.  One result of this is that you can't hear consonants clearly - just vowels.  This is irritating!  People who suffer from it are always saying:  'Don't mumble - speak up!'

If you seem to be getting this kind of deafness, it's essential that you go to a doctor and have your ears checked out.  If necessary she can send you to an ENT consultant.  You may well be offered an audiogram - which is a test that assesses the hearing loss at various pitches.  

Sometimes, a curable cause of deafness is found.  But in many cases, you have to consider the possibility of a hearing aid.

HEARING AIDS

Hearing aids help a lot of people in the over-55 age group.  But you have to remember that they are unlikely to give you perfect hearing.  All they can do is make faint sounds a lot louder.

Please don't rush into buying one.  Where hearing aids are concerned, it's rather easy to be ripped off.  Take your time, so that you get the device that really is best for you. 

In the UK, you have 2 choices:

  • You can get a FREE NHS hearing aid; or
  • You can buy one from a private firm - which may cost you quite a lot

If you want to have an NHS aid, then ask your GP to refer you.  Health service hearing aids are OK, but they come in a rather limited range.  They are improving in quality, but in some areas it may take several months to obtain one.

If you decide to go for a private aid, then you'll probably be able to obtain it very quickly.  You'll have no difficulty in obtaining the exact type you want (for instance, an unobtrusive one!), but you'll have to pay quite a lot for the privilege.

Please DO see a doctor before you buy a private hearing aid.

Because of some rather dodgy things that happened in the past, the work of  hearing aid 'dispensers' has been regulated by the Hearing Aid Council since 1968.  For details of the code that they are supposed to follow, please read the excellent leaflets / website of the Royal National Institute for Deaf People (RNID) - see below:

ANALOGUE AND DIGITAL HEARING AIDS  

The new digital hearing aids are better than the old analogue ones. 

Fortunately, the NHS usually recommends a digital hearing aid.  

Before you decide whether you're going to go for an NHS aid or not, it's a good idea to find out what sort of aids are being provided in your area.  You see, it varies a lot from one region of the UK to another.  

Ask your GP or your local ENT clinic to tell you whether the hearing aids supplied in your area are analogue or digital.  I'm afraid that I cannot tell you what's going on in your part of the country!  Factors such as funding do unfortunately effect what is available.

LISTENING DEVICES

Newspaper ads often feature cheap things called 'Listening Devices'.

These may seem very attractive, because they are low cost.  But they are not - repeat NOT - hearing aids.  Furthermore, the people who sell them are not bound by the regulations of the Hearing Aid Council.

So you probably won't be surprised when I say that I DON'T recommend buying one.

THE RNID WEBSITE

Finally, can I suggest that you now look at the Royal National Institute for Deaf People (RNID) website?

Obviously you already have access to the Internet - or you wouldn't be reading this!  You'll do yourself a favour if you read what the RNID have to say about deafness - and about hearing aids.  Their excellent website is:   www.rnid.org.uk  

Good luck and good hearing!

Q         Is it really true that men's ears get BIGGER as they get older?

A         Yes, it is! I used to think this was a folk-myth. But several years ago the British Medical Journal published a careful study which showed that many males have ears which slowly get larger after the age of 50. No one knows the reason for this, and there's nothing much than can be done about it. Happily, most men don't seem to mind very much!

Q         My granddaughter wants to get her ears pierced. But are there any dangers in having this done?

A         Traditional piercing through the lobe is reasonably safe, when done by a qualified operator - though there is a small risk of infection or bleeding. It's a totally different matter when people go in for the current day fashion for having the UPPER part of the ear pierced. This may cause 'collapse' of the ear cartilage (that is, the gristle), so that you end up with spaniel-type ears for life!

Q         I'm 62, and I recently had some sort of inside-the-ear tumour called an 'ACOUSTIC NEUROMA'. But I don't understand what it is.

A         An acoustic neuroma is a growth which usually causes one-sided deafness and tinnitus - and maybe balance problems. Fortunately, if it's caught early and removed, the outlook is very good.

© Dr D Delvin / Retirement Matters 2007