Hearing loss may be due to nerve deafness (sensorineural hearing loss) or may be mechanical (conductive hearing loss). Sensorineural hearing loss can occur at any time but is more common with increasing age. A gradual reduction in hearing over years is most commonly seen, but if hearing suddenly deteriorates, urgent treatment may be required. Conductive hearing loss may be due to glue ear (otitis media with effusion, OME), which is usually seen in children but can occur in adults as well, for example after a cold. It may also be due to infection, blockage of the ear canal (eg ear wax) or conditions affecting the ear drum or bones of hearing in the middle ear (eg perforation of the tympanic membrane or otosclerosis). Sometimes there are surgical treatments available for hearing loss, but in many cases a hearing aid may be recommended. There are many different types and styles of hearing aid, and the options can be discussed with a hearing aid provider.

Tinnitus, or ringing in the ears, is a very common condition. It may be associated with hearing loss but can occur in the presence of completely normal hearing. Hearing tests and occasionally a scan may be needed.

Ear infections can affect the middle ear (acute otitis media, AOM) or the skin of the ear canal (otitis externa). AOM is most common in young children, while otitis externa is usually seen in adults. It may be associated with water and is sometimes known as “swimmer’s ear”. Otitis externa is treated with antibiotic drops and the ear may also need to be cleaned; this is easily done in the rooms using an operating microscope with the patient awake. Ear wax can also be removed by this microsuction technique.

A perforated ear drum (tympanic membrane) may heal by itself over a few weeks, but if a hole persists then it may need to be repaired surgically (myringoplasty or tympanoplasty).