Hearing Loss
At birth the prevalence of significant hearing loss is approximately 1 in 3,000 whereas by the age of 70 years the prevalence has increased to approximately 1 in 3 individuals. There are a variety of causes of hearing loss. Major subgroups include conductive hearing losses due to disorders of the external and middle ear and sensorineural hearing losses due to disorders of the inner ear, auditory nerve and associated brain structures.

Patients with hearing loss may complain of fullness, pressure in their ears and at times a ringing noise (tinnitus).

Conductive Hearing Loss
Any interference with the transmission of sound through the external ear canal, eardrum, middle ear or ossicles may produce a conductive hearing loss. This includes a wide variety of disorders including occlusion of the ear canal from wax, inflammatory closure of the external ear canal, new bone growth in the ear canal, perforations or scarring of the eardrum, fluid or other disorders of the middle ear, or fixation of the ossicles due to trauma, previous infection or otosclerosis.

Sensorineural Hearing Loss
There are a wide variety of disorders that may cause a sensorineural hearing loss. Among the most common are genetic disorders resulting either in congenital (present at birth) hearing loss or late onset progressive loss, hearing loss due to ototoxic drugs, hearing loss due to infections or immune disorders, tumors of the inner ear or auditory nerve or other neurologic diseases. Sensorineural hearing loss may be present at birth, may occur later in life either suddenly, (such as sudden sensorineural hearing loss), or may progress slowly or rapidly.

Treatment of Hearing Loss
Today there are a wide variety of treatment and rehabilitative modalities available for hearing loss. For example, most of the causes of conductive hearing loss can be eliminated to restore normal or near normal hearing by a variety of means including medications or surgery.

In contrast to the medical situation 20 years ago there is an increasing list of causes of sensorineural hearing loss that may be controlled or even reversed. This includes such disorders as sudden idiopathic deafness, or immune mediated sensorineural hearing loss. For patients with irreversible sensorineural loss at handicapping levels, rehabilitative services including a wide variety of hearing aids and other listening devices. For individuals who are profoundly deaf and for whom a hearing aid is of no use, some may benefit from a cochlear implantation which is a device placed in the inner ear to bypass its damaged segments.

Balance Disorders
Our sense of balance results from the integration of information from the inner ear, eye, and sense organs in our limbs, muscles, and skin. There is a long list of disorders which are known to affect the inner ear and which may produce chronic or episodic disorders of balance. Examples of such disorders include Meniere's disease, benign positional vertigo, degenerative disorders of the balance system, and toxic or traumatic causes of vestibular disturbance. After proper diagnosis, balance disorders may be treated by a wide variety of medical, surgical and rehabilitative techniques.

Facial nerve disorders
The facial nerve reaches the muscles of the face through the internal auditory canal, mastoid and middle ear. Disorders of the facial nerve may cause weakness and paralysis of the face, an inability to close the eye, or abnormal twitching or distortion of the face. Because of its long course through the ear, many disorders of the ear may affect the facial nerve. This includes such disorders as infections of the middle ear, injury, tumors of the inner ear, middle ear or mastoid. After proper diagnosis, there are a variety of medical and surgical treatments that may reverse or at least improve the deformity and dysfunction caused by facial nerve disorders.

Infections of the Ear
Infections of the ear are a relatively common problem. They may occur anywhere in the ear including the external canal (swimmer's ear), the middle ear and mastoid, or in the bone surrounding these structures. Infections of the middle ear and mastoid are particularly common in childhood following upper respiratory infections. Swimmer's ear as the name implies is particularly common in the summer months. Chronic infections of the middle ear and mastoid may result in significant damage to the hearing and balance mechanisms and facial nerve and at times can spread beyond the ear to surrounding structures including the brain.

Tumors of the Ear
There are a number of tumors that can affect the external, middle, and inner ear. Examples include both benign and malignant lesions of the skin of the auricle and external auditory canal, middle ear and mastoid, acoustic neuromas that commonly produce a progressive hearing loss and balance problems in one or both ears, and glomus tumors which arise in blood vessel structures in the middle ear or adjacent skull base. After proper diagnosis, there are a variety of medical and surgical treatments to control such tumors.

Congenital Disorders
Malformation of the external ear, ear canal, middle ear and its contained ossicles or inner ear may occur during prenatal development. Some congenital disorders, particularly those of the auricle and external and middle ear may be surgically reconstructed. For other disorders, specialized hearing aids or cochlear implants may be helpful in rehabilitation.