Better Ear Health

Many medical conditions, such as those listed below, can affect your hearing health. Treatment of these and other hearing losses can often lead to improved or restored hearing. If left undiagnosed and untreated, some conditions can lead to irreversible hearing impairment or deafness. If you suspect that you or your loved one has a problem with their hearing, ensure optimal hearing healthcare by seeking a medical diagnosis from a physician.

OTITIS MEDIA

The most common cause of hearing loss in children is otitis media, the medical term for a middle ear infection or inflammation of the middle ear. This condition can occur in one or both ears and primarily affects children due to the shape of the young Eustachian tube (and is the most frequent diagnosis for children visiting a physician). When left undiagnosed and untreated, otitis media can lead to infection of the mastoid bone behind the ear, a ruptured ear drum, and hearing loss. If treated appropriately, hearing loss related to otitis media can be alleviated.

TINNITUS

Tinnitus is the medical name indicating "ringing in the ears," which includes noises ranging from loud roaring to clicking, humming, or buzzing. Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear. The health of these nerve endings is important for acute hearing, and injury to them brings on hearing loss and often tinnitus. Hearing nerve impairment and tinnitus can also be a natural accompaniment of advancing age. Exposure to loud noise is probably the leading cause of tinnitus damage to hearing in younger people. Medical treatments and assistive hearing devices are often helpful to those with this condition.

SWIMMER'S EAR

An infection of the outer ear structures caused when water gets trapped in the ear canal leading to a collection of trapped bacteria is known as swimmer's ear or otitis externa. In this warm, moist environment, bacteria multiply causing irritation and infection of the ear canal. Although it typically occurs in swimmers, bathing or showering can also contribute to this common infection. In severe cases, the ear canal may swell shut leading to temporary hearing loss and making administration of medications difficult.

EARWAX

Earwax (also known as cerumen) is produced by special glands in the outer part of the ear canal and is designed to trap dust and dirt particles keeping them from reaching the eardrum. Usually the wax accumulates, dries, and then falls out of the ear on its own or is wiped away. One of the most common and easily treatable causes of hearing loss is accumulated earwax. Using cotton swabs or other small objects to remove earwax is not recommended as it pushes the earwax deeper into the ear, increasing buildup and affecting hearing. Excessive earwax can be a chronic condition best treated by a physician.

AUTOIMMUNE INNER EAR DISEASE

Autoimmune inner ear disease (AIED) is an inflammatory condition of the inner ear. It occurs when the body's immune system attacks cells in the inner ear that are mistaken for a virus or bacteria. Prompt medical diagnosis is essential to ensure the most favorable prognosis. Therefore, recognizing the symptoms of AIED is important: sudden hearing loss in one ear progressing rapidly to the second and continued loss of hearing over weeks or months, a feeling of ear fullness, vertigo, and tinnitus. Treatments primarily include medications but hearing aids and cochlear implants are helpful to some.

CHOLESTEATOMA

A cholesteatoma is a skin growth that occurs in the middle ear behind the eardrum. This condition usually results from poor eustachian tube function concurrent with middle ear infection (otitis media), but can also be present at birth. The condition is treatable, but can only be diagnosed by medical examination. Over time, untreated cholesteatoma can lead to bone erosion and spread of the ear infection to localized areas such as the inner ear and brain. If untreated, deafness, brain abscess, meningitis, and death can occur.

PERFORATED EARDRUM

A perforated eardrum is a hole or rupture in the eardrum, a thin membrane that separates the ear canal and the middle ear. A perforated eardrum is often accompanied by decreased hearing and occasional discharge with possible pain. The amount of hearing loss experienced depends on the degree and location of perforation. Sometimes a perforated eardrum will heal spontaneously, other times surgery to repair the hole is necessary. Serious problems can occur if water or bacteria enter the middle ear through the hole. A physician can advise you on protection of the ear from water and bacteria until the hole is repaired.

Source: American Academy of Otolaryngology - Head and Neck Surgery

Nutrition and Autism

Suzan Burghol, Clinical Dietitian at Istishari Hospital

Patients with autism are at risk of experiencing many nutrition-related problems, including: acceptance of only specific foods, refusal of new or unfamiliar foods, less interest in foods, uncommon food preferences, pica, increased hypersensitivity (to food textures, temperature, color, and smell), loss of appetite, constipation or diarrhea, intestinal inflammations, gastro esophageal reflux disease, flatulence, regurgitation, food allergies and intolerances. Therefore, these patients unintentionally adopt a restricted diet that makes them at risk of marginal or inadequate nutrient intake especially for vitamins and minerals.

Nutritional therapy can make a great difference to autistic people; and there is no one therapeutic diet will work for all individual with this disorder, but every patient should be evaluated individually.

Popular nutrition interventions include elimination diets such as gluten-free, casein-free, and mercury-free diets, allergy diets, specific carbohydrates diet, Body Ecology diet, and dietary supplements with essential omega-3 fatty acids, antioxidants, vitamin B6, magnesium, calcium, iron, and zinc. It is also important in some cases to balance blood sugar, check for brain-polluting metals, and exclude food additives.

These dietary modifications have been found in clinical trials to improve mood, behavior, imagination, spontaneous speech, sleep pattern, focus, as well as nutritional status and overall health status in autistic patients.

For these with autism there should be regular evaluation of eating and feeding behaviors related to increasing ability to self-feed and accept new and different foods.

It is also important to deal with the picky-eating behavior, since up to 70% of these patients report problems with excessively narrow eating habits. So here are some tips that may help to diversify a narrow diet:

  • Children may avoid particular foods because they upset their stomachs; so rule out any medical condition or food allergy that could be causing a dislike of particular flavors or food groups.
  • Avoid making food a source of conflict within the family; since arguing or trying to force a child to eat usually makes the situation worse.
  • Many children with autism experience neophobia; which is fear of trying new thing including foods. If this is the situation think of ways to manage this anxiety.
  • Instead of asking the child to taste the new food outright, you can simply look at the new food together, then suggest that the two of you smell it and/or touch it. When you feel your child is ready, suggest licking or tasting the food.
  • Give your child as many choices as possible so he/she can feel in control of meals. For example, say you want your child to eat a vegetable at dinner. Instead of demanding that he/she eats peas, give him/her three choices: peas, carrots or salad.
  • You can present a wide array of food options at mealtime, and then invite your child to choose three foods to put on his/her plate. This approach also helps children know that it's okay to have preferences around food (we all have at least one food we don't like to eat!), but that variety in diet is still important.
  • Some children with autism have sensory difficulties with food that go beyond flavor. For example, a child may dislike the way a cherry tomato turns from solid to squishy in his/her mouth, though he/she likes the flavor. It can be difficult for children to separate out that good taste from the disturbing texture. If this is the case blend foods together to even out their textures.
  • There are great opportunities for playing games and having fun with food to increase acceptance and consumption, so try making faces on pizzas with vegetables or pepperoni, painting with pasta sauce or any other creative idea.

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