The middle ear is the part of the ear between the ear drum and the inner ear. When the eardrum vibrates, it stimulates movement of the ossicles, a trio of tiny bones called the malleus (hammer), incus (anvil) and stapes (stirrup). The stapes attaches to the oval window, which connects the middle and inner ears.
Evaluating the middle ear
Tympanometry
Tympanometry screening is a test that is used to evaluate problems in the middle ear by measuring how your eardrum reacts to air pressure. It can help confirm the presence of fluid in the middle ear and whether that is causing an ear infection, eardrum perforation, Eustachian tube blockage or some other problem.
How Tympanometry Screening Works
To test for fluid in the middle ear, the doctor will insert a handheld probe into your ear. This device changes the air pressure inside the ear while producing a distinct tone. How your eardrum responds to the combination of pressure and sound will be measured and recorded on graphs to determine whether fluid has built up.
Normally, the eardrum moves freely in response to this type of stimuli. When movement does not occur as it should, this signals the presence of fluid and can help guide your physician in recommending an appropriate treatment solution.
In addition to ear infections and perforated eardrums, tympanometry screening can uncover a variety of other disorders.
Mastoid
The middle ear is contained within a bone of the skull called the temporal bone. It is connected to a part of the temporal bone right behind the ear called the mastoid. The mastoid is filled with many tiny air pockets. Because the mastoid is connected to the middle ear, infections in the middle ear can spread to the mastoid.
As the infection spreads, the bone is destroyed, resulting in hearing loss. If antibiotics are unsuccessful in clearing up the infection, then mastoid surgery may be needed.
Mastoiditis
The medical term for infection of the mastoid cells is mastoiditis. Most of the time, this infection responds to antibiotics in the same way that middle ear infections do. Sometimes, however, the infection persists and destroys some of the bone in the mastoid. On rare occasions the infection can erode the bone separating the mastoid and middle ear from the brain, resulting in an infection in the brain. The condition affects children more often than adults since they are prone to middle ear infections.
What causes mastoiditis?
Bacteria can migrate from an infected middle ear into the air cells of the mastoid bone, which then becomes infected Cholesteatoma, an accumulation of skin cells in the middle ear and mastoid, can also prevent the ear from draining properly leading to mastoiditis.
What are the symptoms of mastoiditis?
Symptoms of classic mastoiditis include swelling, redness, and tenderness of the area behind the ear as well as drainage of fluids from the ear, fever, irritability and lethargy.
How is mastoiditis diagnosed?
Mastoiditis can cause serious – even life-threatening – health complications if untreated, so proper diagnosis is a crucial first step toward recovery. Our doctor will examine your ears with an otoscope, looking for signs of infection. Diagnostic tests such as a CT scan or MRI may be administered to help rule out other conditions.
How is it treated?
Many cases of mastoiditis are treated successfully with antibiotics. When antibiotics fail to treat the problem adequately, or it recurs frequently, surgery may be necessary.
Mastoidectomy
Mastoid surgery, or mastoidectomy, involves drilling a hole in the mastoid bone and opening the infected air cells to remove infected tissue. This procedure is performed under general anesthesia, and most patients return home later the same day.