Hearing Awareness Week – What is Otitis Media?

Dr Kelvin Kong, an ear, nose and throat specialist gives us the score on Otitis Media and the importance on ear health for Hearing Awareness Week.

Hearing awareness week is a good time to reflect on the impact of poor hearing. Unfortunately we get so involved in social outcomes; we are often bombarded with information and misinformation. I admit I am so intense with ears, to the point were I can have a conversation and lose my friend from talking too much “medicine”. I thought it might be nice to go back to basics to help the understanding for the community.

One of the things I did not want to do is create a non-readable document that we tend to do in medicine. So this is a straightforward guide to otitis media (ear infection), as I would explain to my patients.

The name itself is confusing. In medicine we forget that we have assumed another language, based on Greek and Latin words. Otitis comes from late 18th century: modern Latin, from Greek ous, ōt- ‘ear’ and itits, meaning inflammation. So Otitis, just means inflammation of the ear. Media, again Latin in origin, means middle layer. So, Otitis media is simply inflammation of the middle layer of the ear.

The ear is divided into 3 parts. An outer, middle and inner part.

Outer ear: The outer ear consists of the auricle or pinna, that is, the bit we can see. Yes some people have various names for them, some not so kind (wing nut, dumbo, Billy Big Muku’s etc), in my language, Gathang, it is known as the “Muku”. This is often decorated with piercings or multiple piercings in some cases.

The outer ear also has a tunnel that leads to the Ear Drum. This tunnel is known as the external auditory canal. This is where we find wax (which is normal) and may be traumatized with cotton buds (yes, stop using them in your ears).

Inner ear: The inner ear houses the important nervous structure of the ear. The wiring, if you like, that transmits a mechanical sound wave into an electrical one. I am continually amazed that we have the ability to change a mechanical energy into an impulse that our brain may translate for us. The intricate nature of this is not the scope of otitis media, but just to know it is important.

Middle Ear: So the ‘middle of the ear’ contains the vibratory component. A sound wave is channelled from the air via the pinna, to a special structure known as the external auditory canal (ear tunnel) to reach the tympanic membrane (ear drum). These make the ear drum ‘dance’ or wobble. The vibrations are then transmitted via 3 delicate ear bones to ensure the energy is not lost and converts the mechanical energy to and electrical impulse when it meets the inner ear.

So if the middle ear is full of fluid, or even worse infected fluid, then the eardrum and ear bones (ossicles) cannot function! I like to compare it to a real music drum (eg bongos) that you can tap (or bang). Imagine if you jumped into the ocean with the drum (bongos), and try to play them underwater, it wouldn’t work. That is, you cannot hear. We haven’t even started talking about the infections and complications.

So this beautifully designed apparatus and organ has the ability to help us communicate. Our rich culture has such a strong aural history and it is imperative for us to be able to pass on our culture. We need to be able to hear to pass on our stories, laughter and wisdom.