The ear allows you to hear and helps to maintain your sense of balance. It is divided into three parts – the outer, middle and inner ear.
The outer ear consists of the earlobe or pinna, and the ear canal. It has a protective lining of hairs and glands that produce wax, which traps dust and stops small objects from entering the ear canal. The outer ear directs sound into the middle ear.
The middle ear is an air-filled cavity that contains three small bones, or ossicles. The bones are called the malleus, incus and stapes. A thin membrane, the eardrum, separates the middle ear from the ear canal. When sound travels down the ear canal, the eardrum vibrates. This vibration is amplified by the ossicles and then passed to the inner ear.
The middle ear is connected to the nose by the eustachian tube, and to another air-filled cavity behind the ear called the mastoid. The eustachian tube is normally closed, but opens when you yawn or swallow.
The inner ear is delicate and complex. It contains the cochlea, which changes sound vibrations into a nerve signal, and the vestibule and semicircular canals, which maintain your sense of balance and position.
Although we take balance for granted, it is a complex process and requires information from the eyes, the balance organs of the inner ear (semicircular canals) and special sensors in the major joints, particularly in the neck. This information is sent to a part of the brain called the cerebellum. A small problem with any one of these information sources can make you feel very dizzy.
Dizziness that is caused by suddenly changing position is often related to neck problems, such as arthritis or whiplash injury, but it can also be caused by crystals forming in the fluid of one of the semicircular canals of the inner ear, which are shaken up with sudden movement.
Occasionally, the inner ear balance organs may suddenly stop working. Common causes of this are viral infections and Ménière’s disease. Both of these conditions typically cause severe dizziness for several hours or days, and people often feel so sick that they vomit. Anti-sickness tablets or injections may be needed as well as bed rest.
Severe dizziness can be very frightening, and people often assume it must be due to a serious disease, such as a stroke or brain tumour. In fact, most balance problems get better on their own quite quickly and do not have any permanent effects. You rarely need to take medication or have treatment for a prolonged period of time.
It is normal for the external ear canal to produce earwax. Earwax may be yellow and soft or dry and flaky. Dead skin cells on the surface of the ear canal gradually travel towards the earlobe, carrying the earwax with them. Normally, earwax is removed from the ears in this way, so you do not need to have them specially cleaned.
Earwax can build up in the ear canal, causing a feeling of blockage and deafness. This is more common if you use cotton buds to clean your ears. If you have a build-up of hard earwax you can use wax-softening ear drops, available from your chemist, or olive oil.
If the wax does not disperse with oil or drops, your ears may need to be 'syringed'. This involves a machine with an ear probe that directs pulses of warm water into the ear. The water is directed at the roof of the ear canal, so that it passes over the earwax to force it out from behind. The water and earwax are collected in a kidney-shaped dish held under the ear.
Ear syringing can also help clear infections of the external ear canal. Ear syringing can sometimes cause dizziness, but only for a few minutes. Occasionally, it may be necessary for you to attend an ENT clinic to have the earwax removed using a microscope and suction device.
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