Meatus Health Dictionary

The ear is concerned with two functions. The more evident is that of the sense of hearing; the other is the sense of equilibration and of motion. The organ is divided into three parts:

(1) the external ear, consisting of the auricle on the surface of the head, and the tube which leads inwards to the drum; (2) the middle ear, separated from the former by the tympanic membrane or drum, and from the internal ear by two other membranes, but communicating with the throat by the Eustachian tube; and (3) the internal ear, comprising the complicated labyrinth from which runs the vestibulocochlear nerve into the brain.

External ear The auricle or pinna consists of a framework of elastic cartilage covered by skin, the lobule at the lower end being a small mass of fat. From the bottom of the concha the external auditory (or acoustic) meatus runs inwards for 25 mm (1 inch), to end blindly at the drum. The outer half of the passage is surrounded by cartilage, lined by skin, on which are placed ?ne hairs pointing outwards, and glands secreting a small amount of wax. In the inner half, the skin is smooth and lies directly upon the temporal bone, in the substance of which the whole hearing apparatus is enclosed.

Middle ear The tympanic membrane, forming the drum, is stretched completely across the end of the passage. It is about 8 mm (one-third of an inch) across, very thin, and white or pale pink in colour, so that it is partly transparent and some of the contents of the middle ear shine through it. The cavity of the middle ear is about 8 mm (one-third of an inch) wide and 4 mm (one-sixth of an inch) in depth from the tympanic membrane to the inner wall of bone. Its important contents are three small bones – the malleus (hammer), incus (anvil) and stapes (stirrup) – collectively known as the auditory ossicles, with two minute muscles which regulate their movements, and the chorda tympani nerve which runs across the cavity. These three bones form a chain across the middle ear, connecting the drum with the internal ear. Their function is to convert the air-waves, which strike upon the drum, into mechanical movements which can affect the ?uid in the inner ear.

The middle ear has two connections which are of great importance as regards disease (see EAR, DISEASES OF). In front, it communicates by a passage 37 mm (1.5 inches) long – the Eustachian (or auditory) tube – with the upper part of the throat, behind the nose; behind and above, it opens into a cavity known as the mastoid antrum. The Eustachian tube admits air from the throat, and so keeps the pressure on both sides of the drum fairly equal.

Internal ear This consists of a complex system of hollows in the substance of the temporal bone enclosing a membranous duplicate. Between the membrane and the bone is a ?uid known as perilymph, while the membrane is distended by another collection of ?uid known as endolymph. This membranous labyrinth, as it is called, consists of two parts. The hinder part, comprising a sac (the utricle) and three short semicircular canals opening at each end into it, is the part concerned with the balancing sense; the forward part consists of another small bag (the saccule), and of a still more important part, the cochlear duct, and is the part concerned with hearing. In the cochlear duct is placed the spiral organ of Corti, on which sound-waves are ?nally received and by which the sounds are communicated to the cochlear nerve, a branch of the vestibulocochlear nerve, which ends in ?laments to this organ of Corti. The essential parts in the organ of Corti are a double row of rods and several rows of cells furnished with ?ne hairs of varying length which respond to di?ering sound frequencies.

The act of hearing When sound-waves in the air reach the ear, the drum is alternately pressed in and pulled out, in consequence of which a to-and-fro movement is communicated to the chain of ossicles. The foot of the stapes communicates these movements to the perilymph. Finally these motions reach the delicate ?laments placed in the organ of Corti, and so affect the auditory nerve, which conveys impressions to the centre in the brain.... ear

A tumour or new growth arising from the nerve of hearing – eighth auditory nerve. In middle-aged and elderly.

Symptoms: tinnitus, nerve deafness, vertigo. Herbal treatment may prove beneficial, before surgery. Treatment alternatives. Tea, mixture. Equal parts: Gotu Kola, Violet leaves, Clivers. 1 heaped teaspoon to each cup boiling water: infuse 10 minutes: dose, half-1 cup thrice daily, before meals.

Powders. Formula. Equal parts: Poke root, Echinacea, Blue Flag root. Mix. Dose: 500mg (two 00 capsules or one-third teaspoon), thrice daily, before meals.

Tinctures. Equal parts: Yellow Dock, Thuja, Poke root. Mix. Dose: 1 teaspoon in water thrice daily. Topical. 2-3 drops warm oil of Mullein injected into the meatus 3-4 times daily.

Nutrients: All vitamins. Selenium. Zinc.

Treatment by or in liaison with a general medical practitioner. ... acoustic neuroma

A test for vestibular function (see EAR). It is performed by irrigating the external auditory meatus of the ear with alternate cold and hot water. This usually stimulates the vestibular apparatus, causing nystagmus (see DIABETES MELLITUS – Diabetic eye disease). If the vestibular apparatus is affected by disease, the response may be absent or reduced.... caloric test

Diseases may affect the EAR alone or as part of a more generalised condition. The disease may affect the outer, middle or inner ear or a combination of these.

Examination of the ear includes inspection of the external ear. An auriscope is used to examine the external ear canal and the ear drum. If a more detailed inspection is required, a microscope may be used to improve illumination and magni?cation.

Tuning-fork or Rinne tests are performed to identify the presence of DEAFNESS. The examiner tests whether the vibrating fork is audible at the meatus, and then the foot of the fork is placed on the mastoid bone of the ear to discover at which of the two sites the patient can hear the vibrations for the longest time. This can help to di?erentiate between conductive and nerve deafness.

Hearing tests are carried out to determine the level of hearing. An audiometer is used to deliver a series of short tones of varying frequency to the ear, either through a pair of headphones or via a sound transducer applied directly to the skull. The intensity of the sound is gradually reduced until it is no longer heard and this represents the threshold of hearing, at that frequency, through air and bone respectively. It may be necessary to play a masking noise into the opposite ear to prevent that ear from hearing the tones, enabling each ear to be tested independently.

General symptoms The following are some of the chief symptoms of ear disease: DEAFNESS (see DEAFNESS). EARACHE is most commonly due to acute in?ammation of the middle ear. Perceived pain in this region may be referred from other areas, such as the earache commonly experienced after tonsillectomy (removal of the TONSILS) or that caused by carious teeth (see TEETH, DISORDERS OF). The treatment will depend on the underlying cause. TINNITUS or ringing in the ear often accompanies deafness, but is sometimes the only symptom of ear disease. Even normal people sometimes experience tinnitus, particularly if put in soundproofed surroundings. It may be described as hissing, buzzing, the sound of the sea, or of bells. The intensity of the tinnitis usually ?uctuates, sometimes disappearing altogether. It may occur in almost any form of ear disease, but is particularly troublesome in nerve deafness due to ageing and in noise-induced deafness. The symptom seems to originate in the brain’s subcortical regions, high in the central nervous system. It may be a symptom of general diseases such as ANAEMIA, high blood pressure and arterial disease, in which cases it is often synchronous with the pulse, and may also be caused by drugs such as QUININE, salicylates (SALICYLIC ACID and its salts, for example, ASPIRIN) and certain ANTIBIOTICS. Treatment of any underlying ear disorder or systemic disease, including DEPRESSION, may reduce or even cure the tinnitis, but unfortunately in many cases the noises persist. Management involves psychological techniques and initially an explanation of the mechanism and reassurance that tinnitus does not signify brain disease, or an impending STROKE, may help the person. Tinnitus maskers – which look like hearing aids – have long been used with a suitably pitched sound helping to ‘mask’ the condition.

Diseases of the external ear

WAX (cerumen) is produced by specialised glands in the outer part of the ear canal only. Impacted wax within the ear canal can cause deafness, tinnitis and sometimes disturbance of balance. Wax can sometimes be softened with olive oil, 5-per-cent bicarbonate of soda or commercially prepared drops, and it will gradually liquefy and ‘remove itself’. If this is ineffective, syringing by a doctor or nurse will usually remove the wax but sometimes it is necessary for a specialist (otologist) to remove it manually with instruments. Syringing should not be done if perforation of the tympanic membrane (eardrum) is suspected. FOREIGN BODIES such as peas, beads or buttons may be found in the external ear canal, especially in children who have usually introduced them themselves. Live insects may also be trapped in the external canal causing intense irritation and noise, and in such cases spirit drops are ?rst instilled into the ear to kill the insect. Except in foreign bodies of vegetable origin, where swelling and pain may occur, syringing may be used to remove some foreign bodies, but often removal by a specialist using suitable instrumentation and an operating microscope is required. In children, a general anaesthetic may be needed. ACUTE OTITIS EXTERNA may be a di?use in?ammation or a boil (furuncle) occurring in the outer ear canal. The pinna is usually tender on movement (unlike acute otitis media – see below) and a discharge may be present. Initially treatment should be local, using magnesium sulphate paste or glycerine and 10-per-cent ichthaminol. Topical antibiotic drops can be used and sometimes antibiotics by mouth are necessary, especially if infection is acute. Clotrimazole drops are a useful antifungal treatment. Analgesics and locally applied warmth should relieve the pain.

CHRONIC OTITIS EXTERNA producing pain and discharge, can be caused by eczema, seborrhoeic DERMATITIS or PSORIASIS. Hair lotions and cosmetic preparations may trigger local allergic reactions in the external ear, and the chronic disorder may be the result of swimming or use of dirty towels. Careful cleaning of the ear by an ENT (Ear, Nose & Throat) surgeon and topical antibiotic or antifungal agents – along with removal of any precipitating cause – are the usual treatments. TUMOURS of the ear can arise in the skin of the auricle, often as a result of exposure to sunlight, and can be benign or malignant. Within the ear canal itself, the commonest tumours are benign outgrowths from the surrounding bone, said to occur in swimmers as a result of repeated exposure to cold water. Polyps may result from chronic infection of the ear canal and drum, particularly in the presence of a perforation. These polyps are soft and may be large enough to ?ll the ear canal, but may shrink considerably after treatment of the associated infection.

Diseases of the middle ear

OTITIS MEDIA or infection of the middle ear, usually occurs as a result of infection spreading up the Eustachian tubes from the nose, throat or sinuses. It may follow a cold, tonsillitis or sinusitis, and may also be caused by swimming and diving where water and infected secretions are forced up the Eustachian tube into the middle ear. Primarily it is a disease of children, with as many as 1.5 million cases occurring in Britain every year. Pain may be intense and throbbing or sharp in character. The condition is accompanied by deafness, fever and often TINNITUS.

In infants, crying may be the only sign that something is wrong – though this is usually accompanied by some localising manifestation such as rubbing or pulling at the ear. Examination of the ear usually reveals redness, and sometimes bulging, of the ear drum. In the early stages there is no discharge, but in the later stages there may be a discharge from perforation of the ear drum as a result of the pressure created in the middle ear by the accumulated pus. This is usually accompanied by an immediate reduction in pain.

Treatment consists of the immediate administration of an antibiotic, usually one of the penicillins (e.g. amoxicillin). In the majority of cases no further treatment is required, but if this does not quickly bring relief then it may be necessary to perform a myringotomy, or incision of the ear drum, to drain pus from the middle ear. When otitis media is treated immediately with su?cient dosage of the appropriate antibiotic, the chances of any permanent damage to the ear or to hearing are reduced to a negligible degree, as is the risk of any complications such as mastoiditis (discussed later in this section). CHRONIC OTITIS MEDIA WITH EFFUSION or glue ear, is the most common in?ammatory condition of the middle ear in children, to the extent that one in four children in the UK entering school has had an episode of ‘glue ear’. It is characterised by a persistent sticky ?uid in the middle ear (hence the name); this causes a conductive-type deafness. It may be associated with enlarged adenoids (see NOSE, DISORDERS OF) which impair the function of the Eustachian tube. If the hearing impairment is persistent and causes problems, drainage of the ?uid, along with antibiotic treatment, may be needed – possibly in conjunction with removal of the adenoids. The insertion of grommets (ventilation tubes) was for a time standard treatment, but while hearing is often restored, there may be no long-term gain and even a risk of damage to the tympanic membrane, so the operation is less popular than it was a decade or so ago. MASTOIDITIS is a serious complication of in?ammation of the middle ear, the incidence of which has been dramatically reduced by the introduction of antibiotics. In?ammation in this cavity usually arises by direct spread of acute or chronic in?ammation from the middle ear. The signs of this condition include swelling and tenderness of the skin behind the ear, redness and swelling inside the ear, pain in the side of the head, high fever, and a discharge from the ear. The management of this condition in the ?rst instance is with antibiotics, usually given intravenously; however, if the condition fails to improve, surgical treatment is necessary. This involves draining any pus from the middle ear and mastoid, and removing diseased lining and bone from the mastoid.

Diseases of the inner ear

MENIÈRE’S DISEASE is a common idiopathic disorder of ENDOLYMPH control in the semicircular canals (see EAR), characterised by the triad of episodic VERTIGO with deafness and tinnitus. The cause is unknown and usually one ear only is affected at ?rst, but eventually the opposite ear is affected in approximately 50 per cent of cases. The onset of dizziness is often sudden and lasts for up to 24 hours. The hearing loss is temporary in the early stages, but with each attack there may be a progressive nerve deafness. Nausea and vomiting often occur. Treatment during the attacks includes rest and drugs to control sickness. Vasodilator drugs such as betahistine hydrochloride may be helpful. Surgical treatment is sometimes required if crippling attacks of dizziness persist despite these measures. OTOSCLEROSIS A disorder of the middle ear that results in progressive deafness. Often running in families, otosclerosis affects about one person in 200; it customarily occurs early in adult life. An overgrowth of bone ?xes the stapes (the innermost bone of the middle ear) and stops sound vibrations from being transmitted to the inner ear. The result is conductive deafness. The disorder usually affects both ears. Those affected tend to talk quietly and deafness increases over a 10–15 year period. Tinnitus often occurs, and occasionally vertigo.

Abnormal hearing tests point to the diagnosis; the deafness may be partially overcome with a hearing aid but surgery is eventually needed. This involves replacing the stapes bone with a synthetic substitute (stapedectomy). (See also OTIC BAROTRAUMA.)... ear, diseases of

Eye movement that occurs after or during the slow injection of 20 ml of ice-cold water into each external auditory meatus (see EAR) in turn.... vestibulo-ocular reflex

(auditory meatus) the canal leading from the pinna to the eardrum.... auditory canal

(auroscope, otoscope) n. an apparatus for examining the ear canal (external meatus) and eardrum. It consists of a funnel (speculum), a light, and lenses (see illustration).... auriscope

n. inflammation of the glans penis, usually associated with tightness of the foreskin (*phimosis). It is more common in childhood than in adult life. An acute attack is associated with redness and swelling of the glans. Treatment is by antibiotics, and further attacks are prevented by *circumcision. In Zoon’s plasma cell balanitis persistent shiny red patches develop on the glans; the cause is unknown. Balanitis xerotica obliterans (BXO, lichen sclerosis et atrophicus) is an autoimmune condition characterized by ivory-white patches on the glans associated with stenosis of the urethral meatus and urethral strictures.... balanitis

(earwax) n. the waxy material that is secreted by the sebaceous glands in the external auditory meatus of the outer ear. Its function is to protect the delicate skin that lines the inside of the meatus.... cerumen

n. (pl. conchae) (in anatomy) any part resembling a shell. For example, the concha auriculae is a depression on the outer surface of the pinna (auricle), which leads to the external auditory meatus of the outer ear. See also nasal concha.... concha

The male organ through which the tubular URETHRA runs from the neck of the URINARY BLADDER to the exterior at the meatus or opening. URINE and SEMEN are discharged along the urethra, which is surrounded by three cylindrical bodies of erectile tissue, two of which (corpora cavernosa) lie adjacent to each other along the upper length of the penis and one (corpus spongiosum) lies beneath them. Normally the penis hangs down in a ?accid state in front of the SCROTUM. When a man is sexually aroused the erectile tissue, which is of spongy constituency and well supplied with small blood vessels, becomes engorged with blood.

This makes the penis erect and ready for insertion into the woman’s vagina in sexual intercourse. The end of the penis, the glans, is covered by a loose fold of skin – the foreskin or PREPUCE – which retracts when the organ is erect. The foreskin is sometimes removed for cultural or medical reasons.

A common congenital disorder of the penis is HYPOSPADIAS, in which the urethra opens somewhere along the under side; it can be repaired surgically. BALANITIS is in?ammation of the glans and foreskin. (See also REPRODUCTIVE SYSTEM; EJACULATION; IMPOTENCE; PRIAPISM.)... penis

or polyp (plural: polypi). A general name applied to tumours which are attached by a stalk to the surface from which they spring. The term refers only to the shape of the growth and has nothing to do with its structure or nature. Most polypi are of a simple nature, although malignant polypi are also found. The usual structure of a polypus is that of a ?ne ?brous core covered with epithelium resembling that of the surrounding surface. The sites in which polypi are most usually found are the interior of the nose, the outer meatus of the ear, and the interior of the womb, bladder, or bowels (see POLYPOSIS).

Their removal is generally easy, as they are simply twisted o?, or cut o?, by some form of snare or ligature. (The tissue removed should be checked for malignant cells.) Those which are situated in the interior of the bladder or bowels, and whose presence is usually recognised because blood appears in the urine or stools, require a more serious operation – usually an endoscopic examination (see ENDOSCOPE).... polypus

Amygdala dulcis (sweet almonds). A fixed oil expressed from Prunus amygdalus without the aid of heat. Contains 45 per cent fixed oil and about 20 per cent protein and an enzyme, emulsin. Demulcent. Nutritive. Emulsifying agent. Used internally as a laxative, or externally as a massage oil. A nourishing skin cream is made by whisking Almond oil 2; Beeswax 1; and Aloe Vera 1; in a mixer. “Oil of Almonds makes smooth the hands and face of delicate persons, and cleanses the skin from spots and pimples” (John Gerard)

Oil is injected into the meatus for softening ear wax prior to removal. A good vehicle for Vitamins A, D and E in cosmetic lotions. Excellent base for ointments, together with Agar-Agar.

Sweet almonds have been used as food since ancient times, being a source of fats, iron, calcium, potassium, phosphorus, copper and zinc. Used widely in Aromatherapy. ... almond oil

Sliced Garlic treatment. Peel corm, leaving transparent epithelial-layer attached. Cut slice and shape it to cover the perforation; push it against the eardrum so that its cut surface hugs the perforation. Pack the external auditory meatus with an alcohol-moistened plug of cotton wool. Water must not enter the ear and forceful nose-blowing avoided. Replace Garlic slice once or twice a week until healing is complete. If middle ear becomes inflamed with excessive exudate, stop treatment and give an anti-inflammatory (such as Echinacea, author). Any exudation usually stops when treatment is discontinued. (Chinese Medical Journal, May 1977) ... ear drums, perforated

(meato-) combining form denoting a meatus. Example: meatotomy (incision into the urethral meatus).... meat

the duct that passes through the hole (nasolacrimal canal) in the palatine bone of the skull. It drains the tears away from the *lacrimal apparatus into the inferior meatus of the nose.... nasolacrimal duct

n. the organ of olfaction, which also acts as an air passage that warms, moistens, and filters the air on its way to the lungs. The external nose is a triangular projection in the front of the face that is composed of cartilage and covered with skin. It leads to the nasal cavity (internal nose), which is lined with mucous membrane containing olfactory cells and is divided into two chambers (fossae) by the nasal septum. The lateral wall of each chamber is formed by the three scroll-shaped *nasal conchae, below each of which is a groovelike passage (meatus). The *paranasal sinuses open into these meatuses.... nose

n. a fungus infection of the ear, causing irritation and inflammation of the canal between the eardrum and the external opening of the ear (external auditory meatus). It is one of the causes of *otitis externa.... otomycosis

the pinna and the external auditory meatus of the *ear.... outer ear

Allium cepa. The domestic onion. Held in high esteem by Galen and Hippocrates. Part used: bulb.

Constituents: flavonoids, volatile oil, allicin, vitamins, sterols, phenolic acids.

Action: hypoglycaemic, antibiotic, anticoagulant, expectorant, hypotensive, antibacterial, antisclerotic, anti-inflammatory, diuretic. Shares some of the properties of Garlic. Mild bacterical (fresh juice). Promotes bile flow, reduces blood sugar, stimulates the heart, coronary flow and systolic pressure.

Uses: Oedema, mild dropsy, high blood pressure. Inclusion in daily diet for those at risk from heart attack or stroke through low HDLs (high-density lipoprotein) levels.

“An Onion a day keeps arteriosclerosis at bay.” (Dr Victor Gurewich, Professor of Medicine, Tuft’s University, Boston, USA)

Onions clear arteries of fat which impedes blood flow. Of value for sour belching, cystitis, chilblains, insect bites, freckles. Two or three drops juice into the auditory meatus for earache and partial deafness. Burns and scalds (bruised raw Onion). Claimed that juice rubbed into the scalp arrests falling hair.

“I have observed that families using Onions freely as an article of diet have escaped epidemic diseases, although their neighbours might be having scarlet fever, etc. I believe Onions are reliable prophylactics. I have prevented the spread of contagious disease in the same household by their timely use.” (Dr L. Covert)

The traditional roasted Onion is still used as a poultice for softening hard tumours and pains of acute gout.

Preparations: Decoction. Water in which Onions are boiled is a powerful diuretic and may also be used for above disorders.

Home tincture. Macerate Onions for 8 days in Holland’s gin, shake daily; strain, bottle. 2-3 teaspoons in water, thrice daily for oedema, dropsy or gravel.

Note: A research team at the National Cancer Institute, China, has shown that the Onion family (Chives, Onions, Leeks and Garlic) can significantly reduce the risk of stomach cancer. ... onion

a chronic skin disease affecting the anogenital area (and rarely other sites), especially the vulva in women and foreskin in men. It is characterized by sheets of thin ivory-white skin and may be caused by chronic irritation by urine. There is a risk of *squamous cell carcinoma. In women, the condition causes intense itching, and atrophy of the labia minora often occurs. Potent topical corticosteroids are helpful for women. In men, normal penile architecture is progressively lost and a constricting band around the foreskin may appear (causing sexual dysfunction and sometimes *paraphimosis) or sometimes narrowing of the urethral meatus may occur. This sometimes necessitates circumcision.... lichen sclerosus

n. inflammation of the ear. Otitis externa is inflammation of the canal between the eardrum and the external opening of the ear (the external auditory meatus). Myringitis is inflammation of the eardrum, often due to viral infection. Acute otitis media is inflammation, usually due to viral or bacterial infection, of the middle ear (the chamber lying behind the eardrum and containing the three bony ossicles that conduct sound to the inner ear). Symptoms include pain and a high fever. Treatment is with antibiotics and sometimes also by surgical drainage (*myringotomy). Secretory otitis media (or otitis media with effusion) is a chronic accumulation of fluid in the middle ear, causing hearing loss (see glue ear). Chronic otitis media (COM) is chronic inflammation of the middle ear associated with perforations of the eardrum and in some instances with *cholesteatoma. The treatment involves surgical repair of perforations (*myringoplasty) or removal of the air cells in the mastoid bone (*mastoidectomy). Chronic otitis media was previously known as chronic suppurative otitis media but the terminology was changed as the formation of pus is not an inevitable part of the condition. See also labyrinthitis.... otitis

the air-filled spaces, lined with mucous membrane, within some of the bones of the skull. They open into the nasal cavity, via the meatuses, and are named according to the bone in which they are situated. They comprise the frontal sinuses and the maxillary sinuses (one pair of each), the ethmoid sinuses (consisting of many spaces inside the ethmoid bone), and the two sphenoid sinuses. See illustration.... paranasal sinuses

(branchial cleft, visceral cleft) any of the paired segmented clefts in each side of the throat of the early embryo that correspond to the gills of fish. Soon after they have formed they close to form the *pharyngeal pouches, except for the first cleft, which persists as the external auditory meatus.... pharyngeal cleft

(auricle) n. the flap of skin and cartilage that projects from the head at the exterior opening of the external auditory meatus of the *ear (see illustration). In humans the pinna is largely vestigial but it may be partly concerned with detecting the direction of sound sources.... pinna

(salpingo-) combining form denoting 1. the Fallopian tube. 2. the auditory tube (meatus).... salping

n. the projection of cartilage in the *pinna of the outer ear that extends back over the opening of the external auditory meatus. It is used as a reference point in orthodontic measurements.... tragus

(eardrum) the membrane at the inner end of the external auditory meatus, separating the outer and middle ears. It is formed from the outer wall of the lining of the tympanic cavity and the skin that lines the external auditory meatus. When sound waves reach the ear the tympanum vibrates, transmitting these vibrations to the malleus – one of the auditory *ossicles in the middle ear – to which it is attached.... tympanic membrane