Fluid in the ear, and hearing loss

I’ll keep this brief, to try and keep it GQ worthy.

I had an annual physical this past week, and apparently the fluid in my left ear doesn’t drain. For many years now, I’ve known that something was up with that ear, I guess now I know what. Also, I had an audiogram, and apparently I’ve suffered a “significant” loss in the left ear. No big surprise, I first started getting big losses about 4 years ago. (about the time my first child was born… hmmmmmm :dubious: )

So my questions. (Which, admittedly should have been posed to the doctor, but were not in any great detail)

  1. Is the fluid issue the actual cause of the loss, or related, or not at all.

  2. Apparently there is a procedure where they can insert an artificial drain in there. Will that help my hearing any? I’ve been told that this procedure is usually done with children, and I’m left with the impression that it’s not a big deal to not get it done, for whatever reason.

I had this problem (I believe it was with both ears) when I was a child.

  1. In my case it had caused significant hearing loss, and some difficulties when learning to speak.

  2. My hearing improved after having the artificial drain put in. Things might have changed in the last 20 years, but when I had them put in, they were rather fragile and would break/come out. I think I had the procedure done 3 times over the course of a few years.

Thanks for the response. Do you recall the procedure? Do they put something in the ear itself? Go in through the neck?

I remember it only vaguely. It was a short procedure; I’d be in and out of the hospital in the same day. They put something in the ear itself. IIRC it’s a tiny tube that is put in the eardrum. No external cutting is necessary. It’s all pretty non-invasive.

The build-up of fluid in the middle-ear is actually causing your hearing loss because it is impeding the passage of sound waves through to the inner ear. This is what’s known as a conductive hearing loss.

The procedure is called a myringotomy. A small incision is made in the ear drum and a pressure equalization tube is inserted. Over time the tube will fall out on its own (although I know a couple of children who did have to go back to the doctor to get them removed). It’s a very common procedure amongst children and can be done on an out-patient basis. Since you’re an adult, I would agree that it’s not a huge deal if you decide against the procedure, but I really think you should consider it given that you’ve actually noticed that something’s been up with that ear. Although you may be able to function with a significant unilateral hearing loss, I think you’ll find life easier with good bilateral hearing.

You can check out some more info at the following site:

(Disclaimer: IANAD, but I am a speech pathologist so I’ve worked with a number of children with middle ear fluid.)

Well, you are really very lucky the fluid buildup in your ear didn’t lead to an intensely painful wait for your eardrum to rupture to relieve the pressure. I spent most of my life with holes in both eardrums, either naturally patent or maintained with tubes, and I’ll probably always have holes in my eardrums. In case you’re wondering, they don’t affect my hearing to any noticeable degree, especially compared to when one of my middle ears is full of liquid.

Firstly, thanks for the responses. I have some questions that the website didn’t answer (at least I didn’t find it).

  1. When this tube falls out after 6mos to several years, is it required to have it reinserted every time? I’m getting the impression this isn’t the case. Will the drainage canal “heal”, thus preventing the need for future insertions?

  2. Just out of curiosity, why the emphasis on children, and not adults? Is that because, as cckerberos said, it may cause speech difficulties?

I agree, and intend on pursuing this. I suppose I should consider myself lucky up to this point, and get it dealt with before it causes and serious problems.

Interesting you should say this. The first time I saw a doctor at this facility, 5 years ago, he looked in my left ear and asked if I ever had my eardrums rupture. I replied with “not that I’m aware”, and that was the end of that. FWIW, these doctors are Navy docs at a Naval Air Station, so I’m guessing they know a thing or two about ear problems.

IANAD, but I work for an ENT/Head & Neck Surgery practice in the billing department. We do LOTS of ear tubes.

It varies from patient to patient; if you’re continuing to have the problem, then they will probably wish to do another set, but some people do hold on to the tubes & don’t lose them. It is possible to lose them close to right away, but I think most doctors will do them again promptly in that case. (This is very rare.)

I believe that’s the usual reason, but the other reason is that it can cause repeated painful ear infections, which COULD rupture your eardrum or cause other problems.

I would definately look into it. Find a good ENT and you should have no problems. We do them for adults here in our office; it’s not even something that has to go to a surgery center or anything for many people.

Good luck!


I’d imagine it’s because they’re related to ear infections, which are more common among children than adults.

You wouldn’t necessarily be aware of having an eardrum rupture. It happened to me and the first time I knew it had happened was when a doctor told me. All I thought had happened was that I had had a nasty ear infection that went away on its own.

I have several years of experience here… As a patient, and as the mother of a patient.

Our 10yo son has hearing loss significant enough that he has to wear hearing aids to hear anything like normally. When he was first tested, though, when he was 4 months old or so, he test at COMPLETELY deaf. Part of the problem was fluid in his ears, so they put tubes in. The tubes helped his ears drain enough that hearing aids were effective, but tests also showed some sensorineural hearing loss (due to damage to the auditory nerve), so he’s been wearing hearing aids since just before his first birthday. He has had four or five sets of tubes now, and all of those are because he gets fluid build-up in his ears when there are no tubes in place. That said, he has had very few full-fledged ear infections.

We changed ENTs about a year ago, and as part of the moving process, they did new hearing tests. The new tests show virtually NO nerve loss, meaning that his hearing loss now appears to be 100% conductive. When the hearing loss is primarily conductive, that means that it is due primarily to damage in one or more of the bones in the middle ear. These bones transmit vibration from the ear drum to the cochlea, and if the bones don’t touch each other correctly, then there is hearing loss. We have an exploratory surgery scheduled for our son in April, but the doctor thinks that his hearing loss is most likely due to damage caused to the bones from excessive fluid in the ears for extended periods of time. If this is the case, he can put artificial “bones” in the ear to replace the natural bones, and his hearing should be restored to something closer to normal.

It is also true that the mere presence of fluid in the middle ear can cause temporary hearing loss. Our now-13yo daughter got her one and only set of ear tubes ONLY because fluid was making her hearing poor, and her language skills started regressing when she was about 18mo. I also get fluid in my ears from colds and allergies. Usually it does not progress to an infection, and decongestant helps until the ears drain naturally, but I have had a couple of ruptured eardrums from it. I also have mild hearing loss in one ear that is probably due to excessive fluid when I was much younger.

Tubes can cause more damage than they fix though. Our son’s last set of ear tubes were put in nearly two years ago, and the first one fell out last month. It left a gaping hole in his eardrum that the doctor says will probably have to be repaired surgically (although I do plan to ask if there is harm in simply leaving the hold as-is, rather than having more tubes inserted).

It’s possible that you’ll need reinsertions depending on what’s causing the fluid buildup. Children are prone to middle-ear fluid because of the angle of their auditory tubes (aka eustachian tubes) . As they grow older, the angle of their tubes change and their middle ear problems tend to disappear as the drainage improves. Since you’re already an adult, this isn’t going to happen. I would ask your ENT what he thinks is causing the fluid build-up and whether this is going to continue to be a chronic problem.

The drainage canal should heal after the tube falls out and this means that you might begin to get fluid build-up again. People who have had many sets of tubes may experience scarring of their ear drums. Theoretically, this could affect your hearing, but to what degree I’m not sure. I’d recommend checking with the audiologist.

Even a minimal hearing loss of 16-25 dB HL in children (which is medically still within normal limits) can have a negative impact on speech, language, and social development. Although adults may not be affected by a 20 dB HL loss, children do not have the vocabulary knowledge or world experience required to “fill in the blanks.” This can also jeopardize their academic performance for the same reasons. (Also, classrooms are really very poor listening environments. I was in a grade two class during snack time the other day and I had to shout to hear my own voice. Oy, what a din.) And keep in mind that this is just for a minimal hearing loss, children with with mild or greater hearing losses are at even greater risk if there is no early intervention.

To get a rough idea of what a minimal hearing loss sounds like, you may want to check out this site: http://www.msu.edu/~huffma23/ You’ll find wave files demonstrating what hearing can be like for both people with otitis media (which is a middle-ear infection) and sensorineural hearing loss.

One thing I should clarify is when I said that your not getting the procedure is not a huge deal, I was assuming that your doctor said it wasn’t medically necessary and was speaking purely from a speech and language perspective. But rereading your post, I realize that your doctor (who I’m guessing is not an ENT) only gave you the impression that it’s not a big deal. So Derleth’s, Indyellen’s, and cckerberos’ posts regarding the risk of a ruptured ear drum are indeed valid. (One thing I might add is that ear infections are not always painful. You may feel itching or even nothing at all.) I would doublecheck with an ENT.

On preview, I’m realizing just how much I wrote. Sorry for the essay, folks. (And this isn’t even my area of expertise – just be glad you didn’t ask me about speech and language!)

Well, consider my ignorance effectively fought. Thank you all very much for the informative replies. Looks like it’s time to see the docs again.

I really appreciate this thread, the thorough answers and the links, as I suffer from this as well. I don’t have insurance so I haven’t been to a Dr., but I’ve had a chronic infection in my right ear for almost a year & a half. I’ve had 3 courses of antibiotics (the last was Cipro, a month or so ago) prescribed by a nurse practioner. I still feel fluid in my ear, but I can’t afford to go back to her right now, so I don’t know if there is infection present. Just self-testing my hearing (using the telephone dial tone and directional tests with the tv or someone talking) I think my hearing in that ear is only 20% or less of normal. I’m very afraid that it’s permanent, but I’m helpless to deal with it. At least your discourse about tubes in the ear & other treatments give me some hope that should I find the money, there’s hope that my hearing can be restored. I do know it’s having a significant impact on my daily life.