Ear disease

Ear disease

Ear disease

Ear disease is any disorder that affects the ear’s structure or function. This can involve the outer ear, middle ear, or inner ear and can result in various symptoms such as hearing loss, tinnitus, dizziness, or pain.

Ear diseases can be congenital, meaning they are present at birth, or acquired, meaning they develop later in life. One example of a congenital ear disease is congenital hearing loss, typically caused by genetic factors or complications during pregnancy or childbirth.

An example of an acquired ear disease is acute otitis media, a typical middle ear infection and common condition (1).

How common is ear disease

Ear disease occurs throughout life. It is estimated that five out of six children are likely to suffer at least one episode of ear infection before the age of three years (2).

Ear disease is less common in adults. Cholesteatoma, for instance, occurs in 6-9/ 100 000 of the population (3,4).

Ear disease in early times

Before the advent of antibiotics and modern surgical techniques, ear diseases posed a significant risk of mortality due to their potential to cause severe complications. (5). Some of these complications include meningitis, a serious  infection of the brain and spinal cord; mastoiditis, an infection of the mastoid bone located behind the ear; and labyrinthitis, an inner ear infection that can lead to hearing loss and balance issues.

Left untreated, these complications could result in permanent disability or even death, highlighting the importance of advancements in ear care and treatment in saving lives (6).

Symptoms of ear disease

Some common symptoms and signs of ear disease include:

  • Pain or discomfort in the ear
  • Earache
  • Itching in the ear
  • Feeling of fullness or blockage in the ear
  • Drainage from the ear
  • Hearing loss or difficulty hearing
  • Tinnitus (ringing in the ear)
  • Dizziness or vertigo
  • Ear sensitivity to touch or pressure
  • Swelling or redness of the ear or ear canal
  • Fever
  • Nausea or vomiting
  • Difficulty balancing
  • Changes in ear wax production or consistency
Ear ache is common in children
Ear ache is common in children

Acute and chronic ear disease

Acute ear disease is a sudden and typically short-term infection or inflammation of the ear, often causing symptoms such as pain, fever, and temporary hearing loss. It can be caused by various factors such as bacteria or viruses and may require treatment with antibiotics or pain relievers. A typical example is acute otitis media in childhood.

Chronic ear disease, on the other hand, is a long-term or recurring condition that may persist for months or years. It is often characterized by ongoing symptoms such as persistent pain, drainage from the ear, hearing loss, and repeated infections. Chronic ear disease can result from untreated acute infections, underlying health conditions, or anatomical abnormalities of the ear. Treatment for chronic ear disease may involve a combination of medications, ear drops, or surgery in severe cases. Common examples include cholesteatoma, chronic to-mastoiditis and wet cavities after previous surgery (7).


Cholesteatoma is a type of chronic ear disease characterized by the growth of abnormal skin cells in the middle ear (8). If left untreated, it can lead to hearing loss, dizziness, facial paralysis, sinus thrombosis, meningitis, and intracranial abscess. Cholesteatoma most often requires surgical treatment to remove the abnormal tissue and prevent further complications.

Dr. Hofmeyr specializes in cholesteatoma surgery and has extensive expertise in performing procedures to treat this condition successfully.

A cholesteatoma (*)
A cholesteatoma (*)

Revision ear surgery

Revision ear surgery refers to a procedure performed on the ear that has already undergone previous ear surgeries but did not achieve the desired outcome or resulted in complications (9). This could be due to various reasons, such as unresolved issues like chronic adhesive otomastoiditis or chronic wet cavities in the ear.

For example, chronic adhesive otomastoiditis is a condition with inflammation and scarring in the middle ear and mastoid bone, leading to persistent ear infections and hearing loss. Chronic wet cavities refer to persistent fluid-filled spaces in the ear that can cause recurrent infections and complications.

Performing revision ear surgery can be challenging as the ear’s anatomy may have been altered from previous surgeries, making it more challenging to correct the issues.

Subtotal petrosectomy

A subtotal petrosectomy is a surgical procedure involving removing a portion of the petrous part of the temporal bone, which is located deep within the skull near the ear. (10). This procedure is typically performed to treat certain types of tumours or chronic infections in the ear or skull base region.

A subtotal petrosectomy is performed when chronic ear disease in this area cannot be adequately treated with less invasive methods, such as medication.

While a subtotal petrosectomy is a complex and delicate procedure, it can be highly effective in treating chronic ear disease.

A modern operating theatre
A modern operating theatre

Dr Hofmeyr's experience

Dr. Hofmeyr has extensive experience in performing cholesteatoma and other revision ear surgery and is skilled in navigating the complexities of these cases to achieve successful outcomes for patients


1. Leung AKC, Wong AHC. Acute Otitis Media in Children. Recent Pat Inflamm Allergy Drug Discov. 2017;11(1):32-40. doi: 10.2174/1874609810666170712145332. PMID: 28707578.

2. National Institute on Deafness and Other Communication Disorders. Ear Infections in Children

3. Djurhuus BD, Faber CE, Skytthe A. Decreasing incidence rate for surgically treated middle ear cholesteatoma in Denmark 1977-2007. Dan Med Bull. 2010 Oct;57(10):A4186. PMID: 21040679.

4. Kemppainen HO, Puhakka HJ, Laippala PJ, Sipilä MM, Manninen MP, Karma PH. Epidemiology and aetiology of middle ear cholesteatoma. Acta Otolaryngol. 1999;119(5):568-72. doi: 10.1080/00016489950180801. PMID: 10478597.

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7. Harun A, Clark J, Semenov YR, Francis HW. The Role of Obliteration in the Achievement of a Dry Mastoid Bowl. Otol Neurotol. 2015 Sep;36(9):1510-7. doi: 10.1097/MAO.0000000000000854. PMID: 26375974; PMCID: PMC4783175.

8. Bhutta MF, Williamson IG, Sudhoff HH. Cholesteatoma. BMJ. 2011 Mar 3;342:d1088. doi: 10.1136/bmj.d1088. PMID: 21372073.

9. Kaylie DM, Gardner EK, Jackson CG. Revision chronic ear surgery. Otolaryngol Head Neck Surg. 2006 Mar;134(3):443-50. doi: 10.1016/j.otohns.2005.10.044. PMID: 16500442.

10. Coker NJ, Jenkins HA, Fisch U. Obliteration of the middle ear and mastoid cleft in subtotal petrosectomy: indications, technique, and results. Ann Otol Rhinol Laryngol. 1986 Jan-Feb;95(1 Pt 1):5-11. doi: 10.1177/000348948609500102. PMID: 3947004.