The Middle Ear In Relation To Tinnitus
To understand tinnitus better, what causes it
, and what can be done to stop ringing ears, it helps to know something about our hearing and how it works. This second article in a three part series introduces the basic anatomy of the middle ear, what it does, how it can go wrong to give rise to tinnitus, and how it can be treated. The other two articles focus on the outer ear and the inner ear and tinnitus. Now, let's look at the middle ear.
The middle ear begins right where the outer ear ends, with the tympanic membrane. The eardrum is the dividing membrane separating the outer and middle ear. The outer surface of the eardrum is considered part of the outer ear, while the inner surface of the eardrum is part of the middle ear.
As sound energy moves through the auditory canal, the wave runs into the tympanic membrane or ear drum. This tiny membrane, the tympanic membrane, is constantly responding to air pressure fluctuations in the atmosphere around us. When a sound wave moves through the ear canal and strikes the tympanic membrane, a chain reaction is set in motion, which is a purely mechanical reaction.
Being a specialized, taut skin membrane, the ear drum vibrates back and forth in response to the energy of the sound wave, according to the qualities of the sound, such as pitch and volume. The vibrations move quickly for the shorter waves of high-pitch sounds, and more slowly for the longer waves of low-pitch sounds. The energy of a loud sound will impress the eardrum more deeply, while the softest detectable sound of a healthy young adult moves the membrane only about 1 millionth of an inch Truly a marvel!
The process that transforms sound waves into information that the brain interprets as the sounds we hear begins with the tympanic membrane. Usually the ear receives more than one sound at once. Imagine sitting in a restaurant conversing with your friend. The eardrum responds by helping you filter out most of the restaurant sounds so that you can focus on what your friend is saying.
To a certain degree, the ear drum can also help prevent damage to the inner ear from very loud sounds. The tympanic muscle will actually contract in reaction to a very loud sound, and not vibrate in the normal way. Thereby it reduces the amount of energy that will reach the brain, protecting you. However, that mechanism cannot protect us from all excessively loud sounds, so we do have to take responsibility for protecting ourselves from sounds that can cause hearing damage.
In our modern, technological world we're exposed to many loud sounds that pre-industrial peoples, for example, never experience. Our ears are adapted to sound volumes that normally occur in nature itself, and have not had time to adapt to protect us from the loud volume levels often experienced in our modern world. Whether it is the constant noise of a machine shop, or the excessive volume of an over-charged car stereo, exposure to such high level sounds is clearly known as the most common cause of hearing loss and tinnitus.
As wonderful as our eardrums might be, they have evolved to shield us from the loud sounds produced by nature itself, not the powerful sound waves generated by today's high-charged music amplifiers. For that reason, we ourselves must take responsibility for shielding our ears from the extremely loud sounds produced today.
With that caution noted, let's take the next step into the middle ear. Thus far we have noted the collection of sound waves from the atmosphere by the outer ears, the funneling through the ear canal, and the striking of the ear drum, causing it to vibrate. The middle ear mechanics then serve to amplify and focus the sound for when it is transferred to the denser, fluid-filled medium of the inner ear. Because the inner ear is fluid-filled rather than air filled, and a denser medium by nature, the amplification that the middle ear performs is really necessary. Our appreciation for how our hearing works can only increase as we understand how the middle ear carries out that amplification and focus.
Within the chamber of the middle ear, which is usually dry, are the ossicles. Of all the bones found in the human body, the ossicles are the most tiny, and the word ossicle comes from the Latin root which means "tiny bone." The sound vibrations of the eardrum are transferred directly to the malleus, the first of the three ossicles, which is attached directly to the eardrum. Then the malleus passes the energy on to the adjoining ossicle, the incus. The incus then strikes the third ossicle, the stapes, again, transferring the energy. In turn, the stapes passes the energy on to the inner ear to which it is attached.
The middle ear is a mechanical wonder, and our sense of hearing is indeed a mechanical process, at variance with our senses of sight and taste which are chemical in nature. Hearing is a mechanical operation.
The ossicles, working like levers, increase the mechanical power of the tympanic membrane, focusing the energy force from the larger membrane to the smaller oval window of the cochlea of the inner ear. As a result, the ossicles pass on amplified energy with greater concentration to the inner ear. That amplification produced by the leverage action of the ossicles is required for when the vibrations encounter the denser medium within the fluid-filled inner ear. Pretty amazing, isn't it?
The eustachian tube, at the far end of the middle ear, connects the dry chamber of the middle ear with the nasopharynx or part of the throat. Anyone who has ever had a head cold knows that the ears, nose, and throat are all connected. The connection for the ear comes via the eustachian tube.
The eustachian tube serves to maintain equal air pressure on both sides of the tympanic membrane. It also provides a drain tube for the middle ear, keeping it free of fluid and congestion, and thereby helping to prevent infections.
It is very common when you fly in an airplane or drive in the mountains to experience the feeling of different air pressure on either side of the eardrum. By yawning or chewing or swallowing, you may have produced a popping sound that came with a sense of relief. That was the eustachian tube functioning to keep the air pressure on either side of the eardrum equalized.
The most common tinnitus problem to arise within the middle ear involves the eustachian tube which can become blocked by swollen, inflamed tissues brought on by sinusitis, rhinitis, or allergy episodes. When the eustachian tube stops up, it can trap fluid within the middle ear which can then become a breeding ground for bacteria or viruses, leading to otitis media, or inflammation or infection of the middle ear, which can engender tinnitus symptoms. Treatment that resolves the infection and inflammation usually takes care of the tinnitus also, but chronic sinusitis or allergies can also engender chronic tinnitus.
by: David Stamon
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