Ears are our organs of hearing. They are also part of the mechanism that controls our balance. An ear can be divided into three sections — outer ear, middle ear and inner ear.
There are two main kinds of deafness:

• Conductive deafness, where sound cannot pass through the outer or middle ear.
• Sensorineural deafness, where the cause of the deafness is in the cochlea or in the hearing nerve.

Ear conditions and what to do about them
In the outer ear: Blockages in the external ear canal may affect hearing. They are usually caused by wax. The wax is made by the ear to clean itself and normally falls out of the ear on its own, but occasionally you may need to visit doctor to have it removed. Do not attempt to remove wax from ears. Never push cotton buds, fingers or anything else into ears.
Otitis externa is where the skin of the ear canal has become inflamed. This may happen if you have scratched your ear or if you have a skin condition such as eczema. The result can be pain and a watery discharge. There is usually little or no hearing loss. Do not scratch your ear. See your doctor to get ear drops and keep your ear dry.
In the middle ear: Glue ear (Otitis media with effusion) is most common in children. If glue ear persists, an operation called a myringotomy may be advised.
Otosclerosis affects more women than men, often starts around the age of 30, and can run in families. It is caused by a bony overgrowth of the stapes. People with otosclerosis gradually become more deaf. Hearing aids are very useful to someone with this condition. Most people can have an operation — a stapedectomy or stapedotomy — where the stapes is replaced by a tiny piston so that sound can travel to the inner ear. The operation has a high success rate.
Damaged ossicles — the tiny bones in the middle ear — can be repaired or replaced during operations called ossiculo-plasties.
Perforated eardrums can be treated by an operation called a myringoplasty, where a tissue graft is used to seal up the hole.
In the inner ear: Sensorineural deafness is most often the result of damage to tiny hair cells in your cochlea. This hair cells cannot be replaced.
Sensorinural deafness from birth may also be genetic although this is rare. People with sensorineural deafness usually find hearing aids very helpful. A cochlear implant may be an option for people who have become completely deaf through sensorineural deafness.
Presbyacusis is the natural hearing loss may people experience in old age. Everyone loses hair cells in the cochlea throughout their life and gradually there hearing becomes less acute. You probably find you can hear speech but cannot understand it. This is often because only the high frequency sounds are affected. Other people seem to ‘mumble’. Hearing aids will be helpful if they are properly fitted; good advice and support, if possible from a hearing therapist, are even more important.
Balance problems: Vertigo (dizziness) and balance problems may be caused by damage to semicircular canals or by a problem with the balance centres at the base of the brain. This damage could be the result of an virus or poor blood supply. In some cases, it is difficult to be sure of the cause.
Usually, your balance will recover on its own, given time. However, you may need to take drugs for the first few days. A physiotherapist can teach you balance exercises that are helpful. You should see a doctor if you have vertigo or balance problems.
Tinnitus: noises in your ears or head- is a condition that about one in seven people experience at some point. The noises may be quiet or loud, and can be hissing, rushing or other sounds.
You may get tinnitus when you develop a hearing loss, as a result of listening to loud sounds, or for no clear reason at all. Various therapies for tinnitus are available; one of the newest is Tinnitus Retraining Therapy.
Noise-induced hearing loss: When we are exposed to harmful noise, sensitive structures in our inner ear can be damaged, causing noise-induced hearing loss (NIHL). Once damaged, our hair cells cannot grow back.

The Write up is compiled by Prof Kamrul Hassan Tarafder, Dpt of Otolaryngology, Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU).