Falls, blows to the head, sports injuries, and even listening to loud music can cause ear damage, which can affect hearing and balance. That's because the ear not only helps us hear, but also keeps us steady on our feet.
Kids need to hear well to develop and use their speech, social, and listening skills. Even mild or partial hearing loss can affect their ability to speak and understand language, while problems with balance can influence how they're able to move and how well they feel.
To understand ear injuries, it's helpful to review the ins and outs of the ears. Basically, the ear is made up of three parts — the outer ear, middle ear, and inner ear.
Hearing begins when sound waves that travel through the air reach the outer ear, or pinna (the visible part of the ear). The outer ear captures the sound vibration and sends it through the ear canal to the middle ear, which contains the eardrum (a thin layer of tissue) and three tiny bones (called ossicles). The sound causes the eardrum to vibrate. The ossicles amplify these vibrations and carry them to the inner ear.
The inner ear is made up of a snail-shaped chamber (the cochlea), which is filled with fluid and lined with four rows of tiny hair cells. When the vibrations move through this fluid, the outer hair cells contract back and forth and amplify the sound.
When the vibrations are big enough, the inner hair cells translate them into electrical nerve impulses in the vestibulocochlear nerve (also called the auditory nerve, acoustic nerve, or eighth cranial nerve), which sends signals to the brain to be interpreted as sound. The vestibulocochlear nerve also helps with balance.
Hearing loss and balance problems can happen when there's damage to key parts of the ear, like the eardrum, ear canal, ossicles, cochlea, or the vestibular nerve.
Here's a look at the most common causes of ear injuries and how they can affect kids:
Cuts, scrapes, burns, or frostbite. When there's an injury (even minor) to the outer ear or ear canal, bleeding and infection can affect other parts of the ear.
Inserting something into the ear. Things like a cotton swab, fingernail, or pencil can scratch the ear canal or cause a tear or hole in the eardrum (called a ruptured eardrum).
Direct blows to the ear or head. Falls, car accidents, sports injuries, or fights may tear the eardrum, dislocate the ossicles, or damage the inner ear. Wrestlers, boxers, and other athletes who endure repeated forceful hits to the outer ear can develop severe bruising or blood clots that block blood flow to the cartilage of the outer ear and damage its shape and structure (known as cauliflower ear).
Loud noise. Kids can have significant or permanent hearing loss when they're exposed to really loud noises daily or over a long period of time. This is called acoustic trauma or noise-induced hearing loss.
When this happens, the tiny hairs in the cochlea become damaged. Loud sounds (like a gunshot, firecracker, or explosion) can cause it, as can noises that are repeated over time (like lawn mowers, power tools, farm equipment, noise from sporting events, band or shop classes, motorbikes, even movie theaters). But for kids and teens, listening to loud music (at concerts, in the car, through headphones) is one of the chief causes of this type of preventable hearing loss.
Sudden, significant change in air pressure. When we fly or scuba dive, air pressure decreases as we go higher and increases as we go lower. If the pressure isn't equalized, the higher air pressure pushes on one side of the eardrum and causes pain and sometimes partial hearing loss, called barotrauma.
Normally, the eustachian tube (a passageway that leads from the middle ear to the back of the throat behind the nose) equalizes the air pressure in the middle ear to the outside air pressure by opening and letting air reach the middle ear. When your ears "pop" while yawning or swallowing, your eustachian tubes are adjusting the air pressure in your middle ears.
But in kids, the relatively narrow eustachian tubes may not work as well, especially if they're clogged by inflammation and mucus from an ear infection or cold, or blocked by enlarged or swollen adenoids. Any pain or hearing problems are usually minor and temporary, though — they usually go away within minutes and don't cause any lasting damage. In some cases, a child can have pain for several hours if the ears don't "pop." Occasionally, extreme pressure changes can fill the middle ear with fluid or blood or cause the eardrum to burst.
Ear injuries can affect kids differently. Some may have partial hearing loss, with symptoms like:
In other cases, kids may have complete hearing loss or deafness (when they can't hear anything at all).
Depending on whether they hurt one or both ears, kids with ear injuries that affect balance may have symptoms like:
You can't protect children from getting hurt all the time — accidents and injuries are par for the course with raising kids. But you can keep prevent some ear injuries by encouraging kids to:
How long hearing or balance problems last and how they're treated will depend on what part of the ear was hurt, what caused the injury, and how severe it is. While minor injuries usually cause temporary problems, serious injuries may cause permanent hearing loss or balance problems.
Vestibular therapy may help kids with balance problems. And some with significant hearing loss may need a hearing aid, an FM system or auditory trainer (specialized devices that block out background noise), or a cochlear implant (a surgically implanted device that helps overcome problems in the inner ear, or cochlea). They also might need listening therapy with an audiologist (hearing specialist).
Make sure to call your doctor if your child has:
If there's a concern, your doctor can refer you to an ear, nose, and throat specialist and possibly an audiologist to figure out the next step to take.
Reviewed by: Robert C. O'Reilly, MD
Date reviewed: March 2012
|Vestibular Disorders Association The Vestibular Disorders Association (VEDA) provides general information to the public about vestibular (inner ear) disorders that cause problems with hearing, balance and vision.|
|American Speech-Language-Hearing Association This group provides services for professionals in audiology, speech-language pathology, and speech and hearing science, and advocates for people with communication disabilities.|
|American Academy of Pediatrics (AAP) The AAP is committed to the health and well-being of infants, adolescents, and young adults. The website offers news articles and tips on health for families.|
|National Institute on Deafness and Other Communication Disorders This division of the National Institutes of Health is devoted to preventing, detecting, diagnosing, and treating hearing problems and other communication disorders.|
|American Academy of Audiology The American Academy of Audiology, the world's largest professional organization of, by and for more than 10,000 audiologists, is dedicated to providing quality hearing care to the public.|
|Middle Ear Infections Ear infections are common among kids and, often, painful. Find out what causes them and how they're treated.|
|Middle Ear Infections and Ear Tube Surgery Many kids get middle ear infections (otitis media). Doctors may suggest ear tube surgery for those with multiple infections or a hearing loss or speech delay.|
|Auditory Neuropathy Spectrum Disorder (ANSD) Some kids have hearing loss due to auditory neuropathy spectrum disorder (ANSD), a problem in the transmission of sound from the inner ear that makes sound disorganized when it reaches the brain.|
|Dealing With Earwax Earwax helps protect the eardrum and fight infection. Parents shouldn't attempt to remove earwax at home, as doing so risks damage to the ear canal and, possibly, a child's hearing.|
|Is Earwax Removal Safe? Is it OK to use cotton swabs to remove earwax?|
|What's Hearing Loss? Hearing loss happens when there is a problem with one or more parts of the ear or ears. Someone who has hearing loss may be able to hear some sounds or nothing at all. To learn more, read this article for kids.|
|Hearing Evaluation in Children Hearing problems can be treated if they're caught early, so it's important to get your child's hearing screened early and evaluated regularly.|
|Perforated Eardrum Perforated eardrums can really hurt. And if you can't hear as well as usual, they can be scary. The good news is, most people who have them get all their hearing back eventually.|
|Flying and Your Child's Ears That weird ear-popping sensation is a normal part of air travel. Here's how to help equalize the air pressure in your child's ears and eliminate, or at least decrease, ear pain.|
|Earbuds Earbuds are basically a tiny pair of speakers that go inside the ears. They're fine at low volumes, but they can cause permanent hearing loss if not used properly. Find out what's safe (and not) in this article for teens.|
|Swimmer's Ear (External Otitis) External otitis (swimmer's ear) is an infection of the ear canal that can be caused by different types of bacteria or fungi. Find out how to prevent or treat it.|
|Taking Care of Your Ears How do you take care of your ears? Find out in this article for kids.|
|Quiz: Ears Take this quiz about your ears.|
|Cochlear Implants Sometimes called a "bionic ear," the cochlear implant can restore hearing for many kinds of hearing loss.|
|What Is an Ear Infection? A middle ear infection happens when germs like bacteria and viruses get in your middle ear and cause trouble. Read this article to find out more.|
|Ototoxicity (Ear Poisoning) Learn about this side effect of taking certain medications.|
|Can Loud Music Hurt My Ears? Loud music can cause temporary and permanent hearing loss. Learn how to protect your ears so you won't be saying, "Huh? What did you say?"|
|Senses Experiment: Do You Hear What I Hear? Test your hearing with this experiment.|
|Hearing Aids Want to hear what's being said to you, by you, and about you? Find out how hearing aids help people with certain types of hearing loss.|
|Ears Hearing is their main job, but it's not all your ears do. Find out all about them in this body basics article for teens.|
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