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Ear, Nose, and Throat Disorders

Scar tissue in inner ears

03/25/2002

Question:

Scar tissue in ear due to ear infections - can it impair hearing? If left for a long period of time, can it build up and decrease hearing as an adult? Our son is 4 years old and we are concerned that the scar tissue has impaired his speech progress todate, and we are worried about long terms effects. We are having an assessment done on his hearing soon, to determine whether or not there is loss of hearing. He already has the "tubes" in his ears, with no fluid present for about nine months. We are told that he has extensive scarring in his ears now, from all of the ear infections over a period of about six months prior to the surgery. Should we have the scar tissue removed? Or should we wait? Can it build up and cause larger problems for our son in time?

Thank you in advance!

Answer:

Scar tissue in the middle ear space is a fairly common problem amongst people with chronic ear disease (chronic infections, for example). And while, scar tissue can cause hearing loss, it is not uniformly true. As an illustration, it is not uncommon for a child to have what appears to be extensive scar tissue yet have normal hearing sensitivity by hearing testing. The key to management in such a case is the audiologic test results. If hearing is normal by hearing tests, then there would be little reason to consider surgery to try and correct already normal hearing. Occasionally, the scarring can cause other problems that might require surgical treatment (e.g. scar tissue causing a predisposition to recurrent infections).

It is also difficult to predict whether or not scar tissue will progress over time and worsen a patient`s hearing. Only serial examinations and audiologic testing will help determine that course. Annual hearing testing, for example, might be worthwhile if a child is otherwise asymptomatic.

In any child with speech delay concerns, a speech-language evaluation by a speech-language therapist is probably worthwhile. Starting with your physician and/or audiologist is recommended. There is certainly a wide-spectrum of `normal` for speech development. Your physician and/or audiologist may help you get a grasp of where your child falls in that spectrum and whether conservative observation or early aggressive intervention is indicated. Children often progress at very different rates in terms of speech skill development.

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Response by:

Daniel   Choo, MD Daniel Choo, MD
Associate Professor and Director, Division of Otology/Neurotology
College of Medicine
University of Cincinnati