The ear is one of our most important sensory organs. Most people don’t realize how important it is until they start hearing worse. Due to our noisy environment, hearing loss is increasing, even younger people are affected, sometimes even teenagers. One cause may be a window rupture in the inner ear.
What is a window rupture?
In the middle and inner ear, there are two very thin membranes that cover the round and oval window. These two membranes separate the air-filled middle ear area from the fluid-filled labyrinth, consisting of the cochlea and vestibular apparatus. When a membrane ruptures in one of these two windows, it is called a window rupture. When this happens, fluid leaks into the middle ear area, causing various symptoms such as hearing loss, deafness and dizziness.
Causes
A window rupture can have several causes. When flying or diving, a sudden change in pressure can cause a window rupture. Injuries to the skull, e.g., from an accident, can also cause injury to the inner ear and result in a window rupture. Very often a window rupture occurs with an explosion or an extremely loud bang. In addition, recreational noise a danger not to be underestimated. A window rupture is a serious injury that must be treated immediately if you want to avoid worse damage.
Symptoms, complaints and signs
A window rupture always has a very negative effect on the affected person’s sense of hearing. In this case, the patients suffer primarily from hearing loss and thus from a very pronounced hearing loss. The hearing loss can be very different and usually also depends on the exact cause of the window rupture. In some cases, however, those affected are dependent on hearing aids in order to still be able to participate in conversations. This disease also causes a very strong feeling of pressure in the ears, which can have a negative effect on the daily life of the affected person. It also often results in ear pain, which can continue to spread to the teeth or head. Likewise, window rupture is not infrequently associated with dizziness, and in severe cases, sufferers may also lose consciousness and fall. This can also result in various injuries. Likewise, some affected persons suffer from noises in the ear or even a tinnitus. This can also occur at night and thus lead to sleep problems and irritability of the affected person. Especially in young people, sudden hearing complaints can lead to psychological upsets or even depression.
Diagnosis and course
If a window rupture is suspected, e.g., after a bang, accident, as a result of excessive pressure, etc., an ear, nose and throat specialist should be consulted immediately to see if a window rupture or another cause is present. There are several examination options to diagnose a window rupture:
Examination with an ear mirror
The doctor uses an ear mirror to examine the external ear canal and the eardrum. If there is an injury to the eardrum, he can detect it through the ear mirror. However, a window rupture is not so easy to detect in this process. But the doctor can tell if an ear infection is affecting hearing. Hearing test (sound audiometry)
By performing a hearing test, the doctor can tell if there is a sound conduction or sound perception disorder. This allows him to determine if the middle ear is damaged. endoscopic examination of the middle ear (tympanoscopy).
Complications
A window rupture leads to severe limitations and complications in the ear. The patient suffers from loss of hearing and, in the worst cases, may suffer complete hearing loss. In addition to the limitations in hearing, there is also dizziness and vomiting. Most patients also suffer from ringing in the ears or tinnitus during a window rupture. Due to the constantly present noise in the ear, there is a severe restriction in life. Those affected suffer from sleep disorders or concentration problems. Due to the hearing loss, an ordinary everyday life is also no longer possible, often the patients are dependent on hearing aids. The window rupture can be treated relatively well by surgery. However, the treatment must be carried out at an early stage.If this is not the case, there will be balance problems and, in the worst case, complete loss of hearing. If treated quickly, the symptom can be completely eliminated and no further complications will occur. Hearing loss in many cases can lead to psychological problems and depression. Often the loss is also associated with social withdrawal.
When should you go to the doctor?
If a window rupture occurs, a doctor must be seen immediately. If the condition is not treated, the patient may also experience permanent hearing loss in the worst case. This usually cannot be reversed, so that the affected person will be deaf for the rest of his or her life. A doctor should be consulted if the patient suffers from severe pressure in the ear for no particular reason. Hearing loss or hearing loss may also be indicative of the window rupture and must be investigated. In many cases, the discomfort is also accompanied by dizziness or ringing in the ears. These have a very negative effect on the patient’s quality of life. If the complaints appear suddenly or persist for several days, an examination by a physician must be performed in any case. The window rupture can usually be examined and diagnosed by an otolaryngologist. The diagnosis itself is made quickly and without complications. Treatment of the window rupture is then also carried out directly by the ENT physician and can significantly alleviate the symptoms. The condition does not negatively affect the life expectancy of the affected person.
Treatment and therapy
If a window rupture is suspected, a tympanoscopy is performed. During this procedure, the eardrum is flipped forward so that the middle ear and eardrum can be easily examined. If a window rupture is present, it can be surgically closed at the same time. Tympanoscopy offers the advantage of being able to combine diagnosis with treatment of the window rupture. If a window rupture is not treated quickly, it can have serious consequences for those affected. There can be severe hearing loss from the window rupture and balance problems that limit life. If the window rupture is detected and treated quickly, the chances of recovery are quite good. Tympanoscopy can treat the window rupture at the same time. Often the window rupture then heals completely, but it depends on the extent of the injury and how quickly the window rupture is treated.
Outlook and prognosis
The prognosis of window rupture is tied to the extent of damage present as well as the timing of medical attention. The greater the damage between the middle and inner ear, the less favorable is an optimal course of healing. The two areas are spanned in the ear by the round and oval windows. As soon as the treating physician manages to sufficiently repair the damaged windows in a surgical procedure, the patient has a favorable prognosis. Sealing of the damage that has occurred is done with connective tissue. If the operation is successful, there is a prospect of subsequent complete regeneration of hearing. The smaller the damage, the more likely it is that hearing function will be restored and the patient will be free of symptoms. Therefore, if the window is slightly cracked, the prognosis is better than if there are holes in the gossamer layers. If the windows are severely affected or if the connective tissue in the ear is not accepted by the organism in the necessary form, there may be a permanent reduction in hearing activity. In addition to hearing loss, in severe cases the patient is threatened with deafness. The prognosis worsens if there has been previous impairment of hearing function, if the patient is exposed to a highly noisy environment, or if the window rupture has been present for several days.
Prevention
To effectively prevent a window rupture, care should be taken to ensure adequate pressure equalization during certain activities such as flying and diving. Before starting intense dives, it would be advisable to slowly start pressure equalization training to get the ears used to diving. Pressure equalization is also important when flying. Chewing gum or swallowing often helps here.Of course, you are powerless against a sudden explosion or a loud bang, you cannot protect yourself against that, not even against unforeseen accidents. Excessive noise can at least be limited in one’s leisure time by not exceeding decibel levels. The effects of leisure noise, e.g. in discotheques, at concerts, by listening to MP3 players, etc., are underestimated. Occupational health and safety regulations must be observed at work, and ear protection should be worn if necessary to prevent window rupture.
Aftercare
In the case of a window rupture, the options for aftercare are very limited. In this regard, in many cases, the condition can also no longer be treated, leaving the affected person dependent on hearing aids in his or her life to alleviate discomfort and improve quality of life. In general, after a window rupture, the ears should no longer be subjected to heavy strain, and loud noises should be avoided. The focus is also on rapid diagnosis and treatment of the window rupture to prevent further complications. In most cases, an outpatient procedure is performed, which alleviates the discomfort. After this procedure, the ears should be particularly protected, although the affected person should also generally rest and recover after the procedure. In the case of balance disorders, measures should also be taken to treat them, as they usually do not heal themselves. To prevent the window rupture, loud and abrupt noises should be avoided. If the window rupture cannot be treated and the affected person is dependent on a hearing aid, care should be taken to always use the aid. This is the only way to prevent further damage to the ears.
What you can do yourself
With the suspicion of a window rupture, a doctor should be consulted in any case. Hearing loss must be medically evaluated and treated, as it will not heal on its own. Medical therapy can be supported by protecting the affected ear from further harmful influences. Affected persons should always wear earmuffs or a cap in the fresh air and wear a bathing cap when showering. In addition, the affected ear should not be exposed to excessive heat. The doctor can answer in detail what measures should be taken here with regard to the condition of the eardrum. If balance problems occur, it is best to use crutches or another walking aid before a fall occurs. Older patients in particular should pay close attention to the body’s warning signals and not take unnecessary risks. Driving should be avoided at all costs with an untreated hearing loss. In general, a window rupture is best treated by sparing the ear and performing a tympanoscopy early on to seal the ruptured or burst window. The sooner treatment is given, the better the chances of healing and restoring hearing.
