Ear
Conditions
Mr Ali Qureishi treats a wide range of common ear conditions.
More information about the conditions treated can be seen below.
Hearing Loss
What is hearing loss?
Hearing loss can develop gradually or suddenly and may affect one or both ears. Conductive hearing loss occurs when sound cannot travel effectively through the outer or middle ear, for example because of wax, fluid or an eardrum problem. Sensorineural hearing loss involves the inner ear or hearing nerve and may be associated with ageing or noise exposure. Both types can occur together.
What are the symptoms?
You may struggle to follow conversations, particularly in background noise, ask people to repeat themselves or turn up the television. Some people also notice tinnitus or a blocked sensation. In children, hearing difficulties may affect speech, learning or behaviour.
How is it assessed?
Assessment usually includes an examination of the ears and a hearing test called an audiogram. A pressure test, called tympanometry, may help assess the middle ear. An MRI scan is sometimes recommended when hearing is unequal or other findings need investigation.
What treatment is available?
Treatment depends on the cause. Options include professional wax removal, treatment of infection, hearing aids or selected ear operations. Some people with severe hearing loss benefit from assessment for a hearing implant. Communication strategies and protecting your ears from excessive noise are also helpful.
When should I seek urgent help?
Seek medical advice immediately if hearing drops suddenly, even if the ear simply feels blocked. Unexplained hearing loss developing over three days or less may need specialist assessment within 24 hours. Do not wait for a routine appointment or assume it is wax.
What is an external ear infection?
Otitis externa is inflammation of the skin lining the ear canal, often with bacterial or fungal infection. It is sometimes called swimmer’s ear. Water exposure, eczema, scratching and cotton buds can damage the skin and make infection more likely.
What are the symptoms?
Common symptoms include itching, earache, discharge and a blocked feeling. Hearing can become muffled when the canal swells or fills with debris. Touching or moving the outer ear may be painful.
How is it assessed?
A clinician examines the ear canal and eardrum. Persistent or recurrent infection may require a swab. Cleaning the canal under direct vision, often using microsuction, can help the examination and allow treatment to reach the affected skin.
What treatment is available?
Treatment usually involves prescribed drops or a spray, chosen according to the cause and whether the eardrum is intact. These may contain an antibiotic, antifungal medicine or steroid. A small medicated wick may be needed if swelling prevents drops entering. Oral antibiotics are reserved for selected cases, such as spreading infection. Keep the ear dry and avoid swimming, cotton buds and scratching while it heals.
When should I seek urgent help?
Seek same-day advice for severe or worsening pain, fever, spreading redness or swelling, particularly if you have diabetes or a weakened immune system. Severe night-time pain or pain that seems out of proportion needs urgent assessment. New facial weakness requires emergency assessment.
External Ear Infections
Middle Ear Infection
What is a middle ear infection?
Otitis media affects the space behind the eardrum. An acute infection often follows a cold and is particularly common in children, although adults can also be affected. Fluid can remain after the infection has settled; this is sometimes called glue ear and does not necessarily mean infection is still present.
What are the symptoms?
Symptoms include earache, fever, pressure and reduced hearing. Children may be unsettled, sleep poorly or eat less. If the eardrum develops a small hole, fluid may discharge from the ear and the pain may ease.
How is it assessed?
Diagnosis usually involves looking at the eardrum with an otoscope. Recurrent infections, persistent discharge or continuing hearing difficulty may need ENT assessment and hearing tests. Ongoing smelly discharge can occasionally indicate cholesteatoma, an abnormal collection of skin that usually requires surgery.
What treatment is available?
Many acute infections improve within a few days. Appropriate pain relief and fluids are important. Antibiotics are not needed for every infection; the decision depends on age, severity, examination findings and the risk of complications. Persistent middle ear problems may require further investigation, and selected patients benefit from grommets or other treatment.
When should I seek urgent help?
Seek urgent same-day assessment for redness or swelling behind the ear, an ear that starts to stick out, severe worsening pain or a very unwell child. Severe headache, neck stiffness, unusual drowsiness or facial weakness needs emergency assessment. Arrange review if symptoms worsen or fail to start improving after about three days.
What is tinnitus?
Tinnitus is the perception of sound without an external sound source. It may be heard as ringing, buzzing, hissing or humming in one ear, both ears or the head. It is common and is often associated with hearing loss. Most cases are not caused by a serious underlying condition.
How can it affect daily life?
Tinnitus may be most noticeable in quiet surroundings. For some people it affects sleep, concentration or emotional wellbeing. Stress can make it more intrusive, and tinnitus itself can also be stressful.
How is it assessed?
Assessment includes a discussion of your symptoms, an ear examination and a hearing test. Persistent tinnitus on one side or a sound that follows your heartbeat needs further assessment. Scans are recommended in selected situations; they are not necessary for everyone.
What treatment is available?
Any treatable cause, such as wax or infection, should be addressed. Hearing aids may help when hearing loss is present. Tinnitus education, gentle background sound and sleep support can make symptoms easier to manage. Cognitive behavioural therapy (CBT) can reduce tinnitus-related distress. There is no single treatment that reliably eliminates tinnitus for everyone, but effective support is available.
When should I seek urgent help?
Seek urgent medical advice if tinnitus beats in time with your pulse. New tinnitus with sudden hearing loss, severe vertigo or facial weakness, or following a head injury, needs immediate assessment. Tell your clinician if tinnitus is affecting your mental health so that support can be arranged.
Tinnitus
Dizziness and Balance
What is dizziness?
Dizziness can mean light-headedness, unsteadiness or a sensation of movement. Vertigo describes a feeling that you or your surroundings are spinning. Inner ear conditions are a common cause, but migraine, medicines, blood pressure problems and neurological conditions can also contribute.
What are the common causes?
Benign paroxysmal positional vertigo (BPPV) causes brief spinning episodes after movements such as rolling over in bed. Vestibular neuritis can cause a prolonged episode of vertigo. Ménière’s disease can cause recurrent vertigo with hearing changes, tinnitus and ear pressure. Migraine can cause dizziness even without a headache.
How is it assessed?
The timing, duration and triggers of your symptoms are important. Assessment may include ear and neurological examinations, eye movement and positional tests, and hearing tests. Further balance tests or imaging are arranged when indicated.
What treatment is available?
Treatment depends on the diagnosis. BPPV can often be treated with a repositioning manoeuvre, such as the Epley manoeuvre. Other conditions may benefit from balance rehabilitation, migraine treatment or short-term medicines for severe symptoms. Do not drive, climb ladders or operate machinery while dizzy.
When should I seek urgent help?
Call 999 for sudden dizziness with facial drooping, limb weakness, difficulty speaking, double vision, a severe new headache or inability to stand or walk. New severe continuous vertigo or vertigo with sudden hearing loss needs urgent same-day assessment. Do not drive yourself to hospital.
What causes ear pain?
Ear pain, also called otalgia, may come from the ear itself or be referred from a nearby structure. Ear infections, pressure changes, an injured eardrum or impacted wax can cause discomfort. Dental problems, jaw joint problems, throat conditions and neck problems can also produce pain that feels as though it is inside the ear.
What symptoms help identify the cause?
Discharge, reduced hearing or fever may suggest an ear problem. Pain with chewing, jaw clicking or toothache may point towards a dental or jaw-related cause. Pain when swallowing can arise from the throat. These patterns are helpful clues, but an examination is needed to establish the cause.
How is it assessed?
Assessment starts with an examination of the ear canal and eardrum. If the ear looks normal, the teeth, jaw, mouth, throat and neck may also need examination. Sometimes a small flexible camera is used to inspect the throat, particularly when unexplained pain persists on one side.
What treatment is available?
Treatment targets the underlying cause. Options may include treatment for infection, safe wax removal, dental care or measures to reduce jaw joint strain. Paracetamol or ibuprofen may help if suitable for you; follow the packet instructions. Do not insert objects or use unprescribed drops if there may be a hole in the eardrum.
When should I seek further help?
Seek prompt assessment for persistent one-sided pain, especially with a neck lump, hoarseness, difficulty swallowing or unexplained weight loss. Seek same-day advice for severe pain, swelling, discharge, fever or new hearing loss. Sudden hearing loss or new neurological symptoms needs immediate assessment.
