A personal amplifier contains a microphone that picks up sound and an amplifier to make the sound louder. It usually consists of a box slightly larger than a matchbox with the components enclosed. A general rule of thumb is the larger the box, the more powerful the device. The box is usually connected to ear-bud headphones through which the amplified sound is heard. They can be useful for people who have difficulty wearing or managing conventional hearing aids or who are unable to tolerate anything inside the ear canal. They are also a good option when the device is managed by another person as the controls are large and headphones are easy to place over the ears. Usually a personal amplifier will have a volume control that can be adjusted by the wearer – but unlike hearing aids they are not set up to match the individual’s specific hearing loss. Often personal amplifiers can be plugged directly into other devices such as the television. They can be a good solution if a simple, easy to manage device is required. They are usually fitted instead of hearing aids but can also be used with hearing aids via the telecoil.

Every case of hearing loss responds to cochlear implantation differently. However patients with an auto- immune hearing loss generally do very well with cochlear implants. This is because their hearing loss is post

lingual, the duration of the loss has been short and because the ganglion cell population in the cochlea is well preserved. The patients at my clinics with auto immune hearing loss (AIED, Sweet’s disease, Cogan’s syndrome, lupus and others) have all had good outcomes. 

The tympanic membrane is recognised by examining the ear with an instrument called an otoscope. It has a bright light, attached speculum and magnifying lens that allow the trained eye of your doctor or ENT surgeon to recognise the structures deeper in the ear canal. A normal ear drum gives off a reflection of light called the light reflex. If the drum or middle ear is abnormal, most commonly due to middle ear fluid or infection, the light reflex is lost and the ear drum appears dull. Of course there are other causes of loss of the light reflex (including flat batteries in the otoscope!) that need to be excluded before diagnosing the ear drum appearance as abnormal. Generally a few weeks after the middle ear condition has resolved, the drum resumes its normal shiny appearance and the light reflex returns. 

No. Ear candling is not an effective way of removing wax. The procedure involves having the patient lie on the opposite ear while a lit hollow candle is inserted into the external auditory canal of the affected ear. It is reported that the combination of heat and suction is supposed to remove earwax. Numerous studies have demonstrated that there is no change in the amount of wax present before and after ear candling and there has not been evidence of earwax actually being found in the candle after the procedure has been conducted. If anything, the process of ear candling can lead to any wax present being pushed further into the ear canal or wax from the candle being added to the ear canal. There is also the risk that the candle could be pushed too far into the ear causing damage to the delicate eardrum and even potentially lead to melted wax adhering to the eardrum requiring surgical intervention. It is far better to see your general practitioner, Ear, Nose and Throat specialist or an audiologist (with specialist training in wax removal techniques) for ear wax removal.The ear candling procedure has been reported by many to be relaxing and many of my clients have reported that they have seen wax and a powder inside the candle after the procedure has been done. However, this is just residue from the candle. I would advise against the use of ear candling and am disappointed that they are sold so freely when they obviously do not work and there are so many potential ill-effects.

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