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In order to understand chronic ear infection and how holes in eardrum are caused, one must have some knowledge of the hearing mechanism.
The auricle and the external ear canal make up the outer ear. Here, the sound waves are collected and amplified, to be transmitted to the eardrum.
The section behind the eardrum and before the inner ear is the middle ear, home to the three hearing bones (the hammer, anvil and stirrup). Vibrations from the sound waves collected by the outer ear are collected, and transmitted to the fluid-filled space of the inner ear by the three bones. Lining the middle ear chamber is a membrane similar to your nasal lining. The membrane contains blood vessels and mucous glands, and is punctuated by the Eustachian tube, which connects the middle ear to the back of the nose.
The Eustachian tube is needed to equalise pressure in the middle ear when differentials occur. Opening your Eustachian tube during a plane flight or other altitude change results in a ‘popping’ sensation and reduction of pressure inside your ear.
The chamber behind a dense layer of bone is the inner ear. It is lined with a delicate membrane and filled with fluid, which transfers the vibration of the stirrup bone into fluid waves, which are transformed into electrical impulses by hair cells in the cochlea.