Ear Health

Ear Health

Common Ear Infections and Treatments

Ear infections are common in both children and adults. In childhood, they arise often and usually clear up quickly. In adults, they may be more severe and could be a sign of an underlying health issue.

There are three main types of ear infections, which correspond to the three main parts of the ear:

* Inner Ear
* Middle Ear
* Outer Ear

Let’s look at each of these in turn.

Inner Ear Infection

The inner ear is the deepest part of the ear.

Signs of infection include:

* Dizziness
* Nausea
* Vomiting

It is important to pay attention to these symptoms because inner ear issues could be a sign of a more serious medical condition, such as meningitis.

Middle Ear Infection

The middle ear is the area right behind your eardrum. Middle ear infections, known as otitis media, is caused by fluid trapped behind the eardrum. This causes the eardrum to bulge, resulting in pain, a feeling of fullness, and possibly fluid leaking from the ear. The person may also have a fever and experience hearing loss.

Outer Ear Infection

The outer ear extends from your eardrum to the outside of your ear canal, and the surrounding ear. It is known as otitis externa. An outer ear infection often starts as an itchy rash and other symptoms can soon appear, including:

* Pain
* Tenderness
* Redness
* Swelling

The Causes of Ear Infections

Ear infections are often caused by bacteria, but there are other ways to get infected. For example, a middle ear infection often stems from a cold or breathing issues which prevent the ears from draining properly.

An outer ear infection is often referred to as swimmer’s ear because it starts due to water that remains in your ear after swimming, bathing or showering. The dampness becomes a breeding ground for bacteria. If you then scratch your ear to the point where you damage the lining, the bacteria can flourish.


The type of ear infection you have will determine the type of treatment you need. In most cases, a course of antibiotics should clear up the infection. You will need to see a doctor to have your ears examined, and get prescriptions and other treatment suggestions as needed.

Middle ear infections can be treated with oral antibiotics, or eardrops containing antibiotics. It is important to use them exactly as directed. You might also need pain relief, such as acetaminophen. If you are still struggling with a cold or the flu, cold medicine or a shot of Tamiflu can help relieve symptoms.

If you have a cold or seasonal allergies, a decongestant and/or antihistamine can help relieve the fluid build-up and pressure. In some cases, the doctor might recommend nasal steroids.

You can also try a technique called autoinsufflation, which can help clear your middle ear and the Eustachian tubes in them. Squeeze your nostrils shut gently. Close your mouth, then try to exhale slowly. This will send air through your Eustachian tubes, which will help drain them.

Treating Outer Ear Infections

Outer ears should be cleaned, but not to excess. Earwax is actually useful for protecting the ear. Use a cotton bud gently. Don’t dig in or go into the ear canal. Creams can be applied to treat inflammation and kill bacteria. If the infection is caused by a virus, avoid irritating the outer ear and it should resolve itself.

Six Ways to Remove Earwax Safely

There are a number of ways to remove ear wax safely if you or a child are troubled by too much of it. However, it is important to note that ear wax can provide valuable protection for your ear canal, to prevent things from entering it and causing infection and/or hearing loss.

Where Does Earwax Come From?

The wax in your ears is secreted by the glands in the skin that lines the outer half of your ear canals. The wax and tiny hairs in these passages (known as cilia) trap dust and other foreign particles that could damage the sensitive structures deeper in the ear, such as your eardrum.

Earwax is more valuable than most people think because the human ear canal is also rather short and has a slightly sloping configuration, leaving the eardrum quite vulnerable. Compare this with a cat ear canal, deep and shaped like a J, or a dog ear canal, even deeper and shaped like an L.

Earwax also helps waterproof the ear to a certain extent so that when you shower, bathe or swim, you don’t get a lot of water in your ear (which can lead to swimmer’s ear).

Earwax Blockage

One of the main reasons people want to remove earwax safely is because they have a blockage. They either produce a lot, and/or it gets hardened to the point where it can’t be washed away naturally or removed with the light application of a cotton bud. Ironically, people often plug their own ears while trying to clean the earwax, pushing it further in rather than getting it out.


Signs and symptoms of earwax blockage can include:

* Decreased hearing in the affected ear
* Earache
* The ear feeling full
* Ringing, or noises in the ear (tinnitus)
* Dizziness
* Cough from post-nasal drip

Seeing a Doctor

If you’re experiencing the signs and symptoms of earwax blockage, it is best to talk to your doctor, because you can’t examine your own ears safely, and there may be a range of causes of the above symptoms besides earwax blockage. For example, an earache may be a sign of infection.

If your ears are excessively waxy, wax removal is safest done by a doctor too. This is because your eardrum can be perforated if you poke around too much. Don’t try to remove earwax yourself by putting anything inside your ear canal. Earwax cleaning with a cotton bud should only be done in the concha or bowl-shaped part of the ear surrounding the ear canal opening.

Children will usually have their ears checked as part of any regular check-up, so the doctor can remove excess earwax as needed.

Ways to Remove Earwax

1. Curet

The doctor will use a small, curved instrument called a curet.

2. Suction

This will “vacuum” out the earwax.

3. Flushing

The doctor might use a rubber-bulb syringe filled with warm water, or a waterpik, normally used for cleaning teeth.

4. Earwax removal kits

If the problem is persistent, you can use a kit at home, such as the Debrox Earwax Removal Kit or the Murine Ear Wax Removal System. However, these drops can irritate the delicate skin of the eardrum and ear canal so should only be used as directed.

5. Candling

Candling is an alternative medical treatment used in India as part of Ayurvedic medicine. They place a lighted, hollow, cone-shaped candle into the ear to try to melt the wax and make it stick to the candle. However, there is no research to support it actually working, and a live flame can result in burns, ear canal obstructions and even eardrum perforations.

6. Softening

Use an eyedropper to apply a few drops of baby oil, mineral oil, glycerin or hydrogen peroxide to soften the wax and make it easier to remove with a cotton bud.

Water will usually help as well. After a shower, gently clean your ear, without poking into the canal.


Tinnitus is a ringing in the ears or other noise that persists, and can interfere with a person’s regular hearing. It is usually temporary, but can become permanent in some cases.

About 50 million Americans have tinnitus and report hissing, clicking, or whistling sounds. Most people who have it are over 50, but it can happen at any age.


No one is exactly sure of the cause, but common factors include excessive or cumulative noise exposure, head and neck injuries, ear infections, stress, and occasionally some sort of underlying medical condition.

Certain medicines can harm hearing. Those who take aspirin in large doses should beware.


Unfortunately, there is no cure for tinnitus, but there are ways of managing it. In four out of five cases, it is a mild annoyance the person gets used to. With one in five cases, however, the sufferer will find it disturbing or debilitating to the point where they feel their quality of life has been compromised.

The Effects of Tinnitus

The effect will vary with the degree of the “noise” in the person’s head. It can make it hard to hear because of the noise and the distraction. It can also lead to insomnia, difficulty with concentration, poor school performance, trouble at work, irritability, anxiety, and depression. The person may feel socially isolated because they have trouble following a conversation and hearing well.

Tinnitus usually sounds like a steady, high-pitched ringing and is subjective – that is, only the person who has it can hear it. Strangely enough, though, in about 1% of cases others can actually hear the noise. In such cases, experts speculate it may come from cardiovascular or musculoskeletal movements within the person’s body, and could potentially be the sign of a medical emergency.


The first step is to see a doctor, who can help you pinpoint any underlying cause of tinnitus so you can choose the right treatment. This may include:

* Treating an ear infection
* Stopping any medications harmful to your ear health
* Treating any temporomandibular joint (TMJ) problems, which affect the joint between the jaw bone and the cheek bone and might affect hearing

There is no cure for most cases of tinnitus, and most people get used to it over time. Trying to ignore it makes it easier to tune it out most of the time.

Some people also try alternative and home remedies. You will often see (expensive) herbal supplements that claim they can help. Most won’t, but up to 33% of people get relief from what is known as the placebo effect – that is, being convinced that a pill is helping them even though it contains no remedy.

Sound therapy uses external sound to try to cover over the sound in the sufferer’s head. Background music or a white noise machine can help. The covering noise should be pleasant, not annoying and not too loud.

Hearing aids can also be used as sound therapy by increasing the environmental sounds around the person and stopping them from paying attention to their tinnitus.

Tinnitus retraining therapy (TRT) involves accepting the sound as normal rather than annoying. A trained professional will help with the TRT and provide a device that produces white noise. Ongoing counseling sessions can also help people regain a good standard of standard of living. It is said to be successful in 80% of cases.

Cognitive behavioral therapy (CBT) can help relieve depression in people with tinnitus, though it does nothing to reduce the noise.

Dealing with sleep issues such as insomnia and mood issues such as depression can improve quality of life.

Reducing stress and avoiding any further damage to your hearing can help. Avoiding contact sports and wearing a helmet will protect against head injury.

Ten Ways to Protect Your Hearing

Loss of hearing and vision is the number one cause of disability in the world. Some people are born deaf, or with hearing difficulties, and others become hard of hearing or deaf as they get older.

Hearing loss is an expected part of the aging process. However, doctors are becoming increasingly alarmed at the number of younger people coming to them with hearing loss.

Prevention and early diagnosis are two of the best ways to care for your hearing health. Here are ten easy things you can do to help prevent hearing loss.

1. Keep the Volume Down

Young people all seem to be walking around with earbuds or headphones attached to their music players or smartphones, phablets and tablets to watch movies or play games. They also tend to use earbuds or clip-ons to talk on the phone. Trying to keep the volume down will lower the risk of hearing becoming damaged over time.

According to the World Health Organization, 1.1 billion teenagers and young adults worldwide are at risk due to their use of audio devices, with earbuds considered the most unsafe because they are so close to the eardrum. If you like music, use headphones and follow the 60/60 rule, meaning you have the headphones at no more than 60% volume for no more than 60 minutes a day.

2. Use Earplugs around Loud Noises

This is a must if you work in a noisy environment, use noisy equipment, or go to noisy places such as concerts and loud bars. Noisy environments would include construction sites and entertainment venues. Noisy equipment would include musical instruments, lawnmowers, chainsaws or jackhammers. If you have to raise your voice to talk to someone else nearby, it can be considered a noisy environment with dangerous levels of sound.

There are disposable and reusable earplugs, often made out of wax or other flexible, moldable substances. You can also go to an ear, nose and throat (ENT) specialist (an otolaryngologist) or hearing center to have a pair custom-fitted for your ears.

For example, many musicians have custom earplugs because of the nature of their job. Their earplugs will filter out harmful sounds while still allowing them to hear conversations and the music.

3. Give Your Ears a Break

Don’t listen to music every waking moment of the day. Try to relax without media switched on.

4. Don’t Use Cotton Buds Too Often

They can damage the ear if you poke them in too far, or pack in the earwax you are trying to remove and muffle your hearing or harm your eardrum.

5. Take Medications Only as Directed

Some medications can actually affect your hearing. Be sure to read all the instructions and literature that comes with any new medicine you take.

6. Keep Your Ears Dry

This will help avoid muffled sounds, fungus, and swimmer’s ear, where water can go deeper into the ear and cause infection or damage. Use a corner of your towel to dry your ear, but don’t poke it in the ear canal.

7. Stress Less

Stress has been linked to ringing in the ears (known as tinnitus), which can become permanent.

8. Work Out More

Exercise is good for your hearing provided you are not doing it with the music blasting. Aerobics pumps health-giving oxygen to all parts of the body.

9. Avoid Hits to the Head

A shock to the head, such as concussion, can harm hearing. American football can be a risk factor and if you cycle, wear a helmet.

10. Get Regular Check-ups

The doctor will usually examine your ears as part of an annual physical. If you have any ear symptoms, go to a doctor – the sooner a potential problem is discovered, the better.

Signs That You Are Hard of Hearing

Being hard of hearing is usually common in older people, but a growing number of younger adults are also becoming affected – often because they don’t protect their hearing against loud noises such as music, machinery, or environments like concerts and bars.

The damage will often happen gradually, over time. There are a number of signs that you might be hard of hearing that you should watch out for, though. Here are ten of the main ones.

1. You Have Trouble Hearing on the Phone

Mobile and landline phones have a volume control setting, so you might not even realize you are having trouble because you’ve cranked up the volume. Check your volume and lower it to about 50% of its limit. If you have trouble hearing the people you are talking to on the phone, then you might have experienced hearing loss.

2. You Have Difficulty Following Conversations with Three or More People

Being “lost” during a conversation isn’t always a sign of hearing loss because it can be difficult for our ears or brain to process a lot of auditory signals all at the same time. However, if you are in a meeting or sitting around the table with family, and can’t keep up and make sense of all that is being said, you might have a hearing problem.

3. People You Share Your Home With, or the Neighbors, Complain the Volume Is Too Loud

This might be in relation to the TV, radio, or music. If you get more than a couple of complaints, it’s time to visit an audiologist to get your hearing tested.

4. You Find Yourself Straining to Hear Things

This might be sounds other people tell you they can hear, or conversation with friends, family or colleagues. If you need to ask people to repeat themselves, or feel tired or headachy after dealing with other people, it could be a sign of hearing loss.

5. You Have Trouble Hearing in Noisy Environments

These can include public transportation, restaurants, and other locations with background noise, which can make it hard to focus on the people speaking with you.

6. You Ask People to Repeat Themselves Often

Some people do mumble, and cell phone reception isn’t perfect, but if you find yourself saying, “What?” a lot and asking them to repeat themselves, you may have hearing loss.

7. You Don’t Think People Speak as Clearly

If you find yourself wishing people would speak more clearly, you might be struggling with being able to hear high frequencies and therefore having difficulty understanding friends, family and colleagues.

8. You Misunderstand What People Say

Like the game Whispers, you feel like the person who is last to get the message. Maybe you’ll hear, “Eat a dog,” not, “See the fog.” These kinds of misunderstandings can be very embarrassing, and often result from high frequency hearing loss.

9. You Have Trouble Hearing Women and Children Speaking

Losing hearing in the high frequencies is usually the first sign of hearing loss as we age, so because women and children speak at higher pitches or frequencies, it will usually be harder to hear them than a male companion with a deep voice.

10. You Start to Get Frustrated Due to Your Problems Hearing

You become annoyed and frustrated during conversations, or are tired of straining to hear the TV. You feel like you are getting left behind at work because you are missing important points at meetings. You go to a restaurant and can’t enjoy the meal because you feel you’re missing out. All of these are common feelings that signal you’ve noticed a difference in your hearing and should get it checked.

One of the signs mentioned above may not be a big deal, but two or more means it’s time to deal with your hearing loss.

Hearing Aids – What Options Are There?

Hearing aids are the most common treatment for hearing loss. But they can be confusing because there are so many styles, features and technologies available in the newest generation of hearing aids.

There are several options that might suit you if you are one of the more than 38 million Americans who have hearing loss to the point where their quality of life is affected. What you choose will ultimately be determined by lifestyle, personal preference, budget, and degree of hearing loss.

Types and Styles of Hearing Aids

All digital hearing aids contain at least one microphone to detect sound and a computer chip that amplifies and processes the sound. They have a speaker that sends the signal to your ear, and a small button battery to power the hearing aid.

The external appearance of a hearing aid can vary considerably. Your choice of style will depend on personal preference and on the recommendation of the audiologist assessing you for your hearing aids.

Hearing aids can be classified as either in-the-ear (ITE) styles or behind-the-ear (BTE) styles. Within each group, there are several different sizes, so some hearing aids will be more visible than others. Let’s look at each style in turn.

ITE Types

Invisible-in-the-canal (IIC) and completely-in-the-canal (CIC) hearing aids

These are the smallest hearing aids available, designed to be as invisible as possible. They fit very deeply into the ear canal and are useful for people with mild or moderate hearing losses.

Every ear canal is different, but in general, they will not be obvious to other people, making them the ideal solution to those who are self-conscious about their appearance.

In-the-canal (ITC) hearing aids

This style sits in the lower portion of the concha, the “bowl” of the ear, and tucks into the ear canal. They are comfortable and easy to use, but they will be more visible than the types discussed above. They do have some pros, however. They have been reported more comfortable and easier to use. They have a longer battery life and it is easier to change the battery. They can also be used for any degree of hearing loss, from mild to severe.

Low profile hearing aids

These are designed to tuck into the concha. They can cover the lower half, or all of it. They are easier to handle than smaller models, making them ideal for older people with arthritis, for example. Because they are so large, they can contain more than one microphone, so users can hear in a range of directions, and they may even have volume controls and programming buttons so you can set your hearing aid to cope with background noise, the TV, and other hearing challenges.

BTE Types

BTE types have become more popular as they have shrunk in size to thin tubes that go behind the ear and small tips that go in the ear canal. They are larger than any ITE model and therefore even easier to handle, have a longer battery life, and offer custom features to help with the various hearing challenges mentioned above. They work well with any degree of hearing loss. They also tend to be cheaper than ITE models.

Mini BTEs

These are the smallest, with the tubes fitting tightly behind the ear. Various ear tips can cope with the degree and type of hearing loss.

Receiver-in-the-ear (RITE) or receiver-in-canal (RIC) hearing aids

These models have the speaker built into the ear tip, not the main part of the hearing aid, getting the speaker closer to the eardrum for better reception.

BTE hearing aids with earmolds

These are larger and more obvious, but also offer room for more features.

What’s the best hearing aid for you? The answer is the one you will wear and be able to change the batteries for.

Six Facts about Glue Ear

Many people have heard of glue ear but are not sure what it is. Here are some key facts about glue ear so you will know the signs and symptoms in yourself or your child.

1. How Does Glue Ear Develop?

The middle ear from the ear drum to the ossicles (tiny bones in the middle ear) is usually filled with air. The middle ear is connected to the back of the nose by a thin channel called the Eustachian tube. Most of the time, this tube is closed. However, when we swallow, chew or yawn, the tube opens to let air into the middle ear and drain any fluid out. If you’ve ever yawned to clear your ears, you might notice a definite improvement in your hearing.

With glue ear, the Eustachian tube stops working properly, so the balance of fluid and air in the middle ear will change. The tube can be narrow, get blocked, or not open properly. This could be due to medications, and colds, flu, allergies, or anything that causes nasal congestion.

If air in the middle ear is not replaced by air coming up the Eustachian tube, the air can pass into the nearby cells and cause a vacuum. A vacuum can allow fluid to seep into the middle ear from the nearby cells and turn into a glue-like fluid.

2. Glue Ear Can Affect Your Hearing

Glue ear is a problem because the thick liquid can muffle sound so you or your child will not be able to hear as well. This is because both the eardrum and the ossicles vibrate when they are hit by sound waves. The vibrations are received by the cochlea. If you have glue ear, the vibrations will be dulled and the “volume” will be turned down.

3. Glue Ear Can Happen at Any Age

Children commonly develop ear infections which lead to glue ear, but glue ear can also happen to adults. It can happen in one or both ears.

Glue ear is quite common, with 8 out of 10 children having at least one episode by the age of 10. It most often manifests between the ages of 2 and 5. Boys are more commonly affected than girls, and most cases are treated in winter.

4. Glue Ear Is Not Always Caused by an Ear Infection

Glue ear can become an ear infection, but in some cases, it starts out as the result of a cold or other upper respiratory issue, or through excessive production of mucus.

5. Some People Are More Prone to Glue Ear Than Others

Children most at risk of glue ear include:

* Children fed on infant formula, rather than breast fed
* Children in daycare
* Those with an older sibling
* Anyone exposed to second-hand cigarette smoke
* Those with hay fever
* Those with Down’s syndrome
* Those with a cleft palate

6. Signs of Glue Ear

A loss of hearing that varies from day to day, and sometimes earache, are all signs that someone could have glue ear. Muffled sounds and a feeling of fullness in the ear can be signs you’ve developed glue ear. If you’ve had a cold or the flu, or feel stuffed up a lot due to allergies like hayfever, it’s also possible you’ve developed glue ear.

What Can Be Done about Ears That Stick Out?

Most people take their ears for granted as part of their overall appearance. However, some people have ears that stick out, making them feel self-conscious about their appearance. Ears that stick out, or protruding ears, are commonly referred to as “Dumbo [the elephant] ears” and children can often be teased or even bullied about their appearance.

Some people become so concerned about what their ears look like that they decide to get them fixed, or to take their child to a specialist to see what can be done.

There are different treatments for ears that stick out. The choice will depend on the age of the person, their personal preference, and how severe the problem is. It can also be a question of cost. Otoplasty, or ear pinning surgery as it is commonly referred as, is considered to be plastic surgery – an elective surgery, not an essential one. Therefore, it is not usually covered by insurance.

What Are Protruding Ears?

Ears that stick out more than two centimeters from the side of the head are considered to be prominent or protruding. In most people, they are caused by what is called their antihelical fold not being formed correctly. This makes the outer rim of the ear, known as the helix, stick out.

Most people with ears that stick out also have a deep concha – that is, the shell-like part of the ear around the ear canal, and this can push the whole ear out from the side of the head.

Treatment Options

There are both non-surgical and surgical options for treating protruding ears. It will depend in part on the age of the patient.

Non-Surgical Ear Molding

Protruding ears can often be corrected in children under the age of six, because the ear is soft then, and still growing. The ears would be “splinted” or molded into shape to lay closer to the side of the head. The time required in splints will vary by child and age. It will be easier in a newborn infant, for example, than a toddler.

Otoplasty Surgery

If your child’s ears are already sticking out and are too stiff for molding, then ear pinning or setback otoplasty will be an option. Doctors usually wait until a child is six because by that point their ears are almost fully grown, and they will most likely be starting to get teased about their appearance.

The surgery involves a cut behind the ears, removal of cartilage, and stitching, in order to create an antihelical fold. There will also be stitches on the back of the conchal cartilage to pin the ear closer to the side of the head.

The postoperative dressings will help pin in the ears into their new position, so it is essential to do as the doctor says for best results. The surgery will be done under general anesthesia on an outpatient basis, and in most cases, the patient will be allowed to go home the same day.

After Surgery

After surgery, you will have to keep an eye out for infections, and the doctor will look at how well the surgical site is healing. Sometimes a patient may need follow-up surgery if the ears pop back into their old position.

For adults, surgery is the best option because the ear is fully grown, but the surgery may be more extensive and not get as good results because the ears have been in that position for so many years.