Ear Concerns

The ear is made up of the outer ear (outer down to the eardrum), middle ear (eardrum and ear bones), and inner ear (nerve endings for hearing and balance). Problems in any one of these areas can be very painful and disruptive to life. The following is a short guide to common ear concerns that we see in the student population and what’s important to know about them.

Ear Infection

Otitis Media is a term that refers to a middle ear infection/inflammation. This is a very common infection in youth. Otitis Media is caused when bacteria from the mouth/throat area when someone has a cold or congestion travels up the Eustachian tube and infects middle ear fluid. As we grow older, our Eustachian tube is longer and our immune systems are more developed, making Otitis Media less likely.

Otitis Externa refers to an infection in the outer ear. This is most often caused by “swimmer’s ear” which is caused most often by bacteria or fungi growing in the outer ear canal. After swimming or showering, it’s important to shake excess water out of the ears. If not, a good environment is created for an infection. In addition, it’s important to realize that our ear wax is natural protection against infection, and any disruption of this with objects such as fingers or Q-tips can disrupt this protection and make the ear more susceptible to infection.

Ear Trauma

Physical trauma: Our ears are vulnerable to injury, either physical or acoustical. Physical injury could be from a traumatic event such as a head trauma or explosion. If, after a head trauma, one feels a sudden, sharp pain in the ear, it’s important to report it to a doctor immediately. It could be indicative of perforated eardrum, which may require surgery depending on the severity. Another common cause for ruptured eardrum is putting objects into the ear. People often put their finger or a Q-tip in their ear to clean it or relieve an itch, but the damage that can be done, as well as the removal of the protective wax, is potentially dangerous to hearing. Never put anything in your ears.

Acoustic trauma: Acoustical trauma, injury from sound, can lead to deafness. Sudden sounds, such as an explosion, can lead to instant deafness. Other acoustic damage can lead to hearing loss on a gradual basis. This is due to damage to the tiny, sensitive hair cells in the inner ear. Standing next to a loud speaker, turning up the volume on ear buds or earphones, operating loud machinery… all these exposures have the potential to damage your hearing. Interestingly, loud exposures during exercise make our tiny inner ear hairs more susceptible due to blood flow changes. Thus, dancing at a concert, listening to music while jogging, etc. can be especially damaging.

As a rough comparison, normal conversation is typically 60 decibels. A rock concert (120 db), truck (100 db), vacuum cleaner (90db), and noisy restaurant (75 db) are exposures that should be infrequent as repeated exposures can lead to damage. If in a quiet room and you can’t hear normal conversation, whispers (40 db), or the rustle of leaves (10 db), you could be experiencing some loss. Immediately after exposure it’s possible to experience a slight, high pitched ringing and a little hearing loss, but it may just be temporary. Repeated exposure, though, will permanently damage hearing.

A note on earbuds: this method of listening is not advised when there is background noise. They do not have the ability to block out surrounding noises, so the user has to turn up the volume to hear the content. Awareness of this phenomena is crucial in self-care to prevent hearing loss.

Hearing Loss

Sensorineural: This refers to damage to the inner ear by loud noises (reviewed above), infection, medication side effects, or old age. It is caused by failure in the acoustic nerve and/or inner ear.

Conductive: Conductive hearing loss involved sound transmission abnormalities in the middle and outer ear. This could be due to impacted earwax, middle ear infection, or injury to the eardrum. Often, the cause is reversible.

Hearing loss should always be evaluated to determine if there is treatment. In the absence of that, it’s possible to explore the option of a hearing aid. This should be discussed with a health care provider.

Other Ear Problems

Earache: Earaches are usually due to a blocked Eustachian tube, the thin tube that connects the back portion of the nose with the middle ear. Usually, this tube allows air flow so that the pressure can equalize between the middle and outer ear. When this pressure builds up, due to infection, and especially when pressure changes take place like on an airplane, the eardrum gets stretched and leads to pain.

Tinnitus: Tinnitus is also known as “ringing in the ears” and can be experienced as roaring, clicking, humming, buzzing, or ringing. It is due to damage to the tiny hair-like inner ear structures and can be caused by acoustic trauma, earwax buildup, infection, medication side effects, perforated eardrum, fluid in the ears, high blood pressure, diabetes, aging, or other health problem. The risk can be reduced by protecting the ear from loud noise, controlling blood pressure, limiting salt intake, limiting aspirin, avoiding caffeine, tobacco, and addictive substances. Also, it is advised to work out regularly to encourage good circulation as well as get enough rest.

Ear Wax: Ear wax, or cerumen, is produced by the body to protect the ear canal by trapping dust, and protecting the ear canal from bacteria or other things that may enter the outer ear. When the ear wax builds up, the extra dries and falls out of the ear on its own or is wiped. When the ear is cleaned with Q-tips or a finger, there is a risk for removing the protective wax, or of pushing the existing wax into the ear canal causing a blockage. The recommendation is to put nothing in your ear unless directed to by a physician.

Other: There are rare conditions that can lead to dizziness (vertigo, Meniere disease) or hearing loss (cholesteatoma) that should be under the care of a health care provider.

How to promote ear health

There are several measures one can practice to promote ear health:

• Avoid colds and flu. They are often the source of ear infections.
• Blow your nose softly. Forceful blows can drive infection into the ears.
• Never stifle a sneeze as it can force infectious material into the ears
• Don’t smoke cigarettes as it interferes with Eustachian tube functioning
• Don’t ignore ear pain, see your health care provider for advice/treatment
• Don’t put anything in your ears! Leave your ear wax alone, it’s doing a job.

If experiencing these or ANY ear/hearing problems, please call us at the health center for an appointment.

How to Care for Your Ears