Ear Care and Ear Health Tips

The most important measure to keep ears healthy is to avoid loud noise. It is also important to keep the auricle and the ear canal clean.

The ears are an important sensory organ responsible for hearing and balance. While we see only the outer part of the ear (the pinna or auricle), the complex inner workings are protected within the skull.

For hearing, sound waves travel from the air through the ear canal and cause the eardrum (tympanic membrane) to vibrate. The bones in the middle ear, the malleus (hammer), incus (anvil) and stapes (stirrup) amplify the vibrations and transfer them to the nerve endings in the cochlea located in the inner ear. The vibrations become electrical impulses and the auditory nerve sends those signals to the brain.

The inner ear is also the location for the labyrinth system, a set of fluid filled semicircular canals that act as a gyroscope and control balance, sensing the position and movement of the head.

Hearing lets us to interact with other people and the environment. It allows for communication, social interaction, and the ability to identify the sounds of our environment -- bringing pleasure and also warning of danger.

The most important measure to keep ears healthy is to avoid loud noise. Prevention is key. Loud noises can damage the three small bones in the middle ear. This noise can be a single exposure like a loud concert, or it can be a repetitive exposure like listening to music of personal headphones, or loud noise at the workplace.

It is important to keep the auricle and the ear canal clean. Their job is to collect sound waves and funnel them to the eardrum so that it can vibrate and produce the sounds that the brain can hear.

Keeping the outer ear clean is relatively easy, but the ear canal is much harder. You should never stick a cotton swab (such as Q-tips) inside the ear canal. If there is wax present, it may be pushed against the eardrum preventing sound from reaching it and also decreasing its ability to vibrate. The ear canal is designed to clean itself; a little wax is normal and it traps dirt and dust, preventing them from getting near the eardrum. It also lubricates the canal and helps prevent infection of the skin lining the canal. To prevent infection, you should keep the ear canals dry after swimming or showering, and you should avoid sharing ear plugs.

Practicing good noise hygiene is important to maintain lifelong hearing. Exposure to loud noises can damage the hearing mechanism and lead to hearing loss. Prevention includes wearing noise cancelling headphones if you are in a noisy workplace. Listening to music at loud volume using a personal music device can be damaging. Exposure to loud sounds can be damaging, even if it is one occurrence. After attending a loud concert, you may have experienced short term hearing loss with symptoms of muffled hearing, inability to understand conversation, ringing in the ears (tinnitus), and full feeling in the ear.

The auricle or external ear can be cleaned with soap and water. It is important to dry them well.

If you feel that there is a buildup of wax in your ear canal, it is important not to stick a cotton swab into the canal. A home remedy for softening ear wax may be tried. You can put a few drops of mineral oil, baby oil, or hydrogen peroxide into the canal, and then lie on your side with the ear facing up to allow gravity to keep the drops in the ear canal for a few minutes without dripping out.

If the ears still feel clogged, and you believe that there may be a wax buildup, you may need to see your healthcare provider. If they find excess wax, they can irrigate the ear with saline (salt water) to remove the wax.

Why do my ears feel clogged but no wax?

The sensation of fullness in the ear may not be caused by a wax buildup in the ear canal, but may be due to fluid accumulation in the middle ear, behind the eardrum. This space is normally bathed in fluid that drains through the eustachian tube to the back of the nose and throat.

If the eustachian tube becomes inflamed, for example in a head cold, the tube can narrow preventing drainage from the middle ear. This causes the sensation of fullness and can decrease hearing because it may decrease the ability of the eardrum and the bones to vibrate.

Inflammation in the ear canal can be prevented or reduced by keeping the ear canal dry, and by not inserting objects into the canal.

Do not share ear plugs and ear buds as they can be a source of infection or inflammation.

Home remedies for ear fullness and inflammation:

• use a warm compress to cover the affected ear
• chew gum, blow your nose, or swallow hard to try to open the eustachian tube and allow fluid to drain from the middle ear
• use over the counter medication like acetaminophen (Tylenol, Panadol) or ibuprofen (Advil) to help with pain

If there is sudden hearing loss, vertigo, or tinnitus, it is important to seek medical care.

Hearing is a vital sense and is also very delicate, and preventive measures should always be made to try to protect it.

• Avoid noises if possible. Try to move away from the noise source, turn down the volume of televisions, radios, personal music devices, and computers.
• Take routine breaks from noisy environments. If there is an isolated exposure, like at a concert, it may take up to 16 hours for hearing to recover.
• Wear protective gear like ear plugs, or noise cancelling headphones

Be aware of symptoms like hearing loss, tinnitus, or vertigo. They may signal damage of the hearing mechanism including the structures in the middle and inner ear. As well, they may be signs of Meniere’s disease or acoustic neuroma.

When should you use ear plugs?

Ear plugs or over the ear noise-cancelling headphones should be used in places with loud noise exposure, especially if the noise level is greater than 85 decibels. Situations where this might occur include:

• workplaces, such as construction sites or factories
• concerts, sport venues, or auto races
• indoor spaces with loud music, such as night clubs
• use of power tools and outdoor lawn equipment

Hearing is a vital sense that helps us interact with the world around us. You should seek medical care if you notice a decrease in your hearing. This may present with any of the following:

• Hearing loss. Difficulty understanding conversations, asking people to repeat themselves, needing to turn up the volume to listen to the radio or television.
• Muffled hearing
• Feeling of a constant or recurrent fullness in the ear
• Ear pain
• Tinnitus or ringing in the ears

The US Preventive Services Task Force does not recommend screening for hearing loss in adults over the age of 50 who have not had any issues with their hearing. This does not apply to adults “with conductive hearing loss, congenital hearing loss, sudden hearing loss, or hearing loss caused by recent noise exposure, or those reporting signs and symptoms of hearing loss”.

Tinnitus, or ringing in the ear, is not normal. It may occur shortly after a loud noise exposure, such as going to a concert, but should resolve quickly with ear rest and quiet. Regardless of any noise exposure, if tinnitus persists or is recurrent, you should seek medical care.

Vertigo, or the sensation of spinning, is not normal. Unless it was self-induced, for example, by a carnival ride or twirling yourself around, vertigo should prompt you to seek medical care.

For ear wax, some of the symptoms for which you should seek advice include:

• signs of infection including redness, swelling, and tenderness about the ear, and potentially a fever
• drainage, pus or bleeding from the ear
• hearing loss or fullness
• lack of improvement after a few days of using ear drops

Remember to pay attention to any symptoms of hearing loss, tinnitus or vertigo. They may signal damage to the hearing mechanism including the structures in the middle and inner ear.