John R. Bennett, MD
1255 East 3900 South #301, Millcreek, Utah 84124
756 East 12200 South, Draper, Utah 84020 22 South 900 East, Salt Lake City, Utah 84102
Generally speaking, the ears are designed to take care of themselves. Ear wax is only made in the outer 1/3 of the ear canal, and it naturally drifts outwards, where it dries and flakes at the opening to the ear. Q-tips should only be used at the openings of the ears, and in a circular motion. Never push the Q-tip deep into the ear canal, as this only pushes the wax deep, and the Q-tip becomes a ‘ramrod’. Do not allow bath water or shower water into the ears, as this irritates the ear lining. If the ear does become packed with wax, you can purchase ear wax softening drops, such as Debrox, to soften and partially dissolve the wax. Most kits also come with irrigation to flush out the ear after softening the wax. This may get rid of smaller particles of wax, but is unlikely to get rid of large cerumen impactions. When the ear gets plugged with wax, please make an appointment with us, and let us clean out the ear in the office. As we age, the wax gets thicker, and it is harder for the wax to come out on its own, especially for men who grow more hair in their ear canals as they age. Some people need to come in every year or so for ear cleaning.
Itchy ears are usually caused by fungal and bacterial growth in the ear canal, but can also sometimes be caused by allergies. White vinegar is a weak acid that, mixed 50:50 with water in an empty dropper bottle (available at drug stones), destroys most fungal and bacterial growth in the ears. Several drops of half-strength vinegar several times a day in the ears takes care of most itchy ears. If your ear is moist and itchy, mix vinegar 50:50 with rubbing alcohol. This will take care of the itch, and also dries out the ear. Hydrogen peroxide to dissolve wax can also be mixed with the vinegar and alcohol, giving you an inexpensive home-made treatment that gets rid of the itch, dries the ears, and dissolves wax.
Swimmer’s Ear is an infection of the ear canal. Although a moist ear is more likely to become infected, the main culprit in Swimmer’s Ear is actually Q-tips, which can rough up the delicate skin of the ear canal, and other attempts to scratch the ear canal. The ear canal skin is paper thin and right over bone, and even scratching with a Q-tip causes enough trauma to allow the fungus and bacteria normally in our ear canals to get under the skin of the ear canal, causing Swimmer’s Ear, also known as otitis externa. Caught early, the home-made drops of vinegar and alcohol may correct it, but people often need prescription antibiotic drops. The infection can get so swollen and painful, that sometimes a sponge wick needs to be placed in the ear canal for several days to allow the antibiotic drops to reach all the way in.
Another risk of putting Q-tips and bobby pins into the ear is that you may traumatize the ear drum, or even poke a hole right through the ear drum. This is of course exceedingly painful, and often occurs when someone is cleaning their ear with a Q-tip, and someone else opens the bathroom door and bumps into you, driving the Q-tip through the ear drum. This hole will sometime heal on its own, but we may have to perform a surgery to fix the perforation.
Eustachian tube dysfunction is common in early childhood, but can occur in adults, particularly with the onset of a cold or allergies. The Eustachian tube connects the back of the nose to the air-filled middle ear space, behind the ear drum. The Eustachian tube is normally closed, and the air in the middle ear space is slowly absorbed by the surrounding tissue. Within several hours, a vacuum forms in the middle ear, stretching and pulling in the ear drum. Most of the time, we subconsciously yawn when we feel this. The yawn tugs on the muscles of the Eustachian tube, allowing air to rush back up the Eustachian tube, giving a gentle pop. We do this every several hours our entire life, and most of us don’t even realize we are doing it. If the Eustachian tube becomes blocked with a cold, hay fever, etc., a simple yawn may not open the ear. In this situation, we should perform a valsalva: close the mouth, pinch the nose, and puff the cheeks out. If the ears still don’t pop, continue puffing the cheeks out, but jut out the chin, and wriggle the jaw side-to-side. Keep trying. Consider over-the-counter nasal sprays such as Afrin, Sudafed pills, and nasal steroid sprays (Nasacort, Rhinocort, Flonase) to decongest the nose and the Eustachian tubes. Try again to pop the ears. If you are unable to pop the ears for several days, then fluid can collect behind the ear drum, and bacteria could grow in this, causing a painful middle ear infection, or otitis media. At this point you will need to go see your doctor.
Please wear hearing protection around loud noises such as concerts, mowing the lawn, and other machinery. If you are around very loud noises such as gun fire, consider using double protection, with ear plugs AND ear muffs. Even a single loud noise close to the ears can cause permanent hearing loss. Once you have lost some of your hearing, it is gone forever. The noise damage is cumulative, and often the effects are not seen until many years later. Protect your hearing, as you will need your ears for the rest of your life!
The first range of hearing loss that most people experience is the high frequency, where the consonant sounds of ‘th,’ ‘f,’ ‘s,’ and ‘k’ are. Most people’s first realization of their hearing loss is in a loud restaurant, and the consonant sounds of the person across the table are washed out by the background noise. You often will still hear the vowel sounds, and it will sound like the other person is mumbling. Please schedule a hearing test if you have noticed hearing loss when there is lots of background noise. We recommend a baseline hearing test at the age of 50.
People with hearing loss, who do not get hearing aids, find they often stop going to social events they used to enjoy, as it is too frustrating for them and the people around them. This leads to loneliness and depression. Recent evidence from Johns Hopkins also shows that people with uncorrected hearing loss are more likely to suffer from dementia, probably from decreased brain stimulation of conversation. The nerve of hearing is a “use it or lose it” nerve, meaning if you wait a long time to get hearing aids, you may lose some of the hearing pathways in the brain that allow you to understand speech. In this case, you might get hearing aids that are turned up high enough to hear the words, but the brain may have lost the ability to understand what you are hearing. Hearing aids would then be much less satisfying. Do not delay getting hearing aids when you need them. When your family says you need hearing aids, they are usually right! Hearing aids are constantly getting better and better. The hearing aids of today are dramatically better than the hearing aids of 5-10 years ago. Our Audiologists have better selection, service, and prices of hearing aids than anyone else in town, work closely with our Physicians, and they will let you try out the hearing aids for a month for free.
When you lose hearing, the brain replaces the missing sound with a ringing or buzzing noise, called tinnitus. Tinnitus does not cause hearing loss. Hearing loss often causes the phantom signal or noise of tinnitus. Many medicines can cause tinnitus, especially Aspirin and other anti-inflammatories. Nicotine and caffeine also can cause tinnitus. Anyone with tinnitus should have a hearing test. The vast majority of tinnitus is completely benign, but some tinnitus can be a sign of a more serious problem, especially one sided tinnitus, rapidly worsening tinnitus, tinnitus with dizziness or any other nerve change, or the sound of your heart beating or fluid pulsing through the ear. These require a careful work up by your Physician. Tinnitus is best dealt with by avoiding complete silence, especially when trying to go to sleep at night. Having the soft noise of a fan, or an alarm clock set to ‘ocean waves’ or ‘mountain stream’ can be quite helpful. There are a number of herbal and vitamin therapies available on line, but these have not been proven to be very helpful, and most tinnitus tends to come and go over time, anyhow. Melatonin and antidepressants have been shown to help people with tinnitus fall asleep better, but their side effects prevent most people from staying on them. Tinnitus training devices or ‘masking’ devices can be built into a hearing aid, or can be purchased from our Audiologists separately. There are also ‘apps’ on smart phones that train you not to notice the tinnitus as much.
Please call Dr. Bennett at 801-328-2522 if you have any questions, problems, or concerns.