Having a Hard Time Hearing? Get It Checked by an ENT

Most of us are familiar with the type of hearing loss that can be improved with hearing aids, but there is another type of hearing loss—the type that can be caused by a buildup of earwax, among other things, and is called conductive hearing loss.

Causes of Hearing Loss

“A sensorineural hearing loss is a hearing loss that occurs in the inner ear and is usually a result of damage to the hair cells in the inner ear. This damage occurs due to aging, noise trauma, genetics, and, occasionally, some types of infections,” explains George Alexiades, MD, FACS, an otolaryngologist and director of the Cochlear Implant Center at Weill Cornell Medicine. “A conductive hearing loss is a loss that occurs in the transmission of sound from the outer ear to the inner ear. This type of hearing loss can be a result of wax impaction in the ear canal.”

Other conditions that may result in conductive hearing loss include having a hole in the eardrum, fluid behind the eardrum, or chronic ear infections that erode the tiny bones in the middle ear— the malleus, incus, and stapes. (These are the same bones that are commonly called the hammer, anvil, and stirrup.)

“Another condition that may cause conductive hearing loss is called otosclerosis, which is a hardening of the stapes bone (the smallest bone in the human body). When this bone hardens, it is frozen in place and is unable to effectively transmit sound to the inner ear,” says Dr. Alexiades.

Earwax Is Normal

It is normal to have some wax in the ear canals.

“Earwax is produced only in the outer third of the ear canal. Earwax serves to moisturize the skin inside the ear and to remove debris as the wax moves from inside the ear canal toward the opening,” explains Dr. Alexiades. “If you have an excessive buildup of earwax, you can have some hearing loss, and sometimes, you can get infections if moisture gets trapped behind the wax.”

Cleaning Cautions

While it’s important to keep your ears clean, some cleaning methods can actually damage your ears.

“Don’t ever use Q-tips in the ear canal,” advises Dr. Alexiades. “Most people think they are cleaning their ears, but oftentimes, they are pushing most of the wax further into the ear canal.”

Using a Q-tip in the ear canal may scrape the delicate skin in the ear canal, which can lead to an outer ear infection. It’s also possible to hit the eardrum with a Q-tip, which is extremely painful, or to perforate the eardrum.

Dr. Alexiades recommends cleaning the outside of your ears with a towel after a shower. He says that people who are bothered by excessive earwax may want to try Debrox, an over-thecounter product that can help remove the wax.

Ear candling, which involves inserting a hollow, wax-covered cone into the ear canal and igniting the other end of it, is another method that can be dangerous. (Proponents of ear candling claim the heat creates suction and draws the earwax out of the ear.)

“Multiple studies have shown that ear candling does not remove wax from the ears. In addition, there is the danger of burns to the ear canal, or, more rarely, burning a hole in the eardrum,” warns Dr. Alexiades.

About Tinnitus

Although tinnitus is not hearing loss, it is a condition that can interfere with normal hearing. Tinnitus is a noise in the ear or ears that occurs without an external source of sound. Tinnitus has been described as a ringing, whooshing, buzzing, hissing, “crickets,” or “seashell” sound. The cause of tinnitus has not been determined. Dr. Alexiades says that tinnitus often accompanies hearing loss, but people with normal hearing can also have tinnitus.

“Some people are left with constant tinnitus after noise exposure, so it is always good practice to wear hearing protection at loud events. Also, anything that is a brain stimulant will tend to make tinnitus worse, so people who are bothered by tinnitus should avoid caffeine, decongestants, and smoking,” advises Dr. Alexiades.

If you have chronic tinnitus or any type of pain or discomfort in your ear, see an ear, nose, and throat specialist (ENT) to make sure there are no medical issues in the ear. An ENT may send you to an audiologist, who will test your hearing and determine if you have hearing loss, and, if so, what type of hearing loss you have.

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