Healthy Ears: Ear Care and Hearing

Definition

Taking care of your ears is important for your overall health and well-being. Beyond hearing, your ears also play a role in maintaining your sense of balance. Having an ear care routine at home can help you keep your ears healthy and prevent conditions that may affect your hearing or balance.  

Here are a few ear care habits:

• Turn down the volume. Protect your hearing by avoiding noises that are too loud. If you can control the volume, opt for the lowest level you can enjoy. When you can’t, protect your ears with hearing protection like earplugs or headgear

• Avoid sticking anything in your ears. It’s never a good idea to put anything inside your ears — including cotton swabs to clean them. Important structures of the ear are just beyond your ear canal and can be easily damaged. 

• Keep your ears dry. It’s important to keep your ears dry — standing water can lead to an infection of the ear canal. Pat your ears dry after showering or swimming.

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Parts of the ear

The ear has several different parts that work together so you can hear properly. This includes the outer ear, middle ear, and inner ear. 

The outer ear includes the:

• Pinna (the outer ear that you can see)

• Ear canal (the pathway from the outer ear to the eardrum)

The middle ear includes the:

• Tympanic membrane (eardrum)

• Malleus, incus, stapes (ear bones that transmit sound)

The inner ear includes the:

• Cochlea (fluid-filled spiral tube that aids in hearing)

• Semicircular canals (help with balance)

• Auditory nerves (transmit signals from the ear to the brain)

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How wearing works

There are several steps that work together for you to process the sounds all around you. These steps let the ear communicate the sounds you are hearing to your brain. 

Here at the steps involved in hearing:

• Sound enters the ear canal and hits the eardrum.

• The sound vibrates the eardrum and causes the ears bones to vibrate. 

• The ear bones transmit sound to the cochlea.

• The fluid in the cochlea vibrates and causes movement of “hair cells” in the semicircular canals.

• Movement of the hair cells triggers an electrical signal.

• The auditory nerves send the signal to the brain to process the sound.

Your hearing may be affected if any part of the ear is not working properly. This can be the result of an acquired condition or injury, or an issue present from birth.

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Hearing loss

An issue affecting any part of the outer, middle, or inner ear can lead to hearing loss. Common reasons for hearing loss include:

• Aging: Age-related hearing loss typically involves damage to the inner ear.

• Autoimmune inner ear disease: This condition causes damage to the inner ear, though it often occurs along with other autoimmune conditions.

• Medications: Certain antibiotics (like azithromycin), cancer treatments (like cisplatin), water pills (like furosemide), and pain relievers (like aspirin) can cause hearing loss.

• Loud noises: Loud noises can damage cells in the cochlea and can cause permanent hearing loss.

• Ménière's disease: This condition affects the inner ear and is more common in middle-age adults. It can cause permanent hearing loss.

• Otosclerosis: This condition causes damage to the bones of the middle ear, preventing them from moving properly.

• Trauma: A serious head injury can affect nerve signals to the brain or damage the eardrum or middle ear, which can damage hearing.

• Recurrent ear infections: Repeated episodes of otitis media (middle ear infection) can lead to permanent hearing loss. 

• Cerumen impaction (wax buildup): Having a buildup of wax in the ear canal can prevent sounds from reaching the eardrum and cause hearing loss. 

This list doesn't include every cause of hearing loss. There are other causes, like forms of congenital hearing loss, that newborn hearing screenings often pick up 

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Ear infections

Ear infections are a common issue affecting the ear. And it’s important to know that there are different types of infections in the ear. That’s because each part of the ear can get an infection. 

Let’s take a closer look at the types of ear infections and how their symptoms can differ.

Outer ear infection

Outer ear infections involve bacteria in the ear canal. It’s commonly called “swimmer’s ear” and can be the result of water getting into the outer ear. This will often cause symptoms like:

• A painful ear to touch or move

• Drainage from the ear canal

• Itching in the ear

• Redness or swelling of the outer ear

These infections are typically treated with topical antibiotics (like Cortisporin) that go inside the ear. Over-the-counter (OTC) pain relievers can also help with pain and discomfort. 

Middle ear infection

Middle ear infections are due to bacteria and fluid buildup in the middle ear. They are commonly caused by viruses as well. These infections can cause inflammation and increased pressure behind the eardrum. 

Symptoms of a middle ear infection often include:

• Pain

• Fever

• Fullness in the ear

• Decreased hearing

Oral antibiotics are commonly used to treat middle ear infections that are caused by bacteria. When the cause is a virus, OTC pain relievers and fever reducers are helpful. 

In cases of long-lasting infection, your provider may refer you to an ear specialist. In severe cases, they may recommend tube placement in the eardrum to let the infection drain. 

Inner ear infection

Inner ear infections are less common than other types of ear infections. These infections can affect the semicircular canals (vestibular neuritis) or the cochlea and auditory nerves (labyrinthitis). 

These infections aren’t painful and are more likely to affect your balance. They typically cause symptoms like:

• Dizziness

• Nausea

• Vomiting

• Vertigo

• A feeling of being “off-balance”

These infections are often due to viruses, so antibiotics won’t help. You’ll have to wait for the virus to run its course. Medications to treat nausea (like promethazine) and dizziness (like meclizine) are often helpful.  

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Ear care

When it comes to caring for your ears, there are two big points to keep in mind:

• Loud noises can harm your hearing. So use ear protection (like earplugs), and lower the volume when possible. 

• Your ears are mostly self-cleaning. So focus on cleaning the outside and keeping them dry. 

Earwax plays an important role in how your ears are able to clean and care for themselves. Earwax is the body’s natural way of protecting your ears from bacteria and other objects getting inside. 

In some cases, earwax can build up and block the ear canal. You may have heard that the best way to remove excess earwax is to use cotton swabs inside the ear. But this can actually make the blockage worse by pushing the wax further down the canal. 

To remove hardened or excess earwax, you can use at-home treatments like:

• OTC ear drops

• Warm saline and a bulb syringe to flush the ear

• A warm washcloth to wash the outer part of the ear

If these methods don't work, your healthcare provider can professionally clean your ears and remove your earwax. If you have frequent wax buildup or tubes in your ear, you can schedule regular cleanings with your provider a few times per year as needed. But remember, most of the time, it’s OK to just let earwax do its protective job.

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