Ear Blockage and Related Conditions
Ear blockage can be caused by various conditions affecting the outer, middle, or inner ear. These conditions include:
Obstructions in the External Canal: Impacted wax or swelling of the skin lining due to infection (otitis externa) can cause blockage in the external canal.
Middle Ear Infections with Fluid: Infections in the middle ear (otitis media) accompanied by fluid (effusion) can lead to blockage and hearing loss.
Eustachian Tube Blockage: Dysfunction of the Eustachian tube commonly occurs with upper respiratory tract infections or sudden changes in environmental pressure, such as during airplane landings or scuba diving. Stress-related jaw spasms (Temporomandibular joint-TMJ dysfunction) can also cause tension in the Eustachian tube muscles. Conditions like Meniere’s disease and acoustic neuroma, which increase inner ear fluid pressure, can also cause ear blockage resembling Eustachian tube dysfunction.
Diagnostics:
Due to the wide range of possible causes, an extensive range of audiological investigations may be necessary to make an accurate diagnosis.
Additional Ear Conditions:
Discharge from the ear: Typically indicates an infection of the ear canal (otitis externa) or middle ear (acute or chronic otitis media). Offensive smelling discharge is more common in chronic infections, especially due to gram-negative bacteria.
Ear injuries: Result from blows to the ear or head, or sudden extreme pressure changes. These injuries can cause painful blood collection under the skin (hematoma), rupture of the eardrum, disruption of ossicles, or damage to middle and inner ear structures.
Ear itching: Caused by infection or irritation of the skin lining the external ear canal (otitis externa).
Ear pain: Commonly caused by infection in the external canal (otitis externa, furunculosis) or middle ear (otitis media). Pain can also be referred from strain in the jaw joint, adjacent chewing muscles, or other ENT sites.
Tinnitus: A symptom that frequently accompanies hearing loss and can occur with almost every ear condition. Subjective tinnitus is only heard by the patient, while objective tinnitus can be heard by others. The annoyance caused by tinnitus varies and is not directly related to its loudness.
Hyperacusis: Increased sensitivity to sounds, making them seem abnormally loud. It is often an early symptom of inner ear disease.
Hearing loss: Divided into two general types:
a) Conductive hearing loss: Caused by disruptions in sound passage from the external ear to the oval window, such as impacted wax, tympanic membrane perforation, otitis media, middle ear effusion, or ossicle problems. Medical or surgical treatments can often correct these hearing losses.
b) Sensorineural hearing loss: Results from damage to the cochlear hair cells or auditory nerve fibers. Common causes include presbycusis (age-related hearing loss) and noise-induced damage. Medical treatment can prevent further deterioration, but sensorineural hearing loss is generally permanent. Hearing devices (aids) are often helpful for significant hearing deficits. Mixed hearing loss, which is a combination of conductive and sensorineural hearing loss, may also occur.
Diagnostics:
Pure tone audiometry, tympanometry, and stapedial reflex tests are used to distinguish between different types of hearing loss and assess the level of disability. Otoacoustic emissions may be measured to screen for early signs of cochlear hair cell damage. An MRI scan of the inner ear is essential when a patient has sensorineural hearing loss in one ear or if it is worse in one ear, to rule out a possible underlying acoustic neuroma.