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To keep your hearing mechanism intact, don't ignore any hearing problem

illustration of an earFor a person who has partial or total hearing loss, the disability is experienced not only by her but also by family and friends. Difficulty in communication, asking others to repeat sentences, and having to watch TV with a loud volume are some of the issues others have to face.

As children, we learn speech only if we are able to hear. Our hearing is crucial to our development particularly in our early life.

Our brain undergoes maximum changes and our neural pathways get matured from the time we are born till we are about three years of age. If deafness in this period goes unnoticed, there can be irreversible damage to the central hearing mechanism. Even surgeries like cochlear implants may not yield desired results.

Hence, early recognition and supplementing with a hearing aid in this period is important—it keeps the hearing mechanism intact, which helps further treatment. Not just in the early years, but hearing loss at any age needs to be attended to immediately. Normally, there are two kinds of hearing loss.

Single ear deafness

This condition commonly goes unnoticed and is sometimes an accidental discovery at regular ear check-ups. Such patients have to be extremely careful with any kind of medication and any intervention in the functional ear.

Sudden deafness

This is a serious condition, which affects a few individuals. Most often the cause is unknown but it could also be because of a viral infection. This condition is a medical emergency and requires immediate ENT consultation. If treated early, even the lost hearing can be recovered.

Following are some of the causes of hearing loss:

Abnormal shape of pinna

This abnormality is sometimes associated with problems in the middle ear and reduced hearing. The shape of pinna as well as the resultant hearing loss can be corrected surgically. Hence, a specialist’s opinion should be sought.

Other illnesses

Medications for certain diseases like tuberculosis and cancer are also toxic to the inner ear cells and can lead to hearing loss. A feeling of ringing sound in the ear with difficulty in hearing and a sense of imbalance should not be ignored.

Noise exposure

Sound has two characteristics—frequency [sharpness] and intensity [loudness], both of which can harm the ear. Long-term exposure to sounds above 85 decibels [dB] may cause permanent hearing loss. This is known as noise-induced hearing loss [NIHL]. About 10 per cent of the population is exposed to hazardous levels of noise.

On exposure to loud noise, there could be a temporary threshold shift or a permanent threshold shift in hearing. Post noise exposure tinnitus is a useful evidence of temporary threshold shift. A useful yardstick of background noise is the ability to hold some kind of conversation in that environment.

When exposed to noise of over 85dB, move away from the area. If it’s not possible, shield your ears with either your hands or earplugs. Avoid being in front of blaring speakers or amplifiers for too long.


Ear wax

Ear wax has a protective function of keeping the pH in the ear low and hence preventing bacteria and fungi from growing. It also keeps the ear canal moist and lubricated to avoid dryness and irritation and traps dust, foreign bodies and dead skin before they reach the ear drum.

Sometimes excess or impacted wax may cause blockage of the ear canal leading to reduced hearing, severe pain and also infection. The best way to remove excess ear wax is to use wax softeners and then get it removed by a doctor.

A general physician would commonly use a syringe with water to remove it while a specialist would prefer the suction technique. Both methods are safe.

Loss of balance and nausea

This can be precipitated by a specific position of the head or can occur along with upper respiratory tract infection. Giddiness, hearing loss and ringing sound in the ear [tinnitus] can occur episodically with normal intervening period. It is also seen in Meniere’s disease [a disorder of the inner ear]. This needs to be resolved by an expert.

Mobile phone radiation

illustration of an earIt is advisable to use ear phones to minimise radiation from mobile phones. Make sure to use a well fitting and soft ear plug and avoid prolonged use to prevent pain and infection in the ear canal. A safe volume of the ear phone is such that it is not audible without the ear phone in the ear.

Foreign body in the ear

Cotton used for cleaning can sometimes be left behind. If not removed, it can lead to infections. In case an insect gets in the ear, put oil [not heated] or any ear drop to drown it before it can be removed.

Removal of vegetative foreign bodies is best left to a specialist. Home trials to remove the foreign body must be dissuaded as it can easily cause ear drum perforation and complicate the situation.

Common cold/sore throat

To avoid throat infection from spreading to the ear, limit air-travel and swimming. While sneezing, keep the mouth open so that the infected secretions do not enter the middle ear via the Eustachian tube.

Ear drum perforation

In case of a ruptured ear drum, avoid water from entering the ear. Soak and squeeze a cotton swab with any oil and place it in the ear. You can also use petroleum jelly instead of oil. Swimming is to be avoided during active infection of the ears.

Discharging ears

It is prudent to have proper aural hygiene in cases of any discharge from the ears. This can be achieved by suction cleaning by the ENT surgeon and mopping the ear gently with sterile cotton bud before instilling ear drops.

Itchy ears

Itchiness commonly occurs because of dryness of the skin, as a result of Seborrheic dermatitis [dandruff] or because of fungal infection of the ear canal. Proper diagnosis with targeted medication is the treatment.

This was first published in the April 2011 issue of Complete Wellbeing.

Dr Sangeet Kumar Poddar, MS [ENT], is consultant ENT surgeon at Sevenhills Hospital in Mumbai.


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