Ear Pain and Hearing Loss: When to Seek Further Evaluation

My ear makes a popping sound when I bite down on things?

As per the title, my ear makes a popping sound when I bite down on things.
I previously visited an otolaryngologist who diagnosed me with ear inflammation and prescribed some anti-inflammatory medication.
However, after finishing the medication, the same symptoms persist, and I have experienced some hearing loss, particularly in the low and mid frequencies when listening to music.
The symptoms began around November last year when I was attending a tutoring class, where the speaker was very loud, and my right ear was directly facing it.
I used my thumb to plug my right ear for sound isolation, sometimes applying significant pressure.
After class, I noticed persistent pain in my ear, and the symptoms have lasted for about six months.
I am unsure if something has shifted inside my ear.
Now, when I chew gum or bite down, my eardrum makes a thumping sound.
I would like to know if these symptoms warrant a visit to a major hospital for a hearing test, and whether the inability to hear mid and low frequencies could lead to permanent hearing loss.
Thank you for your response, doctor.

Xueyu, 10~19 year old female. Ask Date: 2016/04/05

Dr. Zheng Jueyi reply Otolaryngology

Hello! It is recommended to visit a hospital for a hearing test to assist in differential diagnosis.
Wishing you health and happiness! Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/04/05

More Info

Ear pain and hearing loss can be distressing symptoms that often indicate underlying issues requiring medical evaluation. Based on your description, it seems that you have been experiencing persistent ear pain, a sensation of fullness or pressure in the ear, and a noticeable decrease in your ability to hear low and mid-frequency sounds. These symptoms have been ongoing for about six months, which is a significant duration and warrants further investigation.

The initial diagnosis of ear inflammation and the prescription of anti-inflammatory medication suggest that your healthcare provider suspected an inflammatory process, possibly related to exposure to loud sounds, as you mentioned being in a classroom with loudspeakers directed at your ear. This kind of exposure can lead to temporary threshold shifts in hearing, but if the symptoms persist, it may indicate a more serious condition.

The fact that you are experiencing a "pop" or "thump" sensation in your ear when chewing gum or clenching your teeth could be related to Eustachian tube dysfunction. The Eustachian tube helps equalize pressure in the middle ear, and if it is not functioning properly, it can lead to feelings of fullness, discomfort, and even pain. Additionally, if there is any fluid accumulation or inflammation in the middle ear, it can contribute to these symptoms.

Regarding your concern about hearing loss, especially in the low and mid-frequency ranges, it is crucial to understand that prolonged exposure to loud sounds can indeed lead to permanent hearing loss. The risk increases if the exposure is frequent and at high volumes. If you have already noticed a decrease in your ability to hear certain frequencies, it is essential to seek a comprehensive audiological evaluation. This evaluation typically includes pure-tone audiometry, which assesses your hearing thresholds across various frequencies, and tympanometry, which evaluates the function of the middle ear.

Given that your symptoms have persisted despite initial treatment, I strongly recommend that you visit a specialized ENT (Ear, Nose, and Throat) clinic or a comprehensive audiology center. These facilities can provide a thorough examination, including imaging studies if necessary, to rule out any structural issues such as a perforated eardrum, ossicular chain problems, or even more serious conditions like cholesteatoma, which can develop from chronic ear infections.

In summary, your symptoms of ear pain, pressure, and hearing loss, particularly after exposure to loud sounds, indicate that further evaluation is necessary. A detailed hearing assessment and possibly imaging studies will help determine the underlying cause of your symptoms and guide appropriate treatment. Early intervention is crucial in preventing potential permanent hearing loss, so I encourage you to seek further medical attention as soon as possible.

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