Uneven Hearing: Earwax and Eustachian Tube Issues

Q: Uneven Hearing: Earwax and Eustachian Tube Issues

Hello Steve, <br>The issue you mentioned could be due to： 1) Eustachian tube dysfunction： This is the most common cause and can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over. <br>2) Sudden sensorineural hearing loss.

Asymmetry of the ears?

Hello Doctor, on the morning of April 9th (Sunday), I noticed that my right ear was slightly unclear in hearing.
On the evening of April 10th (Monday), I visited a doctor and was informed that it was due to earwax buildup.
The doctor used a tool (similar to a suction device) to remove the earwax, but that night I experienced severe tinnitus.
When I returned for a follow-up, the doctor said everything looked fine and advised me to monitor the situation.
On April 11th (Tuesday), my hearing was normal all day, but this morning, April 12th (Wednesday), I noticed mild symptoms again.
Could this possibly be an issue with my Eustachian tube? I have not experienced any previous issues with uneven hearing between my ears.
Thank you, Doctor.

Steve, 20~29 year old female. Ask Date: 2017/04/12

Dr. Ji Zhaoyun reply Otolaryngology

Hello Steve,
The issue you mentioned could be due to: 1) Eustachian tube dysfunction: This is the most common cause and can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over.
2) Sudden sensorineural hearing loss.
3) Otitis media: a) Acute otitis media: Often occurs alongside upper respiratory infections (like colds) or sinusitis, and in severe cases, there may be discharge from the ear.
b) Chronic otitis media with acute exacerbation: This usually occurs when there is a pre-existing perforation in the eardrum, which can become inflamed due to unclean water or improper ear cleaning.

All of the above conditions can be appropriately managed with medication after consulting a healthcare provider.
If you have already undergone pure tone audiometry (which requires headphones in a soundproof booth, where you respond to sounds by pressing a button, rather than just using a tuning fork), and it has been confirmed that you do not have sudden sensorineural hearing loss, then medication may suffice.
However, if you have not had a pure tone audiometry test, it is advisable to visit a hospital for evaluation to rule out sudden hearing loss.
The golden treatment window for sudden sensorineural hearing loss is within two weeks, and early treatment yields better outcomes.
Wishing you safety and health.
Sincerely,
Dr.
Chi Chao-Yun
Director, Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare

Reply Date: 2017/04/12

More Info

Hello! Thank you for sharing your concerns regarding your recent ear issues. Based on your description, it seems you are experiencing a combination of symptoms that could be related to earwax buildup and possibly Eustachian tube dysfunction.

Earwax, or cerumen, is a natural substance produced by the glands in the ear canal. It serves to protect the ear by trapping dust, debris, and microorganisms. However, excessive earwax can lead to blockage, which may cause symptoms such as muffled hearing, discomfort, and even tinnitus (ear ringing). It appears that your initial visit to the doctor confirmed that earwax was a contributing factor to your hearing difficulties, and the subsequent cleaning provided temporary relief.

The fact that you experienced severe tinnitus after the earwax removal could indicate that your auditory system was reacting to the sudden change in pressure or sound transmission. Tinnitus can sometimes be exacerbated by changes in ear pressure or by the removal of earwax, which may have previously been providing some level of protection or insulation.

Your symptoms of uneven hearing and the recurrence of mild symptoms after a brief period of normalcy could indeed suggest a problem with the Eustachian tube. The Eustachian tube connects the middle ear to the back of the nose and throat, helping to equalize pressure and drain fluid. If this tube is not functioning properly, it can lead to a sensation of fullness, muffled hearing, and even discomfort. Factors such as allergies, sinus infections, or even changes in altitude can affect Eustachian tube function.

Given that you have not previously experienced issues with uneven hearing, it is important to consider any recent changes in your environment or health that could be contributing to this problem. For instance, if you have been exposed to allergens, have had a cold, or have experienced any nasal congestion, these could all impact Eustachian tube function.

To address your concerns, I recommend the following steps:
1. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This can help you and your healthcare provider identify patterns.

2. Nasal Decongestion: If you suspect that nasal congestion might be affecting your Eustachian tube, consider using a saline nasal spray or a decongestant (if appropriate for you) to help alleviate any swelling.

3. Valsalva Maneuver: You can try the Valsalva maneuver, which involves gently blowing while pinching your nose and keeping your mouth closed. This can help equalize pressure in the ears.

4. Follow-Up with an ENT Specialist: If your symptoms persist or worsen, it would be wise to consult an ear, nose, and throat (ENT) specialist. They can perform a thorough examination, including hearing tests and possibly imaging studies, to determine if there are any underlying issues with your Eustachian tube or middle ear.

5. Avoid Loud Noises: Protect your ears from loud sounds, as exposure can lead to further irritation or damage.

In summary, while earwax buildup is a common issue that can lead to temporary hearing problems, your ongoing symptoms may warrant further investigation into Eustachian tube function. It’s essential to address these concerns promptly, especially since you have not experienced uneven hearing before. I hope this information helps you understand your situation better and guides you toward effective management of your symptoms. Best wishes for your health and well-being!

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