ENT
Earwax Blockage: Symptoms, Safe Removal and Prevention
Earwax is a normal protective substance produced in the outer ear canal. It helps trap dust, lubricate the skin and reduce the risk of irritation. In most people, earwax gradually moves toward the ear opening and falls out naturally. A blockage occurs when wax accumulates faster than it can leave or is pushed deeper into the canal.
Symptoms may include reduced hearing, a blocked or full sensation, earache, itching, tinnitus or changes in hearing-aid performance. These symptoms are not specific to wax, so sudden hearing loss, significant pain, discharge or bleeding should be medically assessed rather than treated as simple wax build-up.
Common contributors include narrow ear canals, heavy wax production, hearing aids, earplugs and inserting cotton buds or other objects into the ear. Cotton buds usually push wax deeper and may injure the canal or eardrum.
When appropriate, wax-softening drops may be recommended. Some people should not use drops or irrigation without medical advice, especially those with a perforated eardrum, previous ear surgery, ear tubes, active infection or certain skin conditions. Professional removal may involve microsuction, irrigation or careful removal with instruments under direct vision.
Earwax that causes no symptoms usually does not need to be removed. Seek assessment if hearing remains reduced, the ear is very painful, there is drainage or bleeding, or symptoms appeared suddenly. People who repeatedly develop blockage or use hearing aids may benefit from periodic checks.
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Tinnitus: Causes, Evaluation and Ways to Manage Ringing in the Ears
Tinnitus is the perception of sound without an external source. It may be heard as ringing, buzzing, humming, clicking or roaring and can affect one or both ears. It is a symptom rather than a disease.
Common associations include age-related hearing loss, noise exposure, earwax blockage, middle-ear problems and certain medicines. Sometimes no single cause is identified. Pulsatile tinnitus, which seems to beat in time with the pulse, is different and may require additional investigation.
Assessment starts with a medical history, ear examination and usually a hearing test when tinnitus is persistent, one-sided or associated with hearing changes. Imaging is not required for every patient, but may be considered when tinnitus is pulsatile, one-sided with asymmetric hearing loss or accompanied by neurological signs.
Treatment focuses on identifying reversible causes and reducing the effect on daily life. Removing impacted wax or treating an ear condition may help when these are responsible. Hearing aids may reduce tinnitus awareness in people with hearing loss. Background sound, sound therapy, sleep strategies and cognitive behavioural therapy can help some people manage distress. No single medicine or supplement reliably cures tinnitus, and products making guaranteed claims should be viewed cautiously.
Seek prompt assessment for tinnitus with sudden hearing loss, severe dizziness, facial weakness, neurological symptoms or a sound that follows the heartbeat. Persistent tinnitus that affects sleep, concentration, mood or quality of life should also be discussed with an ENT specialist or audiologist.
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Ear Infections: Types, Symptoms and Treatment
Ear infections can affect the ear canal, middle ear or, less commonly, inner ear. Outer-ear infection, often called swimmer’s ear, affects the canal and may cause pain when the outer ear is touched, itching, swelling and discharge. Middle-ear infection occurs behind the eardrum and is especially common in children after colds. It may cause ear pain, fever, irritability, reduced hearing or fluid leaking if the eardrum perforates.
Diagnosis requires examination of the ear. Treatment depends on the location, cause, age and severity. Outer-ear infections are commonly treated with prescribed ear drops and keeping the ear dry. Middle-ear infections may improve without antibiotics in selected cases, while antibiotics are recommended when clinical criteria indicate bacterial infection or increased risk. Pain relief and hydration remain important.
Do not insert cotton buds, oils or unprescribed drops into a painful or draining ear. Drops may be unsafe if the eardrum is perforated, unless specifically selected by a clinician.
Medical assessment is recommended for severe pain, persistent fever, discharge, swelling behind the ear, dizziness, facial weakness or significant hearing reduction. Infants, people with diabetes, immune suppression or previous ear surgery may need earlier assessment. Repeated infections or persistent middle-ear fluid can affect hearing and may require ENT and audiology review.
Prevention includes avoiding trauma from ear cleaning, drying the outer ear gently after swimming and keeping vaccinations up to date. Children exposed to tobacco smoke have a higher risk of middle-ear problems.
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