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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Hearing Loss: Types, Causes, Testing and Treatment
Hearing loss may develop gradually or suddenly and may affect one or both ears. The main types are conductive hearing loss, caused by problems in the outer or middle ear; sensorineural hearing loss, caused by damage in the inner ear or hearing nerve; and mixed hearing loss, which combines both.
Conductive causes include earwax blockage, fluid behind the eardrum, ear infection, a perforated eardrum and problems with the small middle-ear bones. Sensorineural causes include ageing, repeated loud-noise exposure, certain medicines, genetic conditions, head injury and inner-ear disorders.
Signs include difficulty following conversation, asking people to repeat themselves, increasing television volume, struggling in noisy places, tinnitus, delayed speech in children or reduced response to sound. Hearing loss that develops suddenly over hours or a few days requires urgent ENT assessment because early treatment may improve the chance of recovery in selected cases.
Evaluation usually includes an ear examination and a formal hearing test performed by an audiologist. Tests help identify the degree and type of hearing loss. Additional tests or imaging may be requested depending on the pattern and associated symptoms.
Treatment depends on the cause. Wax, infection or middle-ear fluid may be managed medically or procedurally. Permanent hearing loss may be supported with hearing aids, assistive devices, communication strategies or implantable hearing devices in selected patients. Children should be assessed promptly because hearing is important for speech, language and learning.
Protecting hearing includes using suitable hearing protection around loud sound, keeping personal audio at safe levels and obtaining testing when changes are noticed.
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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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