Dr. Grossan's Ear, Nose and Throat Consultant Pages

 
      Ears
 


Outer Ear Infections (External Otitis)

The human ear is not designed for California living -swimming, daily shampoo, hot tub, scuba diving. The human ear needs wax (cerumen) to protect against the ravages of soap and water. Unfortunately we are taught with religious fervor to scrub the ears with soap and water. WRONG. Or use alcohol ear drops. WRONG. You need the wax. What happens is that once the wax is out of the ear canal you have the equivalent of dishpan hands of the ear canal. The ears itch and you scratch it in your sleep, then it gets infected. So, avoid this by filling the ear canal with baby oil before shower or washing the hair. This prevents irritation caused by soap and water and helps keep the ear canal properly oiled. If itching does start, taking one of the over the counter antihistamines such as Chlortimeton or Benadryl at night may stop the itch and prevent you from scratching the ear in your sleep.

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Eustachian Tube Blockage

Do you have Eustachian Tube Blockage?

In order to hear, we have an ear drum that vibrates with the sound and 3 little bones located in the middle ear that move back and forth in order to transmit the sound to the inner ear where the nerves are. In order for the ear drum and the bones to move properly, the middle ear space has have a pressure equal to that of the air outside the ear. But if you change altitude, the pressure outside changes and you have to adjust the middle ear pressure. This is done through the Eustachian tube (ET), which connects the middle ear to the nose and the outside. When people blow the nose too hard, this can close the ET. Any nasal congestion, swelling can do this. A growth in the back of the nose can press on this opening too. This is why we are concerned when the ET is blocked on one side without an obvious cause, we must look for the cause. Inhaled toxins can injure the ET system too.

With blockage, patients are aware that they can't hear as well; this is because the closure of the ET causes a vacuum to form in the middle ear that prevents the normal vibration of the ear drum. If this closure persists, the body tries to fill this vacuum and the normal air containing cells of the mastoid bone change to mucous making cells and give a condition called Serous Otitis Media or fluid filling the middle ear.

When the ET is blocked, a nasal decongestant such a Zephrex LA is useful. Proteolytic enzyme preparations with papin and bromelain (make sure you use a formula with calibrated enzyme activity) are especially helpful. Drink huge amounts of hot tea. The important thing is to be VERY gentle on trying to clear the ears because you can do more harm by forcing. You may hold the nose and try to gently force air out the ear. Or put your tongue to the top of the mouth and swallow. In my office we use the" cookie machine", a tank of helium with a nasal adapter. When the patient says "cookie" we deliver a jet of helium to inflate the ears.

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Tinnitus

 

Do you have Tinnitus (ringing in the ears)?

Ringing in the ears is a subjective symptom, a sound heard by the patient that cannot be recorded by today's instruments, much like pain. If it is very loud it can distract from sleep and thinking. It can be caused by Meniere's disease - an increase in fluid pressure in the inner ear. It is treated by reducing that presage. High blood pressure may cause tinnitus, and lowering the pressure is effective. Loud noise and associated hearing loss is a causal factor too. Large doses of aspirin and certain aspirin products may bring it on. Avoid these if they are the cause. Stress is not a cause, but once tinnitus becomes annoying the person feels stressed.


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Last Update 2003 October 8
Murray Grossan M.D.
ENTconsult@aol.com