Question: Recently I had grommets placed in my ears. While the drainage system seems to work, I still suffer a heavy hearing loss, despite Sudafed and ear drops. Is there any solution?
Grommets are tiny tubes that are placed through the ear drum to allow air to pass from the outer ear to the middle ear. The middle ear is connected by the Eustachian tube through the center of the head to the back of the nose. This allows the air pressure in the middle ear to equalize with that in the outside air (popping of the ears) when you change altitude by going up or down a hill or in an aircraft.
If the Eustachian tube becomes blocked by phlegm from the nose, pressure can build up in the middle ear to cause discomfort, or with altitude changes, the phlegm may be forced up the Eustachian tube and into the middle ear where it settles as a thick substance known as ‘glue’ (thus a ‘glue ear’). The glue reduces the vibrations of the eardrum and the tiny bones that transmit sounds across the middle ear to the hearing mechanism in the inner ear, causing varying degrees of deafness.
A grommet is inserted through the eardrum to allow air into the middle ear and the increased air pressure will very gradually push the glue back down the Eustachian tube to the nose, eventually clearing the ear. The grommet will be expelled naturally from the ear drum as it heals after a few months. Not until the grommet is expelled will hearing return to normal. Sudafed reduces the amount of new phlegm being produced in the nose, while ear drops can do many tasks, depending on the type of drop, but many ear drops should be avoided while grommets are in place.
If you are continuing to have problems you should see your GP so that the amount of glue in the middle ear and the position of the grommet can be assessed, and the need for ear drops and further Sudafed determined.

Question: My ears are ringing all the time, and when I get nervous or tense they get worse. How can I help this?
Noises in the ears are a common curse that becomes more common the older you are. Many patients are plagued with such noises to the extent that they are unable to lead a normal lifestyle. The first step in treatment is to be thoroughly examined by your doctor to exclude any disease such as high blood pressure, wax in the ears, or an overactive thyroid gland, which may be responsible for the noise. You should also avoid possible aggravating causes such as coffee, tea and cola drinks.
After this, it is often wise to seek a referral to an ear, nose and throat specialist, or a general physician, for more detailed investigations. Unfortunately, in all too many victims of tinnitus (the technical name for ringing in the ears), no cause can be found, and the next step is to experiment with the many different medications that may relieve your problem. This is very much a matter of trial and error, that must be carried out with the cooperation of your GP, as most of these medications require a prescription, and some may have side effects. None has a better than 30% success rate, but they should be tried in turn to see if any help.
Finally, it is possible to use a hearing-aid type device called a tinnitus masker that produces a constant tone to drown out the noises you hear, or have an operation to deafen the involved ear. When tinnitus is combined with dizziness and deafness, the condition is called Meniere’s disease.

Question: I keep getting ear infections, and I’m sick of running to the doctor. Can I treat an ear infection myself?
NO! Once you have an ear infection it is important to obtain medical attention as soon as possible. This is because untreated infections can spread throughout the ear and cause a more serious infections in surrounding tissue.
Treatment of an outer ear infection involves cleaning the ear of any wax or debris (don’t try to do this yourself either) that may be present in the canal, so that the ear can dry out. Antibiotic drops or ointment are then prescribed. In difficult cases, a wick (piece of light material) soaked in an ointment may be put in the ear, and antibiotic tablets may be given.
Middle ear infections always require antibiotic tablets, and constant medical supervision to ensure that the infection has cleared and no damage has been done to the ear. It is important that anyone with recurrent infections is treated adequately, because each infection can injure the ear and eventually cause permanent damage.

Question: What causes ear infections in children every summer ?
Summer is the time of year when children seem to live in swimming pools, and often seem to spend more time under the water than on the surface. The most significant medical problem associated with this phenomenon is otitis externa, or swimmer’s ear. With this disease, the outer ear canal and the outer surface of the ear drum become infected and very painful. It may occur under many circumstances, but by far the most common is retained water in the ear canal.
Bacteria normally live in the outer ear, but if the canal remains constantly wet, the type of bacteria can change from the good ones that are meant to be there, to a type that can cause tissue damage and infection. Water of any type can start this infection, but sea water is less likely to be a problem. Hot spa baths (particularly public ones) and swimming pools are the worst causes.
Private facilities are less likely to cause problems than public ones, not because the public pools and saunas are poorly cared for, but because far more people use them and introduce more bacteria. Warm water is also a greater problem than cold. Another common cause of outer ear infections is wax. Excess wax will aid the retention of water in the ear, and itself can cause infections under hot and sweaty conditions.
Middle ear infections may also be responsible for the sudden onset of severe ear pain in children. These are more serious than outer ear infections, and often occur at the same time as a cold or runny nose due to blockage of the tube that drains from the middle ear to the back of the nose (the Eustachian tube). Medical attention is essential for these infections, because if left untreated permanent damage to the ear may occur.

Question: What are the causes of earache?
There are hundreds of causes. The most common is infection of either the ear canal (eg. swimmer’s ear), or the middle ear. These can develop very rapidly, and one of the most common causes for a 2 am call in general practice is the rapidly developing ear pain from an infection.
Infections of the sinuses may also cause ear pain, as may a blockage with phlegm of the fine tube that leads from the middle ear to the back of the nose. If you fly or climb a mountain with this eustachian tube blocked, the air in the middle ear will be at a different pressure to that outside, the ear drum will become distorted by this difference in pressure, and pain will result. A common cold may be all that is necessary to cause this blockage.
The bones around the ear may sometimes become infected and cause earache, and the jaw joint which is just in front of the ear will cause ear pain if it becomes inflamed or injured. Impacted ear wax is another common cause of ear pain. Dental disease can cause ear pain, and vice versa. Dentists often refer patients to a doctor for treatment of their ear or sinus condition after they have initially seen the dentist for toothache. The list goes on and on, so anyone with an earache will need assessment and treatment by a doctor (or dentist!).