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Myth: To clean my ears, only cotton swabs, keys, or my fingers work
Truth: Do not put anything in your ear that is smaller than your elbow
Many people think that ears must be cleaned like our bodies to remain healthy. While ears do need to be kept clean, they actually clean themselves. How? The skin of the ear canal (cerumen) migrates outward and acts as a protector of the delicate eardrum. Many times, prodding, poking, or picking at this material pushes it back in, causing blockage and potential temporary hearing loss ??or even accidental puncture of the eardrum. In that event, a serious injury to the hearing bones can result in the need for emergency surgery.

And if itchy ears are often incorrectly relieved using cotton swabs the repeated scratching can cause a thickening of the ear canal, much like a callous. This pushes wax even deeper into the ear canal.

But some ear canals don?t remove the wax like they are supposed to ??they are too narrow, so the natural cleaning process cannot do its job. In this case, ear wax accumulates. So how do you know if your ears are cleaning themselves properly?

If your ears are not clean, they may feel gummy and you may be tempted to grab that cotton swab or key. And if wax completely obstructs your ear canal, you may experience hearing loss. But don?t take matters into your own hands! Visit your ENT (Ear, Nose and Throat) doctor, who can safely remove the wax build-up.

But if you want to try alleviating the wax at home, gently clean the outer portion of your ear canal with a wet washcloth. If your ear still feels blocked, you should call your doctor and have the cerumen removed.

The next best thing is to gently irrigate the ear canal with 3% hydrogen peroxide, using a small rubber ear syringe. Then dry the ear canal with a hair dryer set on a medium temperature; hot temperatures can cause temporary dizziness due stimulation of the balance canals.

Myth: If my ear hurts, I must have an infection
Truth: Pain is usually caused by something less severe
One major cause of ear pain is inflammation of the temporomandibular joint (TMJ). The TMJ joint lies adjacent to the ear canal. Because of this close proximity, many of the same pain nerves are shared.

Swimmer?s ear (External Otitis) is another common cause of ear pain. It?s the result of the ear canal becoming and staying wet. This warm, wet, and dark environment is the perfect place for bacteria and fungus to live and multiply, causing an infection.

Another cause of ear pain is otitis media, an infection in the middle ear. This infection occurs after an upper respiratory infection reaches the middle ear, via the Eustachian tube.

Neuralgia, an inflammation of the nerves around the ear, can cause excruciating pain that feels like jabbing or stabbing inside the ear.

So how do you know what?s causing your ear pain?

TMJ is indicated if you press on the jaw joint while opening and closing the mouth and its hurts or is tender. A swimmer?s ear infection may be your problem if gently pulling on your outer ear hurts.

Otitis media and neuralgia are generally accompanied by sharper pain originating deeper in your ear. Otitis media is normally accompanied by pus draining into your ear canal through a perforation in the ear drum.

By now you?re wondering, Can I treat any of these problems myself?

Although TMJ inflammation should be managed by a dentist, you can temporarily relieve the discomfort by eating a soft diet; placing a warm heating pad on the affected jaw joint twice daily; or by taking anti-inflammatory medications. But if the pain still persists after a few days of home treatment, you must consult a dentist that specializes in TMJ pain.

Swimmer?s ear can be prevented by filling the ear canals with rubbing alcohol after every swim. Let it site for a couple of minutes, then draining the alcohol and dry your ears with a hair dryer set on medium temperature. Once swimmer?s ear infection occurs there can be a tendency for recurrence when the ear gets wet. Then it is even more important to treat your ears with alcohol after each and every swim.

If your pain is significant and comes from deep in your ear, you should seek treatment by an ENT doctor right away. Using special instruments, your doctor will clean the ear canal and prescribe antibiotics (either drops or oral medication) to eliminate any infection.

Myth: Popping my ears is dangerous
Truth: Popping your ears is rarely dangerous
While you can have problems with your Eustachian tubes ??the part of your ear that ?pops????rarely is the act of popping them the problem.

So what are some of the problems you might encounter with your Eustachian tubes?

One is blocked Eustachian tubes. The Eustachian tubes connect the middle ear cavity with the throat, aerating the middle ear when you swallow and draining mucous and secretions from the middle ear into the throat. Often a cold or sinus infection will cause the Eustachian tube membranes to swell. When this happens the Eustachian tube is not able to function, causing pressure and stuffiness in your head. Your hearing may feel diminished, and fluid may accumulate in the middle ear.

Another potential problem is abnormally open (patulous) Eustachian tubes. This is an uncommon cause of ear stuffiness and usually occurs when someone loses weight. When your Eustachian tube is open it can cause the sensation that your voice is loud or has an echo (autophony), like you are inside a drum. It may also cause a sensation of hearing air ?whoosh??when you breathe through your nose.

So how can you tell if you have blocked or open Eustachian tubes?

Pinch your nostrils closed and blow hard against them. If you cannot ?pop??your ears, your Eustachian tubes are likely blocked by swelling of the mucus membranes. However, if you suddenly feel pressure relief you?ve probably just opened your Eustachian tubes and equalized the middle ear pressure with ambient air pressure.

This maneuver can be performed many times throughout the day to relieve blocked Eustachian tubes. There is no danger of harming your ears with this technique, but if you get dizzy you should see your ENT (Ear, Nose and Throat) doctor.

To diagnose open Eustachian tubes, sit down and bend forward completely at the waist, putting your head between your legs. If the pressure and stuffiness in your ear disappears you have open Eustachian tubes. Lying flat in bed will relieve the symptoms of open Eustachian tubes.

If popping your ears, bending forward from a seated position, or lying down do not relieve your ear pressure, your problem may be due to increased inner ear pressure and should be evaluated by an ear specialist.

If you have blocked Eustachian tubes over-the-counter medications such as decongestant nasal sprays can help shrink the membranes, relieving pressure in the ears. Flying in an airplane, skin diving, or scuba diving should be avoided if there is blockage of the Eustachian tube, as landing or descending in the water will result in severe pain in the ears. If you must fly, taking Afrin nasal spray (two sprays to each nostril) and a 30mg Sudafed tablet one hour before descending. This will help open your Eustachian tubes, helping prevent ear pain. If symptoms persist, you should contact your ENT doctor.

Depending on the cause of your open Eustachian tube, your ENT doctor may recommend several different treatments. Treatments for increased inner ear pressure include prescribing diuretics or office surgery to deliver steroids to the inner ear.

Myth: Loud noises won?t hurt me because I?m young
Truth: Loud noises can damage anyone?s hearing, no matter their age
Damage to the ear can occur from exposure to loud noises like guns fire near the ear, industrial sounds, lawn and construction equipment, and music played too loud ??especially via headphones.

But how do you know if you have hearing damage? If you experience ringing, stuffiness, or hearing loss after noise exposure, damage to the delicate cells of the cochlea has probably occurred.

Unfortunately, most hearing damage is permanent, so the best treatment is prevention. Ear protection should be worn in any noisy situation:
??loud work environments
??when using power tools and noisy yard equipment
??during firearm use
??when riding a motorcycle
??when exposed to loud music at concerts

But hearing protection doesn?t have to be bulky or ugly. Today?s ear plugs are practically invisible, and ear muffs can blend in if worn in the winter. Custom molded ear plugs are also available to ensure an optimal fit in the ear canal. Additionally, some personal listening devices have volume limits, preventing excess noise exposure.

The good news is that for some cases a short course of steroids may reverse acute hearing damage.

Myth: There is no treatment for tinnitus; I just have to live with it
Truth: Many treatments can help tinnitus sufferers
Tinnitus is a very common hearing-related complaint ??upwards of 50 million American adults have some degree of the hearing disorder. Tinnitus occurs as the little hair cells in the cochlea die, causing noise or ringing in the ear.

Although this ringing is not a serious problem, people experiencing it should be evaluated by an ENT doctor because it can indicate a more serious medical problem. When you are evaluated for tinnitus, your physician will perform special tests to determine the cause and recommend treatment if necessary.

So, what kinds of treatments are available for those with tinnitus? Currently several treatment options exist, including
??Masking tinnitus with outside noise such as music or TV. If the tinnitus is accompanied by hearing loss, a hearing aid can increase outside noise, reducing the intensity of tinnitus.
??Low-salt diet.
??Electrical stimulation.
??Stress reduction.
??Bio feedback.
??Zinc, Ginkgo, garlic pills, and supplements including high level antioxidants.
??Brain retraining, in which a therapist works with you to train your brain not to hear the tinnitus.

Also, knowing that tinnitus is not a life-threatening problem may help you cope.

Myth: My parents went deaf, so I am bound to go deaf, too
Truth: Heredity is a factor in hearing loss, but not a certainty
Hearing loss is a combination of many factors: exposure to loud sounds, general health, heredity, and age. We are genetic products of our family, and hearing loss is no exception. And as we age, the tiny hair cells in the cochlea that lie closest to the middle ear begin to die, resulting in a high-tone hearing loss. But no one factor plays a more influential role than the others, so no one is ?doomed to deafness.??/p>

Normally a gradual process, hearing loss can occur quite suddenly ??even overnight. If you suddenly notice that you can?t hear out of one ear, it is a medical emergency. Put the phone up to your ear; if you can?t hear the dial tone, see an ENT specialist as soon as possible. Hopefully it is just ear wax blocking the ear canal, but you need to visit an ENT to find out for sure.

Signs of more gradual hearing loss include
??Needing to turn the TV or radio turned up louder than other family members
??Asking people to repeat themselves all the time
??Your spouse says you don?t listen to him or her
??Sounds muffled, or distant
??You have trouble hearing from a cellular telephone

While hearing loss is certainly disappointing and inconvenient, it can be treated. Examination by an ENT doctor is necessary to make the correct diagnosis. This usually includes a hearing test and other special ear tests.

Once a diagnosis is made, treatment can begin. Treatment for sudden deafness is done with steroids either taken orally or placed directly into the ear. Additionally, a hearing device may be needed.

Treatment for the more common, progressive hearing loss that can reduce symptoms and effects includes a four-part program of healthy life style changes, including
??At least 30 minutes of daily exercise,
??Vitamin and mineral supplements,
??A healthy diet of veggies, fruits, whole grains, fish and lean meat, and
??Protection from excessive noise exposure.

Myth: There is no treatment for deafness in one ear
Truth: Two successful treatments exist for hearing loss in just one ear
There are two hearing devices that allow a person to hear from a deaf earCROS and BAHA.

CROS (Contra Lateral Routing of Signals) or Bi-CROS is a hearing aid that uses microphones to pick up sound from the deaf ear and transmit it to the hearing ear. As a result, the CROS aid allows sound to be heard from all directions, and even allows a telephone to be used in the deaf ear.

BAHA (Bone Anchored Hearing Aid), or bone stimulator, picks up sound from the deaf ear and transmits it through the skull to the hearing ear. Minor surgery is required to implant a titanium screw behind the ear, serving as an anchor for the external processor, which holds the device. The results are excellent.

Herbert Silverstein, MD, FACS is president and founder of the Florida Ear & Sinus Center and the Ear Research Foundation, in Sarasota, FL. He has been consistently recognized since 1979 as one the "Best Physicians in the USA." He has been a leader in Meniere's Disease treatment for more than 25 years, developing surgical and diagnostic procedures; inventing instruments (such as the Microwick); teaching medical students, residents and fellows; and helping people from all walks of life.