Ears
Ears
In ancient Egypt married women who fooled around often found themselves with nothing from which to hang their earrings. That''''s right--they were punished for their indiscretions by having their ears hacked off.
It might have looked unsightly, but much worse, they were losing part of their sense of hearing. And most everyone would agree that not being able to wear gold hoops is a stroll along the Nile compared with missing out on music and laughter and conversation.
| Don''''t Pack the Wax We poke, prod and probe our ears in an effort to keep them wax-free, but have you ever stopped to ask yourself why? Ear wax is actually a good thing, notes Steven D. Rauch, M.D., assistant professor of otolaryngology at Harvard Medical School. It serves as a moisturizing agent for the ear, has antibacterial properties and keeps out things such as dust, dirt and bugs, he notes. In fact, the ear, which produces wax in glands located in the outer quarter of the inch-long ear canal, is a self-cleaning unit. Though many people use cotton swabs for wax control, Dr. Rauch is against it. "Using one in your ear is like muzzle-loading a cannon. You push all the wax down inside." But some folks do have more wax or very hard wax. This is especially likely if your ear canal is narrow or if you''''re on the phone a lot. Still, you should skip the swab and try this method to prevent build-up: Fill an eyedropper with full-strength hydrogen peroxide (available at pharmacies) and put a few drops in each ear. Repeat about once a week, suggests David Zwillenberg, M.D., otolaryngologist at Thomas Jefferson University Hospital in Philadelphia. "That keeps the wax soft so the ear will drain normally." Or use this variation of the same method: Soak a small cotton ball in hydrogen peroxide, place it in your ear to cover the opening to the inner ear, but don''''t stick it into the inner ear. Lie down on your side with your other ear on the pillow. Let the liquid seep into the canal, then turn over and treat the other ear. Wait five minutes and take a shower, cupping your hand to guide the warm water into your ear to rinse the peroxide out. |
The wondrous sense of hearing gets its start in the skin and cartilage of the outer ear, which collects sound waves and channels them to the eardrum, a fibrous, circular membrane separating the outer ear from the middle ear. The eardrum vibrates in response to the changes in air pressure that constitute sound.
From there the vibrations go to three small bones, called the malleus (hammer), the incus (anvil) and the stapes (stirrup), which form a chain across the middle ear. The vibrations travel to the inner ear, where the cochlea, a snail-shaped organ that''''s lined with 20,000 groups of minute sensory hairs, transmits sound to the brain.
Putting the Brakes on Earaches
You might say that ears are like the Carlsbad Caverns of the body. They tunnel into the sides of your head, marked by all kinds of formations, nooks, crannies and passageways.
Like any closed-off area, the ear is susceptible to poor drainage. Stagnant fluid, trapped in the warm, dark environment of the middle ear, is a good growing place for bacteria and viruses. The result: a middle ear infection and stabbing pain.
Although it''''s mainly children who get middle ear infections, adults sometimes get them following a cold or as a result of the change of pressure during an airplane flight, notes David Zwillenberg, M.D., otolaryngologist at Thomas Jefferson University Hospital in Philadelphia.
| Airplane Ears: When Flying Leaves You Crying For some people every airplane flight brings an experience as predictable as the little foil bag containing a teaspoon of roasted peanuts: an annoying, clogged-up feeling that grips your ears during takeoff and landing. It''''s not a life and death situation, but it sure is bothersome--especially if you''''re a white-knuckle flier to begin with. Not only that, it can be searingly painful. And the clogged-up feeling can last for a day or more afterward. The culprit in airplane ear is the eustachian tube, which connects the back of the throat to the middle ear, notes Anne Simons, M.D., assistant clinical professor of family and community medicine at University of California, San Francisco, and author of Before You Call the Doctor. To help keep the eustachian tube open, try yawning and chewing gum, suggests Dr. Simons. If those methods don''''t work--and you don''''t have a sinus infection--try this for an ear opener. Hold your nose closed, open the back of your throat as if you''''re yawning, bear down, then blow--but very gently. That forces air into the back of your throat and through your eustachian tubes. But you definitely don''''t want to try this if you have a sinus infection or think you might be getting one: When you bear down, you could force bacteria-laden mucus into your inner ear. |
If your ears feel full or if you lose some hearing because of an infection, the problems will generally last from 24 to 48 hours. But if problems persist, you may need to see a doctor about treatment. A bad infection can burst the eardrum. That causes the pain to stop completely, but there''''s a risk that the perforation will not close, possibly requiring surgery to fix it.
The inch-long ear canal leading from the outer ear to the eardrum can become infected by accumulation of water as well, resulting in an ear canal infection called swimmer''''s ear. While an outer ear infection usually will go away on its own, a doctor can prescribe antibiotic-corticosteroid eardrops.
How can you tell an outer ear infection from a middle ear infection? Give the earlobe of the offending ear a couple of yanks, notes Anne Simons, M.D., assistant clinical professor of family and community medicine at the University of California, San Francisco, and author of Before You Call the Doctor. "If it hurts like crazy, it''''s an outer ear infection."
If you''''ve been smarting over aching ears lately, here are a few tips from top docs.
Reach for alcohol. Rubbing alcohol is the perfect solution for wet ears, notes Thomas Pasic, M.D., assistant professor of otolaryngology at the University of Wisconsin-Madison. "After you swim take an eardropper, drop in the alcohol, then let it roll out. The alcohol dries up the water."
Blow it dry. Another surefire ear clearer is a blow dryer, notes Dr. Pasic. "Use a low setting--one that''''s comfortable. Aim the hair dryer at your ear until it''''s dry." But be sure to hold it far enough away that it just blows gently in your ear.
| Mend Thee Your Ears When you compose your wish list of body parts that you''''d change through plastic surgery, your ears would probably rank just before your feet. Who associates ears with beauty? Nevertheless, women do have them cosmetically altered. The most common ear plastic surgery is done on protruding ears, notes Darrick Antell, M.D., assistant clinical professor of plastic surgery at Columbia University and attending plastic surgeon at St. Luke''''s Roosevelt Hospital Center, both in New York City. Most often this type of surgery is done on children when they''''re over the age of five. But if it doesn''''t happen then, it''''s never too late. "I''''ve had young ladies come in who say that they''''re getting married and want to wear their hair up in a bun for the first time," he notes. The surgery is done by suturing cartilage from the back of the edge of the ear to the back of the ear--in effect, folding the ear back on itself. The cost starts around $2,500. Plastic surgeons can also do earlobe repair, which comes in handy if your lobes have been ripped by heavy earrings or when a pierced earring gets caught on something and part of the lobe gets torn off. (Yes, it does happen!) The lobe is sewn back up while you''''re under local anesthesia--a procedure that can be completed in the span of a lunch hour, notes Dr. Antell. |
Deep-six your Q-tips. Cotton swabs have done a lot of ear damage--and Dr. Simons says they''''re "a common villain in the outer ear ailment. Your ear canal is delicate; you can scrape off the skin deep enough to lose its barrier to infection," she notes. "You also push wax down inside, creating a plug in the canal that can trap water behind it."
Use tissue--with a twist. When you''''re done swimming or showering, dry out your ears with the twisted end of a disposable tissue, Dr. Simons suggests. "Unlike cotton swabs, the bit of tissue is too soft to push wax back into the ear or cause any damage to the sensitive skin inside the ear canal."
Pass the vinegar. White vinegar is a surefire ear soother, notes Randy Oppenheimer, M.D., clinical instructor of otolaryngology at the University of California, San Diego. "White vinegar has acetic acid, which helps clear up outer ear infections." Try squeezing in a few drops using an eyedropper--and then put cotton in your ear to hold in the vinegar, he suggests. You can remove the cotton after an hour or so. This treatment can be done several times a day.
Don''''t blow it. If you have a cold, blowing your nose too hard is a bad idea, says Dr. Simons. "You can drive bacteria-laden mucus into the middle ear." Try to blow your nose just hard enough to clear the outermost nasal passages. "If you take in a great big deep breath before you blow, you''''re probably blowing too hard."
Ease your pain. Take acetaminophen or aspirin for the discomfort of an ear infection, notes Dr. Simons. She recommends 650 to 1,000 milligrams every four hours.
Wringing Your Hands over Ringing Ears
You know the annoying, high-pitched tone they play every now and then on television and radio--followed by the announcement that "This is only a test"? Well, think how distracting it would be if that weren''''t only a test. What if that ringing tone were a daily part of your life, even when you slept or listened to Bach or walked by a stream.
That''''s how it is for people with tinnitus--a ringing, buzzing, whistling, hissing or clicking in the ear. If you have tinnitus, you''''re liable to hear these sounds whenever the background is quiet.
Tinnitus can be caused by frequent, prolonged exposure to loud noise. It can also accompany hearing loss--or you might get it when the outer ear canal is blocked with ear wax. Auditory nerve tumors, head injuries and certain inner ear disorders such as Ménière''''s disease can cause it, too. Other culprits are aspirin, some blood pressure medicines and a number of cardiac drugs.
Beginning without warning, and often lasting for years, tinnitus can be extremely upsetting. Because it''''s related to so many underlying medical conditions, your first step is to have a physician examine your ears, notes Dr. Simons. "It''''s worthwhile seeing if you have impacted ear wax or an infection," she says. The doctor will also check for hearing loss, since that''''s another tinnitus-linked condition.
| Knocked Off Balance--With Ménière''''s Imagine an attack of vertigo so severe that you fall to the ground--your stomach grinding, head spinning, feeling so nauseated that vomiting would be a relief. That scenario is a fact of life for people with Ménière''''s disease, a disorder of the inner ear that mainly strikes people over age 50. The onset of Ménière''''s is a signal that there is too much fluid in the membranous labyrinth, the inner ear canals that control balance. Along with fall-down dizziness, people who have Ménière''''s disease may also experience abnormal jerky eye movements, tinnitus and deafness. In most cases only one ear is affected. "About two-thirds of patients have attacks in clusters. It will go into remission for months or for years. Another third have it with no pattern," notes Steven D. Rauch, M.D., assistant professor of otolaryngology at Harvard Medical School in Boston. Ménière''''s disease can make you feel helpless. It has no known cure, but there are a few steps you can take on your own. Because the disorder has to do with fluid in your inner ear, the first line of treatment is to alter your body''''s fluid balance, notes Dr. Rauch. That means no caffeine and no alcohol as well as a strict low-salt diet that allows just 1,000 milligrams of sodium a day. "Buy all fresh foods, do all your own cooking and learn the sodium content of foods," he says. Also, over-the-counter medications can help people cope with the nausea that comes with an attack. Doctors recommend medications containing dimenhydrinate (such as Dramamine) or meclizine hydrochloride (such as Bonine), nonprescription medications for motion sickness and nausea that are available at most drugstores. |
If the racket won''''t stop, though, here are a few ways doctors say you can make the clicking, ringing or buzzing a bit more bearable.
Wear a white-noise aid. If you have persistent tinnitus, you might want to ask your doctor about getting a white-noise generator the size of a hearing aid, suggests Dr. Simons. The white noise--a tuneless, unvarying hissing--serves as a cover-up. "It masks external sound and makes life more bearable."
Park between stations. Inner ear noise can be most distracting at night when you''''re trying to fall asleep. You can turn on the radio between stations and let the static drown it out, says Dr. Simons. Or tune in your favorite radio station so it''''ll distract you until you fall asleep.
Avoid aspirin. High doses of aspirin cause tinnitis, says Dr. Oppenheimer. "Taking a few aspirin doesn''''t cause it, but if you do have tinnitus, it might be best to take Tylenol."
A Balancing Act
The ear brings us more than melodious harmonics, the honk of a Mack truck and the chatter of a jackhammer. It also contributes a sense of balance.
Without the ear we''''d be flopping around like fish on a pier. The semicircular canals located in the back of the inner ear contain hair cells that are bathed in fluid. Some of these cells are sensitive to gravity and acceleration, while others respond to the positions and movements of the head. This information is registered and sent via nerve fibers to the brain so that you always know which end is up.
If you start to feel woozy or queasy when you''''re riding in the back seat of a car or rolling over the bounding main in a ferryboat, you can blame it--at least partially--on your inner ear.
Motion sickness isn''''t just the curse of little kids who lose their lunches in the back seat of the car during a trip to the beach. It''''s a problem for anyone who gets conflicting messages from their body''''s balance system, says Steven D. Rauch, M.D., assistant professor of otolaryngology at Harvard Medical School.
"The balance system is your navigational system, which gets information from the eyes, inner ear and the bones, joints and muscles of the spine and the neck," he notes. "It all gets processed in the brain, where it''''s used to help you maintain posture and shift your gaze."
Problems arise when there''''s a mismatch between the information that comes to your brain through the different sensory channels. When you''''re belowdecks in a boat, for instance, the scene in front of you doesn''''t move, but your ears sense movement. That''''s when the classic motion sickness symptoms crop up: You break into a cold sweat, feel queasy and lightheaded and later progress to vomiting or dry heaves.
There are some tricks to keep your inner ear from pushing you to the outer limits of discomfort. Here''''s what doctors recommend to help make your travels nausea-free.
Get a front-row seat. While traveling find a seat with a good view of what''''s happening, notes Dr. Rauch. In a bus or in a car, your best position is the front seat where you can look forward out the window. If you''''re taking a train, be sure to take a seat that faces forward. On shipboard you may not be able to stay on deck the whole time--but the more, the better.
Make it a pressing matter. Try using an acupressure armband, suggests Dr. Rauch. These devices, available at sporting and boating supply stores, have a plastic button that presses the inside surface of the wrist. "It presses into an acupressure point that reduces nausea," he says. Or you can put pressure on that point by pushing your wrists together with a marble in between. The point you need to press is in the middle of your arm, two finger-widths down from the crease formed by your hand where it meets the wrist.
Go with ginger. Powdered ginger--taken in capsule form--has been shown to help reduce nausea and vomiting during pregnancy, according to a study of women in Denmark. Other research shows that the spice delays the development of motion sickness better than over-the-counter medication. And many people report good luck with ginger ale. Raw ginger has a powerful taste, but either the capsules, ginger ale or other foods such as gingersnaps and crystallized ginger--which you eat like candy--may help settle your stomach.
Go over-the-counter. An over-the-counter medication containing meclizine hydrochloride (such as Dramamine II) is an effective way to avoid the woozies, notes Dr. Oppenheimer. "If you''''re going on a boat trip, take it about half an hour to an hour beforehand."
Stop the Whirl, I Want to Get Off
If your head is spinning and you haven''''t just: (a) exited a stomach-churning carnival ride, (b) cartwheeled down Main Street or (c) seen Lucky Vanous''''s latest workout video, you might just have vertigo, a false sense of motion. Whether it''''s a bobbing up and down or a floating feeling or a force pushing you to the side or backward, this dizzying disorder can be maddening.
There are various causes of vertigo, often related to damage inside the ear. Sometimes these sensations can be traced to a disorder called labyrinthitis, an inflammation of the whole balance portion of the inner ear. Labyrinthitis is usually caused by a virus or a middle ear infection and gradually improves as you get over the infection. Far more troublesome than this passing problem is Ménière''''s disease, which is marked by attacks of vertigo severe enough to cause you to fall to the ground. (See "Knocked Off Balance--With Ménière''''s.")
Living with vertigo can be a challenge, but there are ways to help ease the unsettling effects. Here are a few well-balanced tips to help keep your feet on the ground.
Be fit. Make sure you exercise, says Dr. Rauch. To keep your muscles working well, you need to work on strength and flexibility. "One of your channels--the inner ear--is wrecked for some reason, so part of the therapy is to learn to compensate by using your other channels," he notes. Because good nutrition helps you stay fit, you should also eat at least five servings of fruits and vegetables every day.
Light up your life. It''''s hard to keep your footing when you have vertigo, particularly when you''''re walking in the dark. So you should keep things well-lit, suggests Dr. Rauch. "Put a night-light in the hallway to the bathroom." Also, try not to drive at night or walk on uneven surfaces that are poorly lighted.
Avoid crowds. If you''''re looking over a crowd at a shopping center, scanning a sea of bobbing heads, you might aggravate vertigo symptoms, notes Dr. Rauch. That can also happen when you''''re looking at a wide, unbroken expanse of terrain. "You''''re depending on your vision to anchor you in space since the inner ear is faulty. Wide-open places or crowded places can make that impossible."
Be a high-top woman. Running shoes might be good for jogging, but their thick rubber soles don''''t allow you to feel the floor, notes Dr. Rauch. His recommendation is "a hard-soled leather high-top that wraps around the ankle." That kind of shoe gives you a firm, secure feeling of where the floor is.
''''Ere''''s to Hearing Protection
The biggest cause of hearing loss is something you definitely can''''t avoid. It''''s old age. In fact, about 30 to 60 percent of people over age 60 have some kind of hearing loss, notes Dr. Oppenheimer.
The second biggest cause of hearing loss is as preventable as a pair of earplugs. Going to rock concerts, hanging around pistol ranges, working with heavy machinery--all these noisy activities take their toll on the delicate hairs of the inner ear, notes Dr. Rauch.
Being assailed by that kind of noise is like walking on the same grass over and over again, according to Dr. Rauch. For a while the grass bounces back, but constant wear kills it eventually. "It destroys the sensory cells in the inner ear. They''''re brutalized by the intense vibrations of loud noise, and they just wilt."
So how do you know if you''''re becoming hard-of-hearing? Chances are, someone close to you, such as your husband or best friend, will notice it first. But if you find that you have to keep asking people to repeat themselves, or if you''''re always the one turning up the stereo or television, or if you think everyone else is mumbling, you''''ve discovered three sure signs that your hearing is slipping.
If you don''''t want "What did you say?" to become your catchphrase, follow this prevention advice from doctors.
Know dangerous noise. If an area is so noisy that you can''''t even hear someone who''''s standing an arm''''s length away from you, it''''s time to put in the earplugs, notes Dr. Pasic. "The chances are that it''''s too loud, and it''''s hurting your ears."
Guidelines from the Federal Occupational Safety and Health Administration say that you should wear protection if you''''re exposed to a noise level around 80 decibels for eight hours a day. That''''s about the level of a symphony concert. According to the same guidelines, you should wear ear protection if you''''re exposed to 85 decibels for four hours, 90 decibels for two hours or 95 decibels for one hour. Those racket levels are the equivalent of a snowblower, a rock concert or a power saw.
| Holey Earlobes! Getting your earlobes pierced used to be a rite of passage. Around age 16 you''''d pester your mother into letting you get two extra holes in your head--one for each earlobe. But today, piercing has gone north--all the way up into the ear cartilage. This painful-sounding trend has women sporting enough earrings to set off metal detectors--something that doctors such as William Hendricks, M.D., a dermatologist in private practice in Asheboro, North Carolina, do not recommend. "Don''''t do it," he notes. "There''''s a high chance that you can develop problems with the cartilage of the ear. You might get infections that could become very severe." A serious infection of the cartilage can cause collapse of the ear on the site the infection occurs. Another potential ear splitter is heavy earrings--the ones that resemble hubcaps and over time can tear the earlobes. Often the heavy wire earrings will pull through the lobe and cause a split, notes Dr. Hendricks. Or if you wear heavy post earrings, the back that holds the earring in place can eventually work its way through the front of the ear, he adds. One way you can help prevent  this is to make sure that your earring backs also have those round, plastic disks attached. In the case of a split earlobe, a doctor can sew it back together in her office in about 15 minutes. Dr. Hendricks''''s advice: "You should wear lightweight earrings that don''''t put lots of tension on your ears. You have to be careful about how large they are, because you could snag them on sweaters, babies can pull on them and talking on the phone can cause pressure that pulls them down." Post holes for earrings should be in the lobe--the "dangling" part of the ear shown below the dashed line. |
Pick your protection. Both earplugs or bulkier earphones are effective at blocking out sound, notes Dr. Pasic. Earphones are better at keeping sound out, but earplugs are more convenient and less obtrusive, and they work very well, also, he notes.
There are two types of earplugs: the foam ones you roll up and put in your ears and the rubber ones, which are slightly more effective. "What''''ll save a person''''s hearing is if she uses any at all," Dr. Pasic notes. "So use whatever''''s most convenient for you."
Tone it down. Try to resist blasting your ears with a personal stereo, notes Dr. Rauch. "Keep the level low enough so that others can''''t hear sound coming from the headset. Otherwise, it''''s up too loud and could cause damage."
Put yourself in check. Any bothersome ear problems should be seen by a doctor, pronto, notes Dr. Pasic. Symptoms of drainage, blockage, hearing loss, dizziness or ringing of the ears are all reasons to go to the doctor.
See also Nervous System
