15 secrets about your hearing

It’s easy to take our sense of hearing for granted, but many people suffer damaged or restricted hearing during their lifetime. Angela King explains how to take care of your ears

1    An ache usually means an infection
Earache is a sign you have inflammation or an infection in your middle ear (otitis media). This cavity behind the eardrum can sometimes become inflamed after a sore throat, bad cold or congestion. When the ventilation tube between the middle ear and back of the throat (the Eustachian tube) becomes bunged up, the middle ear is not ventilated and fluid can build up, encouraging infection. Allergies can cause middle ear inflammation or worsen it.

2    You should keep an eye on sticky ears
Glue ear is the name given to persistent middle ear inflammation, usually in children, where the fluid that builds up becomes sticky and can’t drain away. In most cases it goes away on its own, but repeated bouts can even cause deafness. In persistent cases, grommets, tiny artificial ventilation tubes, are inserted to treat it. A small hole is made in the eardrum to drain fluid and then the grommet is put in place. Over time the drum heals, pushing out the grommet, and hearing should return to normal.

3    Using swim plugs is a good idea
Swimmer’s ear, or outer ear infection (otitis externa), occurs in the ear canal. It happens if you swim in water contaminated by bacteria or, in the case of swimming pools, when the ear is exposed to too many chemicals. Using swim plugs is a good idea if you are prone to this or worried about it, as plugs prevent the water getting into the ear canal. The symptoms are itchy ears or, in bad cases, a discharge. Don’t poke around in your ear – go to your GP who can use an otoscope to look in your ear.

4    Dizzy spells can be ear-related
If you experience sudden bouts of dizziness, it could indicate a balance problem related to the inner ear so see your doctor, especially if you are middle-aged. A new study published in the Archives of Internal Medicine shows men and women aged over 40 are 12 times more likely to have a fall because of inner ear dysfunction that throws them off balance. People with diabetes are also susceptible because high blood sugar levels can also damage cells and blood vessels in the inner ear. This can affect both hearing and balance. Yoga and Body Balance exercise classes can help you improve your balance.

5    Ear wax is a great natural cleanser
Ear wax is wonderful! Made in the ear canal, it is the ear’s natural method of self-cleaning and protecting itself. It works by trapping dust and dirt, which it gradually moves to the outside of the ear.
Some people’s ears make more wax than others, but it usually only causes a problem if it is poked down into the ear (by using cotton buds, for example). Pushing it back into the ears can also cause it to put pressure on the eardrum, which affects hearing and can even damage the drum.
Excess ear wax can become hard and compacted if it has been poked down into the ear. To soften and release it, use a dropper of warm olive oil (which is a non-irritant) every day for a week or two. This has to be done before you go to your doctor because the wax will need to be softened before it can be safely removed. Your doctor or practice nurse may syringe your ear to remove the wax, or may send you to an ear, nose and throat clinic to have it removed by microsuction. This uses a thin tube inserted into your ear to gently suck out any excess wax.

6    Surfing can give you bony ears
Surfer’s ear can be a result of swimming regularly in cold water, surfing or wind surfing, and can cause extra growth of the bony part of your ear canal to protect the eardrum. Usually it does not cause any major problems, but in more advanced stages it may trap extra wax or affect your hearing, and will then need treatment.

7    Your ears help control your balance
Vertigo is another word for dizziness, not to do with fear of heights as many people think. It specifically means rotatory dizziness, such as when the room spins round. The link with the ears is that the organs of balance are in the inner ear. The cochlea, a spiral hollow tube coiled like a snail, is the innermost part of the ear (see picture, below). The sensory cells here pick up sound as vibration and send messages to the brain so we ‘hear’. Alongside the cochlea are semi-circular canals that deal with balance. These hooped tubes are filled with fluid and point in different directions, sending information to the brain about the position of your head and the direction your body is moving in. Vision and ‘proprioception’ (a feedback system from the muscles about the body’s limbs and position) also work with the inner ear to control balance.

8    Beware loud noises
A perforated eardrum is one that’s been torn or ruptured. A loud noise such as a bomb can burst eardrums, as can huge pressure changes in an aircraft, or when diving. Severe middle-ear infections can also cause perforation of the eardrum, as can accidents with cotton buds! Small surgical holes in the drum, such as for insertion of grommets, will heal on their own, but a large perforation could cause permanent damage.

9    Popping’ is all about the pressure
Popping in the ears is to do with pressure. For the eardrum to vibrate freely in response to sound, pressure needs be the same either side of it. In some situations, such as during a change in air pressure in the cabin of a plane, you might experience popping. It happens because the middle ear has no time to equalize the pressure, especially if the Eustachian tube (see point 1, above) is congested. By swallowing or yawning, you open the tube, allowing the pressure either side of the ear drum – that’s outside in the ear canal and inside, behind the ear drum – to equalise. The eardrum relaxes back into its normal position, and you hear or experience the ‘pop’ in your ears.

10    The right headphones are vital
Personal music players (MP3 players or iPods) become really risky to hearing when used in noisy situations such as on trains and in cars, or if there is background noise at work. That’s because we turn up the volume to dangerously high levels without realising, to hear music over background noise. Using specialist ear inserts, or headphones that exclude external noise, will protect hearing because you won’t need to turn up the volume so high.
Taking antioxidant supplements may also help protect hair cells in the ears. These need a lot of energy to work, and this energy production releases potentially damaging free radicals. In American studies, giving MP3 users a supplement of vitamin E and aspirin prevented hair cell death after exposure to loud music. Animal experiments had similar success using a cocktail of vitamins C, E and betacarotene.

11    If you have to shout, it’s too loud
Protect your ears from noise to slow down hearing loss. As a rule of thumb, if you are frequently in a noisy place where you have to shout to be heard by someone who is just two metres away, your hearing will be damaged sooner rather than later. Similarly, regular clubbing or listening to music so loud it makes you literally feel the vibrations, will almost certainly damage your hearing over time or give you persistent ringing in the ears (see below).
At loud music venues wear ear protectors – they enable you to hear the music clearly, but not so loudly. Give your ears a break for five to 10 minutes every hour so they can recover a bit. Stand away from the speakers in pubs and clubs. Go to RNID’s www.dontlosethemusic.com for more info.
If you work in a club, bar or in any job that exposes you to loud noise, your employer has a legal obligation to protect your hearing, according to the Health & Safety Executive (www.hse.gov.uk/noise).

12    Everyone suffers some hearing loss
The rate of hearing loss as we get older varies between individuals. Everyone starts to lose some higher pitched sounds from as early as their 20s, but very gradually. For many people, older age means they cannot hear the higher frequencies in speech – so they find it difficult to follow conversation and assume everyone is mumbling. Hearing aids can help by amplifying the sounds that someone finds difficult to hear. This can make a huge difference to everyday conversation, meetings and social life, but no hearing aid – however sophisticated – will make everything perfectly clear, especially if there is a lot of background noise.

13    Learning to relax helps with tinnitus
Tinnitus or ringing in the ears affects lots of people after a night out at a music venue, but they recover from this temporary type of tinnitus. However, repeated exposure can result in loss of hearing. Tinnitus for many people means living with a permanent whistling, buzzing or ringing in the ears. There is no cure, but it can be successfully managed so that it becomes less distressing. Learning to relax and control stress is helpful and products creating a low level of pleasant background noise can help with sleep problems because it’s nicer to listen to a noise outside than inside your head. For help with tinnitus, visit www.tuneouttinnitus.org.uk or call the RNID tinnitus helpline on 0808 808 6666; you can also text on 0808 808 0007.

14    Crackling noises can mean damage
Crackling noises in the ears can be a result of impacted wax or debris near the eardrum vibrating in response to external loud sounds. It may also be caused by a previously damaged eardrum responding to sound waves by vibrating in an abnormal way.

15    Never poke around inside your ear
If any small objects get into the ear, they should be left alone. See your doctor to have the item removed safely. If you try yourself, you risk causing permanent damage.

How your ear works
The part of your ear that you can see collects sound waves and directs them down the ear canal to the eardrum, making it vibrate. Behind the eardrum, in the middle ear, are the three smallest bones in the body, the ossicles, which form a chain to carry the sound waves through to the cochlea in the inner ear.
The cochlea is a tube coiled like a snail and on the inner membrane are thousands of sensory ‘hair’ cells that detect sound vibrations. They are not really hairs, but cells with tuft-like protrusions.
These cells trigger nerve signals that transmit information about sounds to the brain, and it’s these cells that are damaged by loud noise. If they are hit by too much energy (i.e. sound vibrations from noise), they become damaged and may die.
Extremely loud noise such as explosions may even blow the cells apart, but in most cases of hearing loss they gradually die over time.

Test your hearing
If you think that you have a hearing problem, RNID’s hearing check takes five minutes – visit www.rnid.org.uk/hearingmatters or check your hearing by calling RNID’s telephone hearing check on 0844 800 3838.

Expert: Angela King is an expert on how to protect your hearing and keep your ears healthy. She is senior audiologist with the Royal National Institute for the Deaf (RNID), the charity working to change the world for the nine million people in the UK who are deaf or hard of hearing. More information at www.rnid.org.uk.

Compiled by Janette Marshall