The following are some common problems which
patients have. Always consult a physician if any problem
persists for more than a few days.
Ear Pain: Fifty percent
of ear pain is not from the ear. If the pain is from the ear,
there will usually be a hearing loss or the ear will be tender to
the touch. If there is not, consider the following:
In my experience ear pain is commonly
caused by arthritis in the jaw or TMJ pain. For this you
should consult a dentist or oral surgeon. Also, cervical
disk disease has been implicated in causing ear pain. A
neurosurgeon can be consulted to evaluate for this condition.
If the pain is sharp and fleeting
this is often caused by musculoskeletal problems.
If the pain is dull and persistent. You may have sinus
disease, a sinus or throat tumor, tonsillitis or a number of
other ear, nose and throat disorders which can refer pain to the
Itching Ears: In my
experience this is often caused by an ear fungus.
Over-the-counter lotrimin or tinactin solution may be helpful if
placed in the ear two to four times a day. Do not use this
medication if you have a hole in your eardrum.
Ear Wax: This is a
normal finding. In fact, patients with no ear wax are often
miserable and have dry itchy ears. Too much wax can block the
ear canals. DO NOT USE ear candles or Q-tips. Neither
one can remove wax. Q-tips will push the wax further into the
ear canal and impact it, making it harder to remove. There are
over-the-counter drops which can dissolve and wash out the wax.
Ask your pharmacist about these. If your ears stay blocked or
start to hurt, consult an ear, nose and throat doctor.
Ear Ringing: Ringing may
be hissing, buzzing or a cricket sound. This is most often
caused by a hearing loss.
However, if the sound pulsates
with your heart you may have a blockage in your carotid artery
(the large artery going to the brain), a heart murmur or rarely
a vascular tumor next to the ear. Other signs of concern
is if the ringing is louder or only in one ear. This can
be a sign of a unilateral or asymmetrical hearing loss.
Ear growths such as an acoustic neuroma can cause this and
patients need to be to be evaluated to make sure they do not
have this benign tumor.
The best treatment is to mask the
sound with a fan or air filter at night. A hearing aid may
also help. Often the sounds are produced in the brain from
spontaneous firing of the nerves. When nerves are not
stimulated, they fire spontaneously. The same happens to
the auditory nerves in the brain when they do not receive
stimulation because of a hearing loss. Exposing the ears
to sounds may not only mask the tinnitus but actually decrease
it by stimulating the auditory nerves in the brain.
Dizziness: There are
many causes of dizziness besides the ear. If the dizziness is
a sensation of motion especially if associated with ear ringing,
pressure or hearing loss a visit to an ear, nose and throat doctor
is warranted. However, if it is light headedness, loss of
control of the body, or passing out you may have a heart or vascular
problem or even a neurological problem such as a brain tumor.
In this case, consulting your family doctor first is the best
Lump in the Throat:
This is often caused by gastroesophageal
reflux disease or GERD. Some patients with reflux do not have
any heartburn or chest discomfort. Their only symptoms are
those which occur when the stomach acid causes muscle spasms in the
include the avoidance of spicy foods, elevation of the head of
the bed at night and avoid eating and drinking for two hours
before retiring at night. Also, over-the-counter antacids
or prilosec may be helpful. You should consult a doctor
immediately if there are any persistent symptoms, chest or arm
pain. GERD and heart disease can have similar symptoms and
should not be confused.
Other danger signs
which need to be evaluated by an Ear, Nose and Throat Doctor:
- Sudden onset of
paralysis of the face.
lasting longer than two weeks.
- Neck mass or
bump lasting longer than two weeks.
- Nonhealing sore
in the mouth or on the skin.
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