Earache (otalgia) and middle ear infection (otitis media)
Earache often comes from inflammation of the middle ear, frequently after an upper respiratory infection. Typical signs are pressure, throbbing pain, muffled hearing and sometimes fever. If fluid runs out of the ear, the eardrum may have perforated.
Pain felt in the ear can also come from outside the ear: the teeth, the jaw joint, the tonsils or the neck. For that reason the whole ear, nose and throat area is assessed at the appointment.
Hearing loss and sudden hearing loss
Hearing can decline slowly or drop suddenly. A sudden, usually one-sided hearing loss without an obvious external cause is called sudden sensorineural hearing loss; it is often accompanied by pressure in the ear, tinnitus or dizziness.
A sudden hearing loss should be examined within days, not weeks. The examination distinguishes whether the cause lies in the ear canal, the middle ear or the inner ear.
Tinnitus (ringing in the ear)
For tinnitus, the ear canal and eardrum are examined and a hearing test is always part of the assessment, because tinnitus is often linked to hearing loss. Blood pressure, medication, noise exposure, the jaw joint and neck muscles are discussed as well.
One-sided, pulsating or sudden tinnitus, and tinnitus with hearing loss, may lead to referral for further diagnostics. The practice does not promise to remove tinnitus; the aim is to clarify the cause and to give factual advice on what can be done.
Blocked ear, earwax (cerumen) and pressure in the ear
A blocked ear is often caused by earwax, by water after swimming, or by poor ventilation through the Eustachian tube during a cold, an allergy or after a flight. The ear feels dull and your own voice sounds louder.
Earwax is removed under direct view with the ear microscope, using suction, a small hook or irrigation depending on the findings. Cotton buds tend to push wax deeper into the canal and can injure the skin.
Outer ear canal infection (otitis externa), swimmer's ear
Inflammation of the outer ear canal causes itching, pain when the ear is touched and swelling of the canal. Moisture after swimming, cleaning attempts with cotton buds and skin conditions all make it more likely.
Treatment follows the findings, usually cleaning of the canal under direct view together with topical preparations. In diabetes, reduced immunity or severe pain, close follow-up is important.