Did you often feel pressure in the ears or have the sensation that your ears are stuffed, especially at higher altitudes? In such a situation, did you often feel the need to ‘pop’ your ears by actions like swallowing, yawning or chewing gum? Did the condition sometimes grow so adverse as to result in bleeding from your ears? This phenomenon is known as ear barotrauma in which you might feel pressure changes in your ears.

What is Ear Barotrauma?

Ear barotrauma is a condition in which a person faces discomfort in the ears due to pressure changes. In each ear, there is a tube that connects the middle ear to the throat and the nose. It is known as the Eustachian tube which normally equalises the pressure of the middle ear to that of the outside air pressure, by maintaining equal pressure on both sides. When this tube is blocked, a person might face ear barotrauma.

Occasional ear barotrauma might occur in certain situations such as altitude changes. Although in most of the cases it is temporary in nature and is not very harmful to many people, however, if this happens frequently, it may give rise to various other complications. It’s very important to understand the differences between acute or occasional cases with that of chronic or recurring cases of ear barotrauma.

To sum up, ear barotrauma is an injury caused to the ears due to pressure changes and pressure differences between the inside and the outside of the eardrum. The eardrum separates the ear canal of the outer ear from the middle ear. Barotrauma can cause pain and discomfort in the ears due to pressure imbalances or inequalities in the ears and the environment outside.

What is Eustachian Tube?

The Eustachian tube is a canal that connects the middle ear to the nasopharynx - which comprises the upper throat and the back of the nasal cavity. The nasopharynx comprises the upper throat and the back of the nasal cavity. The Eustachian tube, also known as the auditory tube or the pharyngotympanic tube, is approximately 35 mm long and 3 mm in diameter. It maintains and equalises the pressure in the middle ear and the air pressure outside.

Most of the time, the Eustachian tube remains closed except at the time of activities like yawning, swallowing, and chewing, so as to allow air through the passage between the middle ear and the nasopharynx. You might notice a sudden feeling of blockage or stuffing in your ears if there are pressure changes in your ears while at higher altitudes. This condition is known as ear barotrauma. In such a situation, try out these activities to equalise the pressure on both sides.

What are the Functions?

The Eustachian tube is responsible for the following -

• Pressure Equalisation - As already mentioned, the Eustachian tube equalises the pressure of the body and the outside air pressure.

• Mucus Drainage - The Eustachian tube also drains mucus from the middle ear to prevent middle ear infections.

Otitis media or inflammation of the middle ear might affect the Eustachian tube, and children are more vulnerable to this condition.

Symptoms of Ear Barotrauma

Check out for the following common symptoms of ear barotrauma which might occur in mild to moderate cases -

• General ear discomfort

• Dizziness

• Stuffiness or fullness in the ears

• Slight hearing difficulties or mild hearing loss

If this continues for long and goes without proper treatment, or if the case is severe, then the symptoms might be intensified, with the following additional ones -

• Ear pain

• Nose bleeding

• Eardrum injury

• Moderate to severe hearing loss

• Feeling of great pressure in the ears, as if you were underwater

However, generally, the symptoms would go away if you treat the condition on time. Hearing loss caused due to ear barotrauma is almost always temporary and reversible in nature. But the earlier you indulge in a proper hearing loss treatment, the better and faster will be the recovery.

Causes of Ear Barotrauma

One of the main causes of ear barotrauma is the blockage of the Eustachian tube which helps to restore equilibrium during pressure changes, thereby balancing air pressure on both sides of the eardrum. Eustachian tube blockages might occur during activities or events such as -

• Scuba diving

• Hiking

• Ascent and descent of an aeroplane - a condition known as airplane ear

• Driving on the mountains

Diving is the most common cause of ear barotrauma because while you are underwater, you would be experiencing much more pressure in your ears than it that on land. Divers must take enough ear protection before diving because while you are in the range of the first 14 feet of the dive, you are greatly vulnerable to ear injuries. The pressure underwater changes drastically, and therefore divers are advised to descend slowly while diving towards the floor or the sea-bed. Middle ear barotrauma is the most common condition among divers.

However, apart from pressure changes, there are certain risk factors as well which can cause Eustachian tube blockages. For example, a person with allergies or colds or other active infections might have a greater risk of experiencing ear barotrauma. Also, infants and young children are at a greater risk because a child’s Eustachian tube is smaller in length and is positioned differently than that in an adult, which results in Eustachian tube blockages more easily.

How to Treat Ear Barotrauma?

Often clearing the other end (the nasopharynx part of the Eustachian tube) helps equalise the pressure on both the sides of the eardrum. Here are some common activities to do so -

• Yawning

• Chewing gum

• Swallowing

• Practising breathing exercises

• Taking antihistamines

What are the Potential Complications?

In some cases, ear barotrauma might cause eardrum rupture when there is a huge difference in the pressure on either side. A ruptured eardrum might take up to two months to heal. It might cause a temporary hearing loss which can be treated easily.

We have covered a separate blog on Ruptured Eardrum, do check it out: https://hearingplus.in/ourblog/Perforated-Eardrum-Symptoms-Causes-and-Consequences/

Apart from an eardrum rup[ture, the other complications that might occur due to ear barotrauma include -

• Ear infections

• Hearing loss

• Recurring pain

• Vertigo or dizziness

• Bleeding from nose or ears

Consult an audiologist immediately if symptoms persist. If you notice any hearing changes, don’t delay a hearing loss treatment.

How to Prevent it?

• Descend slowly while diving

• Yawning, chewing gum or swallowing while you feel that you might get ear barotrauma might help prevent it or at least relieve the symptoms

• Avoid wearing earplugs while diving or in a flight

• Exhale through your nose while going up at higher altitudes

A little care can make a huge difference.

Do you know? Hearing loss is the third most common and leading health issues that affect people worldwide, and it can affect your relationships and deteriorate your quality of life. Although the most affected group is the old age, unfortunately, it might affect individuals belonging to any age group. And in most cases, progressive hearing loss is permanent and irreversible in nature. That means once you lose your hearing, it’s gone forever and you won’t be able to regain back your natural hearing. Hearing devices like hearing aids or cochlear implants can only help you to hear by amplifying the sounds for you and by making the most out of your residual hearing abilities. But they can do nothing more! So before you turn the volume higher, keep this in mind. Protect your valuable ears while you can, before you pay for it. Don’t take your ears for granted!

What is Progressive Hearing Loss?

Progressive hearing loss is when a mild or moderate hearing loss has been diagnosed and it worsens over time. Initially, it might start with a mild hearing loss that can worsen to a moderate or severe or even profound hearing loss over time. The change in hearing can occur over the years, months or even a few weeks. Sometimes a child might be born with normal hearing, but might begin to lose his or her hearing within 2-3 years. This is known as delayed onset hearing loss, which happens when a child is born with a virus that is not detected at birth until it shows up through various symptoms and conditions later. There might also be other problems at birth which can cause delayed onset hearing loss in children.

Progressive Hearing Loss in Children

The term ‘progressive hearing loss’ might crop up a lot of uncertainty and anxiety. Since this cannot be identified by the children themselves, or even if identified, children won’t be able to express it properly, it is the duty of their parents to take notice of it and be informed about any changes in hearing. A single change might affect speech and language development in children, thus affecting developmental skills. Talk to your audiologist and routinely do your child’s hearing test and monitor any changes to take action as advised by your audiologist on an urgent basis.

What are the Causes?

One or more of the following causes might lead to progressive hearing loss in children -

• Genetic factors

• Certain illnesses like Meningitis causes hearing loss in children and which usually worsens over time

• Middle ear infections like Otitis media

• Certain ototoxic medicines might worsen the hearing abilities of a child, and it might continue worsening even after the child has stopped taking them

What are the Symptoms?

In children, progressive hearing loss might come along with the following symptoms -

• The child is unable to hear what he or she was able to before

• He or she often says ‘what?’ a lot more in the recent days than before

• The child’s speech and language skills change (generally towards deterioration)

• The child’s audiogram report changes from time to time and gradually becomes worse

• Your child wants to hear the TV or the radio or to his or her favourite music louder than before

• If your child is a user of hearing aids, he or she suddenly doesn’t want to wear them but before he or she didn’t mind wearing them

• Your child is often complaining about getting dizzy or losing his or her balance

• Your child has recently started facing problems at school due to her hearing loss.

If you notice some or all of the above symptoms, talk to your audiologist immediately. Perform a routine hearing check-up and go for some effective treatment of hearing loss or make improvements in it if your child is already a part of one. Do as suggested by your audiologist. He or she is the best judge in this case. Nobody else can understand your child’s hearing needs better.

What is the Solution?

Children with progressive hearing loss are generally treated with either of the two traditional and effective methods of hearing loss treatment - hearing aids or cochlear implants. For very young children who are yet to learn and develop speech and language skills are generally implanted with cochlear devices, which are very effective and helps the child to compete with his or her peers with normal hearing in developing communication skills well.

Talk to your child and tell him or her not to fear or worry about anything and that everything will be alright. Give your child the support he or she needs and never let him or her feel depressed. Make sure that you go for strong hearing aids to support his hearing abilities so that his or her speech and language skills are not hampered. Don’t compromise with anything here. And if your child is suffering from severe to profound hearing loss, then your audiologist might want to go for cochlear implantation. Do as required and as suggested because you can’t afford to ruin your child's future in any way. Keep a good track of your child’s activities at school and his or her progress in academics. In the meanwhile, you too have to be mentally strong. Talking to other parents, teachers, counsellors and of course, your audiologist might help.

Progressive Hearing Loss in Adults

High-frequency progressive hearing loss in adults happens gradually over time as the person begins to age, the condition which is termed as presbycusis. It happens due to damage caused to the tiny and sensitive hair cells in the cochlea of the inner ear. These little hair cells are responsible for hearing as they receive the sound vibrations as received from the outer ear after travelling via the middle ear where these sound signals are being amplified, and convert them into electrical impulses. These electrical signals are then sent to the brain via the auditory nerve where they are perceived as sounds.

If the hair cells are damaged, they won’t be able to convert these sound signals properly, thus would fail to transfer proper electrical signals to the brain. This would lead to hearing problems, and if this continues (that is if you leave your hearing loss untreated) it worsens the condition of your brain, thus gradually making it inactive. An inactive or dormant brain would fail to perceive sounds properly even if it receives sounds after a long time. This condition is known as Auditory Deprivation, in which the brain fails to recognise any sounds even if a person wears hearing aids. It needs time to adjust to this ‘new’ world of sounds from which it was deprived of for so long. This is why people often say that they can’t understand even if they can hear, especially while trying to comprehend speech.

Hair cells in the cochlea might be damaged or even lost due to overexposure to extremely loud decibels of noises. This happens over time and the process is so gradual that it often goes unnoticed until the damage is already done and that’s when the person already starts various problems related to hearing in his or her day-to-day life.

Symptoms of Prescubysis

• Difficulty hearing high-frequency or high-pitched sounds, such as a whistle, a squeal, a scream, a child or woman’s voice, and consonant sounds like S, F, Th, Sh, V, K, and P.

• Difficulty following conversations over the phone

• Having the feeling that people are mumbling

• Difficulty following conversations while in noisy listening situations, as your ears are unable to distinguish words in speech

• Having the need to turn up the TV or radio volume more than usual and which is too loud for the other members of your family

• Tinnitus or hearing ringing or hissing sounds even in the absence of any external sound

We have covered a detailed blog over the early signs of hearing loss. Do check it out once in the link that follows: https://hearingplus.in/ourblog/Do-I-Have-Hearing-Loss-5-Early-Signs-and-Symptoms

Hearing loss treatment options like hearing aids might help a person with presbycusis or age-related hearing loss. However, he or she might also require auditory-verbal therapy (AVT) or speech therapy to help him or her to understand the semantic meaning of what he or she is listening, especially in speech.

We have a separate blog on age-related hearing loss, do consider going through it once to learn about the causes and how to deal with it: https://hearingplus.in/ourblog/Ageing_and_Hearing_Loss

The best part about presbycusis is it is preventable. It is true that people are going to experience some kind of hearing problems as they start ageing. But you can take care to prevent it for as long as possible. In short, you can delay it and even lessen the impacts of hearing loss in old age. So take care of your precious pair of organs while you can and stay healthy.

While some are born with a perforated eardrum, in some people it happens in the course of their lifetime, due to various reasons like injuries or trauma or some infections or diseases. Whatever be the cause, the consequences of a ruptured eardrum are greater. The most serious effect of the condition is hearing loss. It might also make the internal and delicate parts of your ears vulnerable to various infections or injuries.

What is an Eardrum?

In human beings and other tetrapods (four-limbed animals), an eardrum, also known as the tympanic membrane, is a thin, cone-shaped membrane that separates the ear canal of the outer ear from the middle ear. The sound waves received by the outer ear strike against the eardrum and cause it to vibrate.

The function of the eardrum is to transmit the sound waves from the external ear to the ear ossicles in the middle ear. The middle ear then passes them over to the fluid-filled cochlea in the inner ear, which sends them to the brain after converting them into electrical impulses.

We have already covered a separate blog on the hearing mechanism of human beings, consider going through it: https://hearingplus.in/ourblog/How-Do-We-Hear-An-Insight-into-Our-Hearing-Mechanism/

What is an Eardrum Rupture?

A ruptured or perforated eardrum is a hole or a tear in the tympanic membrane. Since the vibrations that are generated when sound waves enter our ears, and which are carried over to the ear ossicles of the middle ear, any tear or hole in the eardrum would not cause it to vibrate. This can hamper the transmission of the sound waves from the ear canal of the outer ear to the middle and inner ears respectively. As these vibrations are necessary for hearing, any damage caused to the tympanic membrane might cause hearing problems.

Although it is normally healed within a few days, in rare cases, however, a perforated eardrum can cause permanent hearing loss. In such a case, one must not delay in getting a proper hearing loss treatment such as hearing aids.

The Common Symptoms

• Pain, which in some cases might be severe

• Bleeding, especially if the rupture is caused by middle ear infections

• Watery, bloody or pus-like fluid drainage from the affected ear

• Temporary hearing loss

• Tinnitus or hearing a constant ringing, buzzing or other such sounds in the affected ear even if there is no external sound present

• Dizziness or spinning sensation (vertigo)

• Nausea or vomiting that might result from vertigo

Consult a professional audiologist immediately without delay if you notice these symptoms. Also, develop the habit of getting your ears tested from time-to-time.

What are the Causes?

Here are some common causes of eardrum rupture -

• Ear infections, especially in children or people with colds or flu

• Middle ear infections like Otitis Media

• Exposure to extremely loud noises or blasts

• Severe head trauma or injury

• Barotrauma - a condition when your ears fail to balance the atmospheric pressure with that of your ears. Results due to pressure changes, such as at higher altitudes or while scuba diving

• If a foreign object gets inside your ear

• Injury or trauma to the ear or any side of the head

What are the Consequences?

A ruptured eardrum might lead to -

• Hearing loss

• Ear infections like Otitis Media

• Middle ear cyst

• Ear injuries

What is the Solution?

A ruptured eardrum usually gets healed by itself within a few weeks. In certain cases, however, it needs to be repaired surgically.

Seek help immediately because you never know what might be the extent of the damage. If the condition is severe it might lead to hearing loss. And no hearing loss treatment can bring back your natural hearing ability if it is a permanent hearing loss.

A prolonged untreated hearing loss would come along with other consequences like depression and other emotional disbalances. Hearing aids might help in such cases to treat any loss of hearing, but you mustn’t wait that long!

While you have been worrying about how to choose the right hearing aid devices or which would be a reliable hearing aid clinic, did you know that you could have prevented this from happening? It would have been better if you turned the volume down while watching the favourite show of yours or listening to that favourite music. Yes, there are a host of reasons that might cause hearing loss, but most of the time it is due to exposure to loud noises. And surprisingly, most hearing loss problems are preventable. Prevention is always better than cure!

Why Should I Protect My Hearing?

It’s simple! You need to prevent yourself from acquiring hearing loss! Because a healthy hearing health means a healthy and happy life.

We often take our hearing for granted and never even realise that we need to take care of it! We listen to music, watch TV shows or listen to our favourite radio programme, for hours together, without almost giving a break in between. We don’t care to protect our ears while stuck in a noisy road full of honking of vehicles. We love attending rock concerts and dance to the rhythm of the playlist played by some cool DJ at a disco. The list is endless!

Among all these activities, your ears are crying for help! You might fail to realise that such habits and activities might damage thew very hearing that is enabling us to hear! So while you enjoy listening, take care that you do it responsibly and within certain limits!

Hearing loss, in most cases, it is progressive in nature and is irreversible if it is a permanent one. So let’s face the harsh truth. Once you lose your hearing, it’s gone forever! Yes, it’s true that as you start ageing, you are going to face certain loss of hearing. But the more careful and protective you are about your hearing health, the more would be the years you are going to enjoy with a healthy hearing.

What Causes Hearing Loss?

Most of us are sure to experience hearing loss at some point in our lifetime because it is almost inevident as we start ageing. But delaying the age of onset is in our hands, and we can prevent it till as long as possible. While some causes are not in our hands, but the major cause is preventable - that being exposed to very loud noises.

What occurs in your ears that leads to hearing loss?

Now, coming to the main scenario that causes you to suffer from a hearing impairment, let’s understand a bit of hearing mechanism first. The inner ear has a spiral-shaped cochlea which receives sound waves from the middle ear, after getting amplified by the ear ossicles. Our cochlea consists of thousands of tiny hair-like sensitive structure called hair cells. After receiving these sound waves, the hair cells in the cochlea convert them into electrical impulses and send them to our brain via the auditory nerve. It is at this point when sound is perceived by us.

This is why it is necessary to go for an early hearing diagnosis than regretting later! So before it’s too late, here are nine easy tips for you to protect that vital organ of yours!

9 Ways You Can Protect Your Precious Ears!

• Use earplugs or earmuffs while you are around some loud noises. Always make it a point to carry a pair in your bags wherever you travel. According to studies, noise-induced hearing loss or NIHL is the most popular cause of permanent hearing loss across the world.

• Turn the volume down. While listening to music, make sure that you don’t put the volume too high. Also, lessen the duration of listening at a stretch. Many audiologists suggest following the 60-60 rule while listening to your favourite music - which states that the ideal and safe volume should not be more than 60%, having a duration of not more than 60 minutes.

• Take listening breaks. It is always recommended that one should not listen to anything for hours together. You must always take listening breaks in between. This will give time for your ears to recover, especially if you are at a loud listening situation like rock concerts or a disco. If possible, step outside for 5-10 minutes after every half an hour or so and give your ears the required time to rest.

• Take medications only as directed. There are certain ototoxic medications which are harmful to your hearing health. So always refer a doctor before taking any.

• Stop using cotton swabs or sharp tools to clean your ears. Firstly because your earwax has a lot of beneficial qualities like keeping away dirt and infection germs, and secondly because these might hurt or injure the internal delicate parts of your ears.

• Keep your ears dry. Make sure you wipe your ears dry with a soft cloth or better still you can block water from entering the ear canal with the help of custom-fit swimmers’ earplugs after bathing or swimming. Excess moisture can be harmful to your ears as it attracts bacteria which might attack your ear canal and cause infections.

• Exercise properly. Do you know exercise is good for your ears as well? Activities like walking, cycling, running or jogging improve blood circulation in your ears, thus keeping them healthy and properly functional. However, while you are cycling or riding a motorbike, make sure to wear a helmet, so that if you fall you can protect your head, along with your ears.

• Manage stress levels. Too much stress and anxiety are often linked to permanent or temporary tinnitus (ringing in the ears). Stress creates pressure on your nerves and blood vessels, thus affecting blood circulation in your body parts - including your ears.

• Regular hearing check-ups are a must! Even if you might feel that you are hearing fine, you might never know. It’s always better to be sure. Get your hearing tested from time to time by consulting a professional and certified audiologist at your nearest hearing aid clinic.

A hearing loss treatment or the act of wearing hearing aid devices is not as easy as you might think. They will definitely help you out, especially if you buy the latest digital hearing aids. But they can do nothing other than making the most out of your residual hearing abilities. Once your hearing is gone, it won’t come back again! So protect it while you can! Isn’t it better to prevent it than buying hearing aid devices?

Stay healthy and be a responsible family member!

Do you know what is the most received complaint from people who have recently started facing hearing difficulties? It’s ‘I can hear, but I cannot understand!’ or ‘the words appear blurry and unclear’, or ‘why don’t you speak clearly and stop mumbling?’, and the like. If this is the case with you, then yes it’s most likely that you have hearing loss. Or if you have faced any of your loved ones coming up with statements like this, try to help them out. You (or your loved one) need to treat this condition at the earliest - because most of the times, hearing loss is progressive in nature. Hearing loss treatment is not a big deal nowadays, with such advanced technological innovations in the field of audiology.

Our Hearing Mechanism

This brings us to the question of how the hearing procedure works and what are the steps involved in it.

Our hearing is a complex process which is not limited to the functioning of the ears itself but involves the brain as well. It is our brain that is responsible for the actual part of hearing. If your brain fails to work properly, you won’t be able to understand or decode the meaning of the sound you are hearing. And this is why some people with untreated hearing loss complain that even though they could hear, they find it difficult to understand the meaning of it, and this is most evident in speech understanding such as during conversations.

While it is the job of the brain to translate the sounds as they receive into meaningful words, our ears are responsible for amplifying and delivering the sounds to the brain after converting them into meaningful signals which can be decoded easily by our brain.

To know more about how the hearing mechanism of human beings and other mammals works, consider going through this blog: https://hearingplus.in/ourblog/How-Do-We-Hear-An-Insight-into-Our-Hearing-Mechanism/

Hearing vs. Understanding

The first thing that you must do is getting a hearing test done. In a hearing diagnostic test, your results would be plotted on an audiogram. If you are diagnosed with a high-frequency hearing loss, you would find it difficult to hear the high-pitched sounds. While on the other hand, you might have a completely normal hearing ability in the low-frequency range and can hear low-pitched sounds quite perfectly. In speech, the high-pitched sounds include the consonant sounds like S, F, Th, Sh, V, K, P, while the vowels A, E, I, O and U are low in pitch. Studies show that most of the people with hearing impairment experience a high-frequency hearing loss. This explains why some people with hearing loss find it difficult to get hold of the meaning even though they can hear the sounds.

Signs of High-Frequency Hearing Loss

Check out for these signs that are common with people suffering from high-frequency hearing loss.

• Difficulty following and understanding conversations both in quiet and in noisy listening situations

• Difficulty talking over the phone

• Trouble understanding TV or radio shows even after turning the volume up

• You no longer find listening to music soothing or pleasurable as they seem distorted, especially at higher volumes

• Trouble understanding the voices of women and children because they are usually high-pitched in nature

• Friends, family members or colleagues often get frustrated and feel you aren’t listening to them

• This leads to misunderstandings in your personal relationships

• You feel tired and exhausted from listening

So the next time your spouse accuses you of having a ‘selective hearing’ you must not delay on getting a proper hearing loss treatment, because it’s high time that you should! An untreated hearing loss would bring along more health issues including both physical and psychological.

Talk to your audiologist today and get the right hearing aid machine. The digital hearing aids of today not only help you get rid of all these difficult situations but would also make your life a healthy one, making this world a happy place to live in.