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My right ear has been completely blocked for a week now. Upon visiting polyclinic, I was told that It was ear infection. Have been on antibiotics for 5 days now and there isn’t any improvements. Also put ear drops into my ear but also didn’t help. I do feel more tired than usual and the pressure in the eardrums feel extremely uncomfortable. My appointment is only in another 2 weeks time. Should i seek treatment earlier? I’m afraid things will get worse if I don’t.
Thank you for your question. Ear blockage or hearing loss can be due to:
1. Conductive hearing loss – Hearing loss due to a physical blockage of the ear canal or middle ear (space deep to the ear drum thaf houses the hearing bones). Common causes include:
- Impacted ear wax
- Ear infections
- Fluid in the middle ear
- Foreign body in the ear
- Stiffening of the hearing bones.
Conductive hearing loss are usually reversible (ie hearing can revert back to normal) once the underlying cause is treated.
2. Sensorineural hearing loss – Hearing loss due to a problem with the hearing organ (cochlea) or hearing nerve that is located in the inner ear. Common causes include:
- Exposure to loud noises for a prolong period of time
- Viral infection of the hearing nerve or organ.
Sensorneural hearing loss unfortunately is usually not reversible.
If you’ve been told that your ear is infected, the two most common ear infections are otitis externa (infection of the ear canal) and otitis media (infection of the middle ear – the space that is deep to the ear drum that houses the hearing bones).
Without a full clinical history and physical examination, it is difficult to tell which type of ear infection you are suffering from.
Otitis externa usually presents with ear pain, ear discharge and ear blockage. It occurs usually after ear digging or more commonly in swimmers.
It is treated with ear cleaning (using a mini vacuum system to remove debris and pus in the ear canal by an ENT Specialist) and application of antibiotic ear drops or ear creams. This usually resolves in 1-2weeks.
If you have this condition and no longer have ear pain after using the antibiotic ear drops, there is no urgency in getting your ears reviewed. However, it is likely that you need the debris or ear wax cleaned out by an ENT Specialist to relief your ear blockage.
If your ear infection is otits media (with fluid behind the ear drum), you may have ear blockage and pressure as your main symptom and little or no pain.
Otitis media is due to a problem with an ineffective eustachian tube that failed to equalize the middle ear pressure with the outside pressure.
Treatment includes oral antibiotics and frequent attempts to equalize your middle ear pressure to open the Eustachian tube. These include “popping of your ear” (Valsalva manouver), swallowing or yawning. It takes about 4-6weeks or longer for fluid in the middle ear to resolve. Again there is no urgency to consult a doctor for this.
You should consult a doctor earlier for your ear blockage if:
1. You are still experiencing ear pain
2. You have fever
3. You have otitis externa and would like the debris, ear wax and pus removed (by an ENT Specialist) to fasten your recovery
4. Your ear blockage occured very suddenly (need to exclude sudden sensorineural hearing loss – which is best treated with oral steroids preferably in the first 2 weeks of presentation)
5. You are concerned
Hope this helps.
Dr Gan Eng Cern
Pacific Healthcare Specialist Centre, Paragon Medical