I use Hydrogen Peroxide to clean wax from my ears. Is this a safe practice and how often should you clean your ears?

Wax production is normal, and there is a natural turnover of wax in the ears. Cleaning is not necessary except in a few individuals who have very narrow external canals who may experience a build up of wax against the ear drum. I wouldn’t have thought that hydrogen peroxide was a good idea at all, since it can cause irritation to the skin, and may damage the sensitive skin lining your external ear canal.

The main cause of wax build–up, is people trying to clean out their ears with cotton buds! This simply pushes the wax back down the external canal, where it compacts against the ear drum, and eventually needs to be syringed out! Leave your ears alone. The wax will come out on its own without any help. Incidentally, ear wax is soluble in water.

What are Middle Ear Infections?

Middle ear infections occur behind the eardrum (the thin sheet of tissue that passes sound waves between the outer and middle ear). These infections are usually due to bacteria or viruses, which are often related to a recent cold or allergy problem. Middle ear infections are most common in young children, whose ear anatomy is not yet fully developed. Children under age five, boys, bottle–fed infants, and children in daycare run the greatest risk of infection.

Are these infections serious?

Middle ear infections can be painful and they tend to disrupt sleep. Middle ear infections can also limit the ear drum’s flexibility, reducing your child’s ability to hear. This could make it harder for your child to learn to talk. Depending on how long it lasts, your child’s learning ability could be affected.

What causes Middle Ear Fluid?

Post ear infection. It is common for children to have middle ear infections. And some children with middle ear infection later have middle ear fluid, blockage of the Eustachian tube, cold or flu. There is no one cause for middle ear fluid. Often, your child’s health care provider will not know what caused the middle ear fluid.

What causes Snoring?

Snoring indicates a partial upper airway obstruction. The nose, throat, mouth or any combination of these sites can cause the problem. The noisy sounds of snoring occur when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose. This is the collapsible part of the airway where the soft palate and uvula (fleshy structure that dangles from the roof of the mouth back into the throat). When these structures vibrate during breathing, that is snoring. Problem snoring grows worse with age. 25% of all adults are habitual snorers.

Is Snoring Serious?

Medically
Yes. Heavy snorers tend to develop high blood pressure at a younger age than non–snorers. Obstructive sleep apnea is an exaggerated form of snoring. Loud snoring is interrupted by frequent episodes of totally obstructed breathing. These people may spend up to half their sleep time with blood oxygen levels below normal. During these obstructive episodes, the heart must pump harder. This can cause irregular heart beats, and eventually high blood pressure.

Sleep apnea patients may spend little of their night–time hours in deep sleep stages. They awaken not refreshed and are sleepy much of the day. They may fall asleep while driving or while on the job.
Socially
Yes. It disrupts family life. Spouses often have sleep deprivation, depression, and mood alteration. Marital discord is a common result.

Have you experienced excessive daytime sleepiness?	Yes	No
Have you experienced any of the following: Morning headaches? Restless sleep patterns? Excessive snoring?	Yes	No
His your snoring forced your spouse to sleep in another room?	Yes	No
Have there been witnessed episodes where you stop breathing for 10 seconds or more?	Yes	No
Have you ever fallen asleep driving to or from work?	Yes	No
Have you ever fallen asleep inappropriately during social activities?	Yes	No
Have you ever had trauma to the nose, face or throat?	Yes	No
If so, please describe have you ever had a sleep study? If yes: Where? When?	Yes	No

If you answer is “Yes” to any of the following questions…evaluation is recommended.

Are there any treatments or cures for snoring? My husband snores however he lies in bed.

Snoring is a common and very distressing problem, often resulting in partners sleeping apart because one or the other cannot get to sleep through the noise! A new treatment has been approved which uses radio waves to shrink tissue in the air passages of the nose and throat which are the cause of snoring. The treatment is called somnoplasty and involves piercing the tongue or soft palate with a needle connected to a radio frequency generator. The tissue is then heated up and shrunk in a process which takes about half an hour.

However, there are other things to try before such intervention. There are a number of lifestyle changes which can help with habitual snoring. These include losing weight, exercising, stopping smoking, and refraining from alcohol at night. There are also special “Snoring pillows” and nose strips which are available at most pharmacies. Dentists can make devices which hold the tongue in place and leave the air passages clear.

Try lifestyle changes and pillows before resorting to an ENT specialist. Good luck!

I have a son aged three and a half and a daughter aged nineteen months. Every two weeks, without fail, one of them develops a constant runny nose, and passes it on to the other. My daughter generally just has a runny nose, while my son develops a bad cough each time. I have tried every type of medicines from antibiotics to homeopathic remedies, to no avail. Is there a medication on the market which will help with this?

This pattern of runny noses, coughing, and often, early evening fevers, every two weeks or so, is a perfect illustration of the regular colds which young children get as they are growing up. The common cold is caused by a variety of viruses, none of them amenable to treatment by any means. Children react differently to the viruses, some having simply a runny nose, while others are to the inflammation of the airways that the virus can cause, which results in a cough. This pattern is perfectly normal in any child where they are constantly exposed to the myriad of viruses in the environment.

Unfortunately, there is no specific treatment. These infections all resolve on their own, rapidly being replaced by new ones as you have noticed! Having said that, there are simple measures you can take to make the child more comfortable. Make sure they are drinking plenty of fluids so that the secretions are less sticky. Paracetamol will help settle them at night, as will something like Vicks rubbed onto the chest. If your son develops a cough with each cold, which is worse at night and when he is running around and playing, then it is possible that he has a tendency to asthma. Check this out with your GP.

What causes blocked ears and Eustachian tubes?

The Eustachian tube can be blocked, or obscured, for a variety of reasons. When that occurs, the middle ear pressure cannot be equalized. The air already there absorbs and a vacuum occurs, sucking the eardrum inward. Such an eardrum cannot vibrate naturally, so hearing sounds muffled or blocked. Also, the stretching of the eardrum can be painful. If the tube remains blocked for a period of time, fluid (like blood serum) will seep into the area from the membranes in an attempt to fill up the ear to overcome the vacuum. This is called “Fluid in the ear”, serious otitis or aero–otitis.

The most common cause for a blocked Eustachian tube is the “Common cold”. Sinus infections and nasal allergies (e.g. hay–fever) are also frequent causes. This is because the membranes that line the Eustachian tube are similar to and continuous with nasal membranes. Consequently, a stuffy nose leads to stuffy ears because the swollen membranes block the opening of the Eustachian tube.

Another cause of blocked Eustachian tubes is infection of the middle ear which creates swollen membranes. Children are especially vulnerable to blockages as their Eustachian tubes are narrower than adults.

How can Air Travel cause problems?

Air travel is sometimes associated with rapid changes in air pressure. To maintain comfort, the Eustachian tube must function properly, that is, open frequently and widely enough to equalize the changes in air pressure. This is especially true when the airplane is coming down for a landing, going from low atmospheric pressure down closer to earth where the air pressure is higher. In the early days of airplanes with open cabins and cockpits, this was a major problem to flyers. Today’s aircraft are pressurized so that air pressure changes are minimized. Even so, some changes in pressure are unavoidable, even in the best and most modern airplanes. Actually, any situation in which rapid altitude or pressure changes occur creates the problem. You may have experienced it when riding in elevators of tall buildings or when diving to the bottom of a swimming pool. Deep sea divers are taught how to equalize their ear pressures; so are pilots.

How do you unblock your ears?

The act of swallowing activates the muscle that opens the Eustachian tube. You swallow more often when you chew gum or let mints melt in your mouth. These are good practices, especially just before and during descent. Yawning is even better. It is a stronger activator of that muscle. Be sure to avoid sleeping during descent, because you may not be swallowing enough to keep up with the pressure changes. (The flight attendant will be happy to awaken you just before descent.)

If yawning and swallowing are not effective, the most forceful way to unblock your ears is as follows:

1. Pinch your nostrils shut.
2. Take a mouthful of air 1.
3. Using your cheek and throat muscles, force the air into the back of your nose as if you were trying to blow your thumb and fingers of your nostrils.

When you hear a loud pop in your ears, you have succeeded. You may have to repeat this several times during descent. Babies cannot intentionally pop their ears, but may do so if they are sucking on a bottle or pacifier. Feed your baby, and do not allow him to sleep during descent.

What precautions should you take?

When inflating you ears, you should not use force from your chest (lungs) or abdomen (diaphragm) which can create pressures that are too high. The proper technique involves only pressure created by your cheek and throat muscles.

If you have a cold, a sinus infection, or an allergy attack, it is best to postpone an airplane trip. Also, if you recently have undergone ear surgery, consult with your surgeon on how soon you may safely fly.

What about Decongestants and Nose Sprays?

Many experienced air travelers use a decongestant pill or nasal spray an hour or so before descent. That will shrink the membranes and make ears pop more easily. Travelers with allergy problems should take their medication at the beginning of the flight for the same reason.

Decongestant tablets and sprays can be purchased without a prescription. However they should be avoided by persons with heart disease, high blood pressure, irregular heart rhythms, thyroid disease or excessive nervousness. Such persons should consult their physicians before using these medicines. Pregnant women should likewise consult their physicians first.

What to do if your ears will not unblock?

Even after landing you can continue the pressure equalizing techniques, and you may find the decongestants and nose sprays to be helpful. (However, avoid making a habit of nose sprays. After a few days they may cause more congestion than they relieve.) If your ears fail to open, or if pain persists, you will need to seek the help of a physician who has experience in the care of ear disorders. He may need to release the pressure or fluid with a small incision in the ear drum.

How well does my child hear?

Most newborn infants startle or “Jump” to sudden loud noises. By three months, a baby usually recognizes a parent’s voice. By six months, an infant should turn his or her eyes or head toward a sound. By twelve months, a child should imitate some sounds and produce a few words, such as “Mama” or “Bye–bye”.

When is hearing evaluation indicated?

Hearing evaluation may be indicated if a young child has limited, poor, or no speech; seems frequently inattentive, has difficulty learning; or has any signs of hearing loss, such as increasing the television volume. In conjunction with any behavioral symptoms, hearing assessment also may be necessary if there are certain risk factors for hearing loss, such as childhood hearing loss in family members, severe complications at birth, frequent ear infections, or infections such as meningitis or cytomegalo virus.

What kinds of hearing loss are there?

Conductive hearing loss is caused by an interference in the transmission of sound to the inner ear. Infants and young children frequently develop conductive hearing loss due to ear infections. This loss is usually mild, temporary, and treatable with medicine or surgery. Sensori–neural hearing loss involves malformation, dysfunction, or damage to the inner ear (cochlea). It usually exists at birth. It may be hereditary or may be caused by a number of medical problems, but often the cause is unknown. This type of hearing loss is usually permanent. The degree of sensori–neural hearing loss can be mild, moderate, severe, or profound. Sometimes the loss is progressive (hearing gradually becomes poorer) and sometimes unilateral (one ear only). Sensori–neural hearing loss is generally not medically or surgically treatable, but children with this type of hearing loss can often be helped with hearing aids. A mixed hearing loss occurs when both conductive and sensori–neural hearing loss are present at the same time. A central hearing loss involves the hearing areas of the brain, which may show as difficulty “processing” speech and other auditory information.

What about the Cochlear Implant?

A cochlear implant does not restore hearing. It is intended for children with profound hearing loss who do not benefit from hearing aids.