Why is My Ear Painful and Blocked? Dr Annabelle’s Six Common Causes

So why has your ear been feeling painful and/or blocked lately? Ear pain and blocked ear are common troublesome conditions that present to our top ENT specialists in Singapore. Ear pain can sometimes originate from structures around the ear, for example the jaw joint (Temporomandibular joint or TMJ), to cause severe referred ear pain. “Referred” ear pain means that the pain does not itself arise from the ear but may come from adjacent structures.Other causes of referred ear pain may also come fromthe space at the back of your nose, called the postnasal space, where the Eustachian pressure tube is located, so nose and sinus infections may also lead to blocked ear and ear pain symptoms.

6 Common Causes of A Painful Blocked Ear
Earwax buildup (impacted wax)
Ear infection
Eustachian pressure tube problems
Sinus and nose infections
TMJ (jaw) disorders
Preauricular sinus/cyst infections

Impacted earwax is probably the most common reason for you to feel earache and a blocked ear sensation. Earwax is not “dirty” and actuallypossesses natural oils to protect your ear canal skin. The ear is a self-cleaning “device”, as the skin lining the ear canal is programmed to slowly transport the earwax out of your ear. Hence there is no reason to clean your ears yourself. However, some people have rather narrow ear canals or may tend to produce more wax than usual, so they might have to visit their top ENT specialist in Singapore to have their ears safely cleaned out via micro-suctioning, under a microscope.

Ear infections affecting the outer ear skin can be very painful and may even lead to headaches if they continue to worsen. Fungal infections of the ear are quite common in our ENT clinics in Singapore because fungal spores thrive in our warm humid weather here. Many people cannot resist the urge to dig their ears so this unfortunate habit of ear-diggingmay also introduce bacteria and fungal organisms into the ear, especially when the ear canal skin becomes injured or scratched by the trauma of ear-digging. People who love water sports are also at risk of getting infections of the ear canal, known as “Swimmer’s Ear”.  Outer ear infections should be treated by having the ear gently cleaned and the appropriate type of eardrops applied inside. Sometimes, antifungal ointment may be needed to be applied directly inside the ear by the Singapore ENT specialist seeing you.

Eardrum infections may be even more painful than outer ear infections and may be associated with fever and malaise.Otorrhea (ear discharge)may accompany eardrum infections to lead to an unpleasant-smelling yellow discharge of fluid from your infected ear. As the infected eardrum swells up, it maylead to a perforation (ruptured eardrum), releasing the infected pusfrom behind the eardrum.  See your best ENT specialist in Singapore urgently for the right course of oral antibiotics to help treat your ear infection.

Eustachian tube dysfunction or pressure tube problems may give rise to persistent blocked ear with popping sounds inside the ear. Sometimes, you may also suffer a feeling of pressure discomfort with earache. It mighthave started off with a sinus infection which improved with medication but there may still have been residual inflammation of the Eustachian pressure tube, even after the nose and sinus infections have all resolved. It is very important for your top ENT specialist in Singapore to check the back of your nose (postnasal space) with an endoscope camera to make sure the Eustachian tube symptoms are not related to obstruction by a nasopharyngeal cancer growing inside your nose.

If nasal decongestants, antihistamines or antibiotics don’t relieve the blocked ear feeling from  Eustachian tube pressure problems, then balloon dilation the Eustachian tube should and/or the insertion of a tiny ventilation tube (grommet) into the eardrum may help.

Sinus/nose infections (sinusitis) may cause infected purulent discharge to accumulate behind your nose, draining into the ear via the Eustachian pressure tube. The ear becomes infected via this route and may subsequently result in an eardrum infection as described above. Again, strong antibiotics are needed with nasal medications and saline irrigation of your infected sinuses. Sometimes, a CT sinus scan (detailed X-ray imaging) may be required with a view to undertaking functional endoscopic sinus surgery (FESS) to completely clear the trapped infected fluiddeep within the sinuses.

TMJ (temporomandibular) disorders arise from the TMJ or the “jaw joint” and can be quite painful. TMJ symptoms usually consist of recurrent jaw ache with clicking and creaky sounds brought on by eating or chewing your food. Often, such patients tend to grind their teeth repeatedly at night when asleep and may not be aware of this, until their sleep partner notices. If this continues for a period of time, then chronic inflammation of this complex joint can result. Patients with TMJ disorders may sometimes mistakenly think their discomfort is arising from an ear infection but this is actually “referred” ear pain due to the TMJ dysfunction. This is because both the ear and TMJ structures are supplied by a similar group of nerve endings. TMJ disorders, if left untreated, may progress to worsening jaw pain, headaches/migraines and neck ache due to the sustained muscle tension for a prolonged period of time.

Finally, infection of the preauricular sinus/cysts may also result in ear pain and swelling. Some people have these tiny pits located just in front of their ears, as a result of incomplete development of the ear structure in the fetal development stage. There is a risk of infection of these preauricular pits as they are often connected to an underlying sinus or “track” of skin joined to the cartilage of the ear itself. Sometimes, cheesy infected discharge may be seen oozing out of these pits while in the advanced severe stages, large skin abscesses (collection of pus) may form. Such abscesses of the ear require surgical drainage and a course of antibiotics, with a view to full excision/removal of the preauricular sinus/cyst a few weeks later in a staged procedure to prevent recurrent infections of the ear.

So, now you know the six common causes of a painful ear and blocked ear! Please visit your top ENT specialist in Singapore soon if you happen to suffer any of the above ear conditions. Hear well, breathe well, live well!

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