Your Ultimate Guide to Healthy Ears

If a typical day finds you blasting your iPod, shouting over the din at dinner and blaring the TV, this will come as no surprise: “Hearing loss is now a growing epidemic among women in their 30s and 40s,” says Douglas Backous, MD, medical director of the Center for Hearing and Skull Base Surgery at the Swedish Neuroscience Institute in Seattle. Even in the quietest places, we can face unrelated issues, like infection, vertigo and congestion. All ears now? Follow our guide to caring for and protecting this key organ.

Problem No. 1: Hearing loss

The lowdown This isn’t a concern just for drummers and construction workers. “Even having earbuds at full blast while you’re running every day can cause permanent damage over time,” says Eric Smouha, MD, director of otology and neurology at Mount Sinai Hospital in New York City. “Intense exposure to sound causes wear and tear on the hair cells in your cochlea.”

What it feels like Conversations are muffled; you may notice that you’re asking people to speak more slowly or repeat themselves. “If you turn the TV volume up so high that others complain about the noise, that’s a red flag,” says Barry Hirsch, MD, director of the division of neurotology at the University of Pittsburgh Medical Center.

Rx See your doctor. The first step is to check your ears—wax may simply be blocking sound waves from entering your ear canal. Otherwise, you’ll be referred to an audiologist for a hearing test. “If you have trouble hearing sounds above 25 decibels [dB], it’s considered hearing loss and needs to be thoroughly evaluated,” says Sarah Sydlowski, PhD, an audiologist at the Cleveland Clinic. While there’s no way to reverse noise-induced hearing loss, mild forms can be treated with an assistive listening device. If your loss is more pronounced, you’ll need a hearing aid. To keep things from getting to that point, use earplugs whenever you’re in a noisy situation—say, a concert or football game. “And when you’re listening to tunes, keep the volume at the halfway point,” Sydlowski says.

Problem No. 2: Pressure changes

The lowdown You know that awful ear pop (the one your kids shriek about) as the plane you’re in starts to descend? It has a fancy name—barotrauma. “The air pressure in your middle ear is usually the same as the air pressure outside your body,” Dr. Hirsch explains. But when you’re landing, the cabin pressure increases. “The outside pressure pushes your eardrum inward,” he says. Your Eustachian tubes—which connect your middle ear to the back of your nose and throat—regulate air pressure, but they can’t always react quickly enough. The result: serious discomfort. (When a plane goes up, the reverse happens; it’s a lot less likely to cause pain.) These symptoms can get worse if you have a stuffed-up schnoz from a cold.

What it feels like Mild to moderate pressure or pain in your ear, along with stuffiness.

Rx Take a big yawn, chew gum or suck on a hard candy. “These actions pull the muscles that open your Eustachian tubes and equalize the pressure,” Dr. Hirsch says. Alternatively, try the Valsalva maneuver: Pinch your nostrils shut, close your mouth and force air into the back of your nose, as if you’re blowing it. If you have a full-fledged cold, use a drugstore decongestant nasal spray, such as Afrin, and pop a decongestant pill like Sudafed before you fly.

Problem No. 3: Tinnitus

The lowdown Up to 20 percent of people under age 50 are plagued by tinnitus—ringing in the ears. It’s usually a symptom of an underlying condition, such as hearing loss or an ear injury. “One theory about the cause: When hair cells in the inner ear are damaged by a trigger like loud noise, random electrical impulses are generated, which the brain perceives as ringing,” Sydlowski says. Other possible culprits include high blood pressure (which can restrict blood flow to ears), stiffening of the bones of your inner ear (a condition called otosclerosis), jaw joint problems (TMJ) and certain medications, such as the antibiotic erythromycin and the antimalaria med quinine.

What it feels like A ringing, buzzing or hissing sound that may vary from a low roar to a high-pitched squeal. You may hear it in one or both of your ears, and it can either be constant or come and go.

Rx If you experience tinnitus after being exposed to a loud noise, wait a day or two to see if it subsides. But if it doesn’t, visit an audiologist. Treating the cause or going off the offending meds should make symptoms disappear.

How infections start

While kids are much more prone to them than we are, middle ear infections—which usually develop after fluid builds up there after a cold—may be on the rise in adults, says Dr. Backous. “I see this more and more in my practice,” he notes, “probably because there’s more particulate matter in the air on account of pollution and smoking that can trigger infections.” That said, the most common kind of ear infection in grown-ups is an outer ear infection, aka swimmer’s ear. It’s typically caused by water left in your ear after a swim, but “it can also be caused by sticking cotton swabs in your ear, which damages the thin layer of skin lining your ear canal,” says Sean McMenomey, MD, professor of otolaryngology at New York University. Prevent them by refraining from putting swabs or even fingers deep into your ears. If you swim, rinse your ears out afterward with a mixture that’s 50 percent rubbing alcohol and 50 percent white vinegar—use a baby syringe to squirt it in.

How you hear

1. A source of sound sends vibrations, or sound waves, into the air.

2. The waves funnel through the ear opening, go down the external ear canal and strike your eardrum, making it vibrate.

3. The vibrations are passed to the three small bones of the middle ear.

4. The bones transmit them to the cochlea, which contains tubes filled with fluid. Inside the tubes, tiny hair cells pick up the vibrations and convert them into nerve impulses.

5. These impulses are delivered to the brain via the auditory nerve.

6. The brain interprets the impulses as sound (music, voice, a car horn, etc.).