What’s that annoying sound in my ears?

Q: I have an ear problem that has baffled me for some time now. A few weeks ago, my right ear developed this persistent itch. After some time, I noticed that I could not hear properly. I decided to approach my pharmacist for a possible cure to my problem and after looking into my ear, she informed me that my ear problem was probably because it had too much wax. She recommended that I buy some medicated ear drops that would soften the wax and allow it to come out safely. Interestingly, as soon I put in the drops, the ear developed this strange irritating sound like ringing bells. I decided to stop using the ear drops and went to a doctor who suggested that the cause of the problem was probably an ear infection and prescribed a five-day course of antibiotics. He also informed me that if the problem persisted, he would refer me to an ENT specialist. The ringing sound has not stopped and in addition, I can barely hear anything wiht the affected ear. I believe that ENT doctors are not easily accessible and are also quite expensive to consult. Please advise me on which remedy or course of action would help get my hearing back.

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Ringing in the ears is a very common problem. Almost everyone has experienced it at some point, but it usually lasts a few minutes and resolves without intervention. About 20 per cent of all people develop a persistent disturbing ringing or buzzing sound in the ear, which can be associated with lack of balance whilst walking. A few, like in your case, go on to develop hearing loss.

The sudden loss of function in an organ (whether sight or hearing or smell or taste) must be urgently assessed by a trained medical specialist to prevent permanent disability.

What causes ringing in the ears?

Ringing in the ears is medically known as ‘tinnitus’.

Prolonged exposure to loud sounds is the most common cause of tinnitus. People with high risk jobs such as carpenters, steel workers, jua kali artisans who work with metal, people working around airport landing and plane parking strips, musicians, night club workers etc. may develop tinnitus as a result of their occupational exposure to loud sounds. People who listen to loud music using ear phones may get the same buzzing sound.

Blockage of the ear due to build-up of wax can lead to tinnitus and hearing loss. Often people cause this blockage by frequently pushing cotton buds into their ears in an attempt to clean them.

Ear infection (especially a severe one) can also give you a buzzing sound in your ear, but infections are often accompanied by ear ache.

The elderly sometimes develop tinnitus and hearing loss but usually the process is gradual and not sudden as in your case.

Long term medication: You haven’t mentioned whether or not you are on drugs but certain drugs such as aspirin, some antibiotics, antidepressants, anti-seizure and anti-malaria medication can give you tinnitus. In fact, over 100 drugs available on the market have listed tinnitus as a possible side effect.

Injuries to the head and neck and problems with the jaw can lead to tinnitus. Sometimes, rare conditions such as tumours inside the ear or stiffening of the small bones found on the inside of the bone may lead to hearing problems. A relatively infrequent condition known as Meniere’s disease may lead to tinnitus, dizzy spells and hearing loss.

Sometimes tinnitus can just be a warning sign of another health condition unrelated to the ear such as high blood pressure, cardiovascular disease (diseases of the heart and blood vessels), anaemia, thyroid problems, allergies, autoimmune disease (conditions where the body’s immune wrongly ‘attacks’ different organs) and even diabetes.

Tinnitus can be a real challenge to deal with because it can lead to difficulty concentrating, difficulty sleeping and anxiety— all of which significantly reduce one’s quality of life. For most people, stress and fatigue seem to worsen the ear symptoms.

You need specialist evaluation

In your case, you need to seek the help of an ear, nose and throat (ENT) specialist. There are quite a number of ENT specialists in the major cities and their consultation fees vary from Sh1,000 to Sh 5,000 (those attached to mission and government hospitals charge a whole lot less).

Although seeking help from another health professional may be cheaper, it can delay your assessment and you may end up with permanent hearing loss which will be far more challenging (and expensive) to deal with in the long run.

The ENT doctor is going to need to take a detailed history from you about the tinnitus and your hearing loss (because as you see from the list given to you earlier, there are many possible causes for your problem). Once, she is done with this, she will assess the external part of your ear for things like excess wax, infections and she will check to see if your ear drum is healthy.

Excess ear wax can easily be removed during your visit. If she cannot find anything wrong on the external part of your ear, she will then proceed to perform hearing assessment tests known as ‘audiometry’ —this will be able to give her a rough idea which part inside your ear is giving you the hearing loss. If need be, she may carry out different tests.

There is no blanket solution for your problem. Treatment depends on the cause. This will only be determined after you have had a thorough examination.