All Ears: How to Take Care of Your Hearing

March 31, 2023

We often take our ears for granted, but they’re delicate organs that can develop a multitude of problems, some of which can lead to hearing loss.

To help maintain your hearing and avoid problems, University Hospitals ear specialist Daniel Killeen, MD, answers some common questions and concerns.

Q: Should You Clean Your Ears With a Q-tip?

A: You should not use a Q-tip to clean your ears. You can potentially damage your ear drum and even create a hole in the ear drum. Most of the time, the Q-tip only pushes ear wax deeper into the ear canal. I tell people not to put anything smaller than your elbow in your ear.

For most people, the ears clean themselves, and do not require any maintenance. Some people produce more wax, or it may get trapped in the ear canal if it’s small. I recommend mineral oil or baby oil for this. Place a small amount in the ear canal a few times a week. This helps soften the ear wax and lubricate the ear canal, which will help wax fall out on its own. Ear drops may also be helpful. In some cases of significant wax build-up, I recommend occasional, scheduled cleaning under the microscope by an ear, nose, and throat specialist (ENT).

Q: Is It Dangerous to Hold in a Sneeze?

A: Holding in a sneeze is unlikely to cause permanent damage. It is theoretically possible to push enough air through the eustachian tube, which is a tube that connects the middle ear to the back of the nose, to create a tear in the ear drum, but this is unlikely.

If a tear is created, it will heal on its own most of the time. Rarely, a tear may not heal, which can be repaired surgically. For some patients with eustachian tubes that open less frequently, I recommend intentionally plugging and blowing their nose in order to push air through the eustachian tube to open it several times a day.

Q: I Have a Hole in My Ear Drum. Does It Need to be Fixed?

A: Holes in the ear drum, or tympanic membrane perforations, do not necessarily require repair. Most heal on their own without repair. If it has been several months since the initial tear, and it has not healed, it may not heal on its own. The biggest issue with tears is developing recurrent infections, which can happen when water gets in the ear. I recommend avoiding swimming and using cotton ball in the ear canal with Vaseline when bathing to prevent water from getting in the ear.

Tears in the ear may also affect hearing, which can be minimal or significant. For patients with a tear for many months who wish to resume swimming and normal bathing activities, surgical repair is an option with 80-90 percent chance of success.

Q: What Is a Safe Volume for Ear Buds/Headphones?

A: Unfortunately, there is not a uniform answer to this question. It is generally safe to be exposed to 85 decibels (dB) of sound for 8 hours. However, it is difficult to know the sound output for different headphones or ear buds. Ear buds and headphones can produce in excess of 100 dB of sound.

As a rough guideline, I would recommend keeping the volume at 50-60 percent of the maximum volume, which is safe for most ear buds or headphones. But again, this is not necessarily the case for every device. The volume is loo loud if you hear ringing or buzzing after you have stopped listening to music. This may indicate temporary or even permanent hearing loss.

Q: I Had Sudden Hearing Loss. Could It Be Wax?

A: Sudden loss of hearing may be caused by accumulation of ear wax, but it may also represent a true loss of hearing. The inner ear can experience sudden hearing loss, and we still do not know the exact reason. It is thought to be a viral infection or a vascular issue.

If treatment with either oral steroids or steroids injected into the middle ear is started soon, ideally within 2 weeks of onset, the chances of recovery of some or all of the hearing loss is improved. I recommend seeing an ENT whenever a sudden loss of hearing is experienced.

Q: My Dad’s Hearing Aid Doesn’t Seem to Work. Are There Other Options?

A: Hearing loss is a common problem that occurs with noise exposure and aging. Hearing aids are the first-line treatment and are very effective. When patients have difficulty with hearing aids, they can be adjusted by an audiologist to improve performance.

However, as hearing loss progresses, the clarity of hearing can also decline. Hearing aids are good at making sounds louder, but they cannot significantly improve the clarity. At a certain point, hearing aids become less beneficial for a person to understand speech. At this point, we often consider cochlear implantation. A cochlear implant is a device that is inserted into the inner ear to directly stimulate the nerve from the inner ear to the brain, replacing sound.

Cochlear implantation does require surgical implantation, but the majority of patients go home the same day as surgery. Sound from a cochlear implant is fundamentally different than natural hearing, and it may take 6 months or longer to acclimate to the device. Nevertheless, this is an option for patients with severe hearing loss that is no longer helped by hearing aids.