Ears Archives - ENT Health

Ear Health Tips for Scuba Diving and Free Diving

John Trumbo — Mon, 31 Mar 2025 16:05:35 +0000

Ear Health Tips for Scuba Diving and Free Diving

Scuba diving is an incredible activity that lets people submerge into and explore an entirely different watery world. But to breathe air, special equipment and precautions are necessary when going underwater. Remember that diving carries some inherent risks and recreational divers should always do everything possible to minimize their risks, optimize safety, and keep your ears safe and comfortable while scuba diving.

What's Important to Know about Ear Anatomy?

The ear consists of three parts: the outer ear (including the ear canal), the middle ear (the air-filled space behind the eardrum), and the inner ear (the fluid-filled portion that contains hearing and balance nerves and mechanisms). The eardrum picks up sound from outside and passes it into the middle ear where three tiny hearing bones transmit the sound to the inner ear. The eardrum is a watertight, elastic membrane but it’s also very thin and extremely sensitive to changes in pressure. The middle ear is full of air and the pressure needs to be equalized with the outside environment or it will stretch the eardrum, potentially becoming painful. The air vent to the middle ear is known as the Eustachian tube, which contains a valve that is normally closed to prevent material, germs, and internal sounds from entering the ear. It normally opens every few minutes when you swallow, yawn, or move your jaw.

Why and How Should Divers Clear (or "Pop") Their Ears?

When divers move deeper underwater, the surrounding water pressure increases rapidly, but the air pressure in the middle ear will not change unless the Eustachian tube opens to clear the difference in pressure. That’s why it’s important that divers learn to clear their ears frequently as soon as they feel any “squeeze” or change in pressure (also when returning to the surface). Most divers find that it is more challenging to clear their ears when descending because the middle ear pressure becomes less than the surrounding water pressure and this squeezes the valve of the Eustachian tube, making it harder to open. When ascending, the middle ear pressure is greater than the outside pressure and it tends to push the air out through the valve on its own. The same effects occur in air travel, but the rate of pressure changes is greater with diving.

There are several techniques to clear the ears, including:

Valsalva Maneuver—A person holds their nose and mouth closed and gently tries to blow their nose without letting the air out. This is the most common technique. The nose blowing should never be forceful or abrupt as the excess pressure suddenly popping into the ear could damage the eardrum, middle ear structures, or even cause permanent nerve damage to hearing and balance.

Lowry Technique—A person performs the Valsalva maneuver while swallowing at the same time. This may take some practice.

Edmonds Technique—A person tenses the soft palate (the soft tissue flap in the back of the roof of the mouth) and throat muscles, pushing the jaw forward and downward, then performing the Valsalva maneuver. An exercise that can help you to learn this technique is to hold the mouth open halfway, place the tip of the tongue against your upper two front teeth, then try to swallow.

When diving, it’s easiest to clear your ears when your body is vertical with your head upward and fins pointing downward. You can also tilt your head back, looking up toward the surface, which brings the Eustachian tube into a horizontal position, making it easier to open. You should clear your ears frequently and as soon as you begin to feel any ear squeeze before continuing. Most people will feel pain if they go below two meters (6.6 feet) without ear clearing, and the eardrum can even rupture by three meters (9.8 feet) depth without clearing.

What If I Cannot Clear My Ears?

Difficulty clearing the ears with pressure changes is called “barochallenge” and failure to clear the ears can cause pain and injury to your ears, known as “barotrauma,” including eardrum rupture and hearing loss. If you cannot clear your ears, stop, grab a descent line if available to stabilize your depth, and ascend a bit to try to make it easier to clear. If you still cannot clear, give “Not OK/Problem” hand signals to your diving buddy (i.e., hand outstretched, palm down, fingers splayed out, rotate wrist/hand so thumb and little fingers rock up and down) followed by pointing to your ear. Ultimately, it’s best to return to the surface and try again later or another day. Do not try to “push through” the pain.

Also, a respiratory illness or allergies causing nasal congestion may make it more difficult to clear your ears. If you cannot clear your ears using the techniques above, then you will likely not be able to clear your ears underwater, which is more challenging.

Are There Treatment Options to Help Clear My Ears?

Allergies can be treated with antihistamine medications, nasal steroid sprays, and nasal saline irrigations. Antihistamines come as oral or nasal spray medications that are available over the counter. Some common oral medications include cetirizine (Zyrtec®), loratadine (Claritin®), and fexofenadine (Allegra®). These medications are usually non-sedating. Diphenhydramine (Benadryl®) is sedating and therefore not a good choice for diving. There are many different nasal steroid sprays, and they are generally similar. They will work best if taken regularly for five or more days prior to diving. Decongestant sprays should only be used when necessary. Talk to your doctor to see which medication is best for you.

A decongestant spray such as oxymetazoline (Afrin®) can be taken 30 minutes before a dive and the maximum benefit will usually last about two hours. Although it is labeled as effective for eight hours, the amount of benefit is unreliable after two hours. Some divers will repeat the spray if there are to be repetitive dives on a single day. Caution should be exercised with this medication as it can raise your blood pressure and heart rate as well as increase your oxygen consumption from your tank. Additionally, it can only be used for no more than two to three days as the nasal mucosa can become highly dependent on the spray, causing severe nasal congestion when attempting to stop the medication. Decongestant spray should only be used when necessary.

An oral decongestant such as pseudoephedrine (Sudafed®) can be taken to supplement the nasal decongestant spray. Only the short-acting, four-hour tablets should be used as the long-acting tablets may release the drug at an unpredictable rate. Like the decongestant spray, it will also raise blood pressure, pulse, and oxygen consumption, and it will be an additive effect if taken together with nasal decongestant.

What If My Ear Continues to Feel Blocked after Surfacing?

If your ear feels blocked after surfacing, it may not have fully cleared and you can continue using the techniques and medications listed above. You may have a retained vacuum, or even fluid, in the middle ear and you may have decreased hearing. You should still hear your own voice normally (not muffled or distorted), indicating that your nerve hearing (i.e., sensorineural hearing) is still fine. If you have pain, you should seek medical attention, and your dive master/instructor should know who to contact nearby.

If you experience blood coming from your ear, indicating a ruptured eardrum, you should see an ENT (ear, nose, and throat) specialist. If you have dizziness, vertigo, or sensorineural hearing loss (i.e., your own voice sounds muffled or distorted, and you cannot hear yourself scratch the skin in front of your ear), then you should be seen immediately in a local emergency room. If the emergency room is unfamiliar with diving injuries, they should call a medical center who does treat such injuries or contact the Diver’s Alert Network (DAN) for advice.

What Other Precautions Should I Take?

It is not recommended to dive with a perforated eardrum. The pressure can cause water to pass through the perforation and may cause dizziness or vertigo. Severe dizziness can be disorienting and may result in nausea and vomiting, which could be extremely dangerous. It is also not recommended to wear earplugs as they trap air within the ear canal and cause pressure changes that could injure your ear.

For patients who are chronically unable to clear their ears, there is a new procedure, if appropriate, called Eustachian Tube Balloon Dilation (ETBD) that may be offered by your ENT specialist. If your doctor determines that your Eustachian tubes are chronically congested with inflammation despite treating any known existing related medical conditions (such as sinusitis, allergies, or gastroesophageal reflux disease), then the ETBD procedure might be recommended. This minimally invasive outpatient procedure can be done in the office with local or general anesthesia.

References

Divers Alert Network (DAN) (https://dan.org)

Bove AA. Diving medicine. Am J Respir Crit Care Med. 2014 Jun 15;189(12):1479-86

Lambert D, Binkley M, Gaskill Z. Underwater and Scuba Diving Accidents. Emerg Med Clin North Am. 2024 Aug;42(3):551-563.

Mallen JR, Roberts DS. SCUBA Medicine for otolaryngologists: Part I. Diving into SCUBA physiology and injury prevention. Laryngoscope. 2020 Jan;130(1):52-58.

Related Conditions

Benign Paroxysmal Positional Vertigo (BPPV)

Ears and Altitude (Barotrauma)

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Ear Health Tips for Scuba Diving and Free Diving appeared first on ENT Health.

Understanding Balance and Maintaining Independence for Older Adults

John Trumbo — Wed, 15 May 2024 14:52:04 +0000

Understanding Balance and Maintaining Independence for Older Adults

Understanding balance is an important step toward maintaining health and independence as we age. One in four adults over the age of 65 will experience a fall each year.¹ Falls can often result in injuries such as broken bones but may also make older adults reluctant to participate in activities they once enjoyed. However, difficulty with balance is not necessarily inevitable and many changes in equilibrium can be caused by issues such as muscle weakness, arthritis, vision changes, low blood pressure, and taking multiple (more than four) medications at a time, also called polypharmacy. Identifying and limiting these situations, when possible, can help many older adults avoid loss of independence.

Physical fitness is one of the most important pillars of a long and healthy life. Walking, biking, and other aerobic activities approved by your doctor promote a healthy cardiovascular system. There is even some evidence that regular sauna use can mimic the benefits of aerobic activity and support cardiovascular health. Movement-based practices such as yoga and tai chi preserve balance and stability; classes can be found in many communities and organizations.

Strength training with weights or resistance bands is a great way to prevent loss of muscle mass and strength, known as sarcopenia, that accelerates after age 50. Strength training is also a good way to prevent osteoporosis, or bone disease. There is good evidence that with stronger bones and muscles, even if you do fall, you are less likely to have a serious injury.

Be sure to speak with your doctor before making any changes in your physical activity levels.

Three Helpful Daily Exercises

Here are three exercises that you can incorporate into your daily routine. Repeat these 10-15 times daily or as recommended by your doctor:

Single-leg Stance—Standing on one leg is a great way to test your stability. As you improve, try to increase the difficulty by doing it while brushing your teeth or adding hand weights.

Step 1: Stand behind a counter or sturdy chair with your back straight and your feet together.
Step 2: Slowly lift your right foot off the floor. If you need extra support, hold onto the back of the chair or counter with both hands as you lift your foot.
Step 3: Bend your right knee to a 90-degree angle.
Step 4: Hold the stance and maintain your balance for 10 seconds.
Step 5: Lower your right foot back to the floor.

Heel-toe Raises—Shuffling your feet when you walk can cause falls. Heel-toe raises can strengthen your shin and ankle muscles, helping you walk more safely and efficiently.

Step 1: Sit or stand upright with your back straight and your hands in your lap or on your hips. Keep your feet flat on the floor.
Step 2: Press into the balls of your feet to lift your heels and stand on your tiptoes. Hold for five to 10 seconds before lowering your feet flat on the floor.
Step 3: Press into your heels and lift your toes as high as you can, hinging at your ankles, raising slowly and with control. Hold for five to 10 seconds before placing your feet flat on the floor.

Sit-to-stand—This exercise mimics a key functional movement of daily living and can boost your core and leg strength.

Step 1: Scoot toward the front of your chair with your back straight and your feet hip-width apart. You can rest your hands on your lap or the armrests.
Step 2: Engage your core by contracting the muscles in your midsection; this helps strengthen and stabilize your body and support your spine and pelvis. Press your feet into the floor as you stand up from your seat.
Step 3: Pause for a breath while standing tall.
Step 4: Hinge at your hips and bend your knees to sit down, returning to the starting position.

Additional Steps to Help You Stay Healthy

Nutrition plays an important role in overall health. To get the most out of your physical fitness goals, make sure you are eating enough protein, in addition to a diet rich in vegetables, fruits, and whole grains. Lean meats such as fish and chicken, beans, lentils, and tofu are great sources of protein. Another way to help your bones stay healthy is with adequate dietary calcium found in yogurt, cottage cheese, beans, and spinach. Daily exposure to sunlight for about 20 minutes supports your body’s production of vitamin D. Also, pay attention to how much water you drink because dehydration can contribute to problems with balance.

As we age our sleep patterns may change, too—earlier to bed, earlier to rise, for instance. While this can be explained by natural changes in your “body clock,” make sure you are getting enough sleep to feel well rested. When you are overly tired your reaction time can be delayed. Be aware that many common medications can make you feel sleepy, so regularly reviewing your medication list with your doctor and removing any unnecessary items is a good idea. Medications for vertigo such as meclizine (brand name Antivert®) and diazepam (brand name Valium®) are generally not helpful for balance problems and are not recommended for those over 65-years-old due to risk of confusion and falls. Making some simple but important changes to your sleep hygiene can also improve the overall quality and duration of your sleep.

Preparation and planning are key. There are many additions to your living place that can be installed to provide extra options for stability. Keep regular appointments to check your hearing and vision, and make sure you have well-fitting shoes. Staying active physically and socially is one of the best ways to ensure a fulfilling life as we age.

¹ https://www.cdc.gov/falls/data/

Related Conditions

Falls Prevention for Older Adults

Frequently Asked Questions (FAQs) about Age-related Hearing Loss

The Impact of Age-Related Hearing Loss

Improve Your Sleep Quality

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Understanding Balance and Maintaining Independence for Older Adults appeared first on ENT Health.

Tips for Preventing Congenital Cytomegalovirus (cCMV)

Brian Sprowl — Mon, 01 May 2023 19:04:40 +0000

Tips for Preventing Congenital Cytomegalovirus (cCMV)

Cytomegalovirus (CMV) is a virus that in a healthy person may cause a flu-like illness or sometimes no symptoms at all. A majority of people have been exposed to the virus at some point in their lives. However, if a pregnant mother is exposed, the virus can spread to the baby. Congenital CMV (cCMV) is the most common infection that babies can be born with.

CMV can cause a range of birth defects, including low birth weight, a small head, a rash, vision loss, liver or lung problems, neurological issues, or developmental delays. More commonly, it can cause hearing loss. CMV is the most common non-hereditary cause of sensorineural hearing loss in infants and children.

CMV is commonly spread by young children, especially toddlers in daycare. It is passed through body secretions, like saliva or urine. Children under 3-years-old can carry CMV in their secretions for months or even years after being exposed.

Here are three main tips for preventing the spread of CMV:

Good hand hygiene. Washing hands frequently is very important. Wash your hands after wiping runny noses, touching toys, doing laundry, or changing diapers. Make sure to use soapy water and wash for at least 20 seconds. Use hand sanitizer if you don’t have easy access to a sink.
Avoid sharing food or drinks. Use separate straws, utensils, and plates. Serve yourself separately. Don’t hold the child’s pacifier in your mouth and don’t share a toothbrush.
Don’t kiss on or around the mouth. Try to kiss on the forehead or top of the head instead of the cheek.

References

https://bulletin.entnet.org/home/article/22657560/out-of-committee-pediatric-otolaryngology-congenital-cytomegalovirus-and-pediatric-hearing-loss

https://www.nationalcmv.org/

Rawlinson, W. D., Boppana, S. B., Fowler, K. B., et al. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. The Lancet Infectious Diseases 2017;17(6): e177-e188.

Adler SP, Finney JW, Manganello AM, Best AM. Prevention of child-to-mother transmission of cytomegalovirus among pregnant women. J Pediatr. 2004;145(4):485–91.

Related Conditions

Genes and Hearing Loss

Noise-induced Hearing Loss in Children

Sensorineural Hearing Loss (SNHL)

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Tips for Preventing Congenital Cytomegalovirus (cCMV) appeared first on ENT Health.

Hearing Loss with the Use of Protective Face Masks

John Trumbo — Sat, 29 Aug 2020 14:23:30 +0000

Hearing Loss with the Use of Protective Face Masks

During the COVID-19 pandemic, we have all learned about the vital benefits of wearing protective face masks and coverings. They can significantly prevent or limit the transfer of respiratory droplets that may contain the virus. However, for those with underlying hearing loss or impairment, face masks can introduce a new, unexpected barrier to communicating with others, whether they are currently using hearing aids or not.

First, a face mask or covering has the potential to alter both the volume of the sound produced when speaking as well as the tone and clarity of the words. In a way, they act as mufflers of sound. For those with significant hearing loss who have learned to use facial expression and lip reading to enhance the spoken voice, they may lose that valuable tool because the mask covers the face and mouth. Second, when you factor in social distancing of six feet or more, the challenge only multiplies for those used to closer interactions.

What If I Wear Hearing Aids?

People who wear hearing aids can have problems with a face mask fitting over and disrupting both “behind the ear” (BTE) and “in the ear” (ITE) hearing aids. Masks can interfere with tube continuity and change the position of the hearing aid in the canal, which can interfere with its effectiveness. Patients can also have their hearing aids pulled out and broken if the devices catch on the loop of the mask.

So, What Can I Do?

There are some simple things you can do to help maximize your ability to hear when someone you are speaking to is wearing a face mask or covering. One of the most important things is to try to minimize background noise as much as possible. Background noise can significantly impair a person’s ability to understand communication even in people with normal hearing.

Also, it is important to stand in front of a person when speaking instead of standing beside or behind them because you can still gather clues from body language and expressions. And if you wear hearing aids, make sure that the batteries are operational, and that the devices are fitting properly in your ear.

For those speaking to someone with a hearing loss in this situation, it is important to speak slowly and enunciate your words, while not yelling at the person. Clear masks, or masks with a clear panel over the mouth, may also be available to assist with lip reading. For individuals with hearing loss but without hearing aids, you might consider a Personal Sound Amplifying Product (PSAP) or a common phone app that amplifies sound.

Even after taking all these precautions, you should realize that it is still quite difficult for many people to hear in certain circumstances, particularly while wearing protective face masks and coverings. Just be patient and understand that everyone’s hearing circumstances may be different.

Related Conditions

How to Find the Right Hearing Aid for You

What You Should Know about Coronavirus Disease 2019 (COVID-19)

Your Ear Gear and Hearing Health

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Hearing Loss with the Use of Protective Face Masks appeared first on ENT Health.

What You Should Know about Coronavirus Disease 2019 (COVID-19)

John Trumbo — Thu, 05 Mar 2020 20:30:39 +0000

What You Should Know about Coronavirus Disease 2019 (COVID-19)

Coronavirus disease 2019 (COVID-19) is a respiratory disease that has spread around the world. Events and information regarding COVID-19 are changing rapidly; stay up to date with the latest developments from Centers for Disease Control’s (CDC) official website.

You can also learn about the CDC’s latest information on COVID-19 vaccines here.

What Can I Do to Prevent Exposure to COVID-19?

To help prevent exposure to COVID-19, CDC recommends that you:

Avoid close contact with people who are sick.
Avoid touching your eyes, nose, and mouth.
Stay home when you are sick.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

You can read more CDC recommendations, including the use of face masks, for protecting your health and the health of your loved ones here.

What Are the Symptoms of COVID-19?

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear two to 14 days after exposure to the virus. Anyone can have mild to severe symptoms. People with these symptoms may have COVID-19:

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

This list does not include all possible symptoms. Read more about COVID-19 symptoms, including when you should seek emergency medical attention if someone is showing any of these signs, from the CDC here.

Dr. Duane J. Taylor gives an overview of how ENT practices have adapted to provide treatment during the COVID-19 pandemic.

Dr. Spencer C. Payne provides an overview of proper testing techniques for COVID-19.

Related Conditions

Dysgeusia

Hearing Loss with the Use of Protective Face Masks

Hyposmia and Anosmia

Smell Retraining Therapy

Telemedicine Best Practices

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post What You Should Know about Coronavirus Disease 2019 (COVID-19) appeared first on ENT Health.

Falls Prevention for Older Adults

John Trumbo — Thu, 21 Nov 2019 16:27:29 +0000

Falls Prevention for Older Adults

Falls and their resulting injuries, disability, loss of independence, and impact on family members are among the most serious health issues affecting older adults. Falls also take a toll on the U.S. healthcare system overall. About $50 billion is spent every year on non-fatal fall injuries,¹ according to the Centers for Disease Control and Prevention.

The increased risk for falls in the elderly can be attributed, in general, to aging and decreased activity, as well as a slow deterioration of the central nervous system (brain and balance system). For example, the sensory cells in the ears’ balance system gradually decrease in number and cannot be replaced. The nerves that carry important sensory information to the brain do not work as well, leading to problems in the way the brain processes complex motor operations. Plus, nerve endings themselves do not produce the chemicals needed for the transmission of information. This process worsens after age 50.

Other conditions and disorders common in older adults can also affect the central nervous system and balance. Hardening of the arteries, called atherosclerotic cardiovascular disease, decreases blood flow and can lead to stroke. Arthritis can cause permanent crippling effects on the bones and joints of the hips, knees, and ankles, and osteoporosis can lead to bone and muscle weakness. Together, these ailments can dramatically increase the probability of serious injury from a fall or cause a spontaneous fracture that might lead to a fall.

Finally, muscle strength gradually decreases with age while joint tendons and ligaments lose their flexibility, resulting in limited range of motion. Carrying out complex motions that were once routine can become more difficult from the combined effects of bone disease, joint disease, and inactivity.

Can Medications Contribute to Falls?

Absolutely! Often, older patients are prescribed multiple medications from multiple physicians and specialists that can have additive side effects on the brain and sensory function. Coordination of all medications through a single physician can help avoid interactions leading to adverse drug reactions. Maintain a complete list of all your medications and dosages, and make sure to share this list with every provider you see. Your list should include:

Over-the-counter medications, such as antihistamines, sleep aids, analgesics, and cough suppressants
Medications used to treat high blood pressure, heart disease, allergy, insomnia, stomach acidity, and depression
Medications listing alcohol as an ingredient, since it affects movement and judgment and adversely interacts with many medications
Vitamins, herbs, and other supplements

How Can I Recover from an Injury Caused by a Fall?

Make sure to seek immediate medical attention following any fall. A thorough and complete evaluation of sensory, muscle/joint, and balance functions should be performed. This includes a search for causes of dizziness, such as disorders of the inner ear, circulatory system, heart, and central nervous system. An evaluation of the inner ear balance system can be important, as well as a careful review of all medications (prescription and over the counter), eyeglasses, hearing aids, and more.

Head injuries, sometimes caused by falls, can damage the sensory organs in the inner ears, or the brain itself. Physical activity that is recommended and approved by your physician can assist in recovery; however, injuries to the knees, hips, and back often do not heal completely and can lead to a limited range of motion. Physical therapy can help achieve the greatest possible function.

Rehabilitation as directed by professional caregivers seeks to increase the body’s range of motion, physical strength, and balance and may include physical or vestibular (inner ear) therapy designed to reduce vertigo and dizziness, gaze instability, and/or imbalance. Walkers and canes can aid stability, while simple changes in the home, such as installing handrails in bathrooms or along walls, can help increase confidence and reduce the likelihood of another fall.

It’s also important to keep in mind that drastically changing a familiar environment can delay recovery. Including family members and home support groups improves the odds of rehabilitation. Returning to approved physical activity along with social interaction with family and community organizations help patients stay active, engaged, mentally aware, and responsive to their surroundings.

What Can I Do to Help Prevent Falls?

As problematic as they can be, falls are also predictable and preventable, even for older adults. In addition to aging, many changes in muscle, bone, and the central nervous system can be brought on by inactive lifestyles and self-inflicted damage from smoking, poor diet, lack of exercise, and other factors. Although hardening of the arteries is occasionally hereditary, in most cases it can be reduced by diets low in cholesterol and saturated fatty acids, as well as regular physical exercise.

In addition to healthy diets and habits, other health considerations include:

Have regular hearing and vision check-ups—if your hearing and vision are impaired, important cues that help maintain balance can be overlooked
Get up slowly from sitting or lying down—a momentary drop in blood pressure can cause dizziness when standing up too quickly
Stay active by walking—walking is a good form of exercise and can improve your strength, muscle tone, and coordination
Enhance your balance when moving—wear sturdy, low-heeled shoes with wide, nonslip soles; a cane or walker can help maintain balance on uneven ground or slippery surfaces; avoid ice

Beware of potentially hazardous situations in your home, such as:

Keep walking surfaces smooth and even—be mindful of raised doorway thresholds; rearrange furniture to keep electrical cords and other obstacles out of walking paths; secure area rugs to the floor with approved rug tape or tacks
Ensure appropriate lighting—put a light switch by the bedroom door and by your bed so you do not have to walk across the room to turn on a light; night lights in your bedrooms, halls, and bathrooms are very helpful
Install grab handles—be sure stairways and bathrooms have sturdy handrails; use nonskid mats inside and outside your shower and tub
Use approved shower chairs and bath benches
Never stand on a chair anywhere

1 Florence CS, Bergen G, Atherly A, Burns ER, Stevens JA, Drake C. Medical Costs of Fatal and Nonfatal Falls in Older Adults. Journal of the American Geriatrics Society, 2018 March, DOI:10.1111/jgs.15304

Related Conditions

Aging and Swallowing

Benign Paroxysmal Positional Vertigo (BPPV)

Frequently Asked Questions (FAQs) about Age-related Hearing Loss

Understanding Balance and Maintaining Independence for Older Adults

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Falls Prevention for Older Adults appeared first on ENT Health.

hearWHO Hearing Screening App

Tina Maggio — Fri, 01 Mar 2019 23:06:24 +0000

hearWHO Hearing Screening App

hearWHO* is a free app developed by the World Health Organization for mobile devices which allows people to check their hearing regularly. The app is targeted at those who are at risk of hearing loss or who already experience some of the symptoms related to hearing loss.

How Does It Work?

According to the World Health Organization, the sponsor of the app, hearWHO is based on a validated digits-in-noise technology: users are asked to concentrate, listen, and enter into their mobile device a series of three numbers when prompted. These numbers have been recorded against varying levels of background sound, simulating listening conditions in everyday life. The app displays the user’s score and its meaning and stores the outcome of the test so that the user can monitor hearing status over time. Reminders to take the test regularly can be set by users. The app can be used by individuals as well as health providers with a view to facilitating hearing screening especially in low-resources settings.

Compatibility: iOS & Android Devices

Download on the App Store>

Get it on Google Play>

*hearWHO was developed by the World Health Organization in conjunction with World Hearing Day 2019. For more information, visit https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/hearwho

Related Conditions

Conductive Hearing Loss

Sensorineural Hearing Loss

Your Ear Gear & Hearing Health

How to Find the Right Hearing Aid for You

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post hearWHO Hearing Screening App appeared first on ENT Health.

Your Ear Gear and Hearing Health

John Trumbo — Fri, 08 Feb 2019 16:41:28 +0000

Your Ear Gear and Hearing Health

Your ear gear, the listening devices you wear in or around your ears, is a critical part of your hearing health. The boombox was invented in the Netherlands in 1969. A decade later, a device called the Walkman® shrank those giant speakers so they would fit around your ears, providing you with a personalized, mobilized listening experience. Then, in 2001, the world was introduced to the iPod®.

According to Statista.com, in 2017, 368 million headphones or headsets were sold worldwide. Eighty-seven percent of people use their headphones to listen to music; 49 percent use them to watch TV or movies; 36 percent to listen to the radio; 28 percent to listen to audiobooks; and 25 percent for good old-fashioned phone calls. That’s a lot of noise in your ears—what could go wrong?

Here’s What You Need to Know about Noise-induced Hearing Loss

Noise-induced hearing loss happens because of loud noises that damage the inner ear. Listening to music at volumes louder than 85 decibels (dB) for prolonged periods of time will cause permanent hearing loss. The National Institute for Occupational Safety and Health (NIOSH) and Centers for Disease Control and Prevention (CDC) permit workers to listen to 85 dB for eight hours in a row. But for every three dB above that, the time that is considered “safe” is divided in half. That means you’re only recommended to listen at 88 dB for four hours, at 91 dB for two hours, at 94 dB for one hour, at 97 dB for 30 minutes, at 100 dB for 15 minutes, and so on. The average portable music player is played at 100 dB, and cellphones or listening devices in the U.S. can produce a maximum of 115 dB.

Here Are Five Tips for Preserving Your Hearing

Turn it down—Set your volume limit on your device so you’re listening at no louder than 70 percent of the possible volume.
Turn it off—Hearing damage occurs at loud volumes for long periods of times. You can use the 60/60 rule: listen at 60 percent volume for 60 minutes, then take a break for 30 minutes or more to allow your ears to rest and recover.
Choose over-the-ear headphones over earbuds—Earbuds can be up to nine dB louder than over-the-ear headphones. That would reduce your safe listening time from two hours to 15 minutes if you were listening at 91 dB!
Choose noise-cancelling headphones—This is particularly important if you like listening to your device(s) in noisy environments, like busy city streets. Without realizing it, you will dial up the volume in your earbuds to overcome the noise around you.
It’s all about that bass—If you’re a big fan of the deep vibration and “head-banging” effect of music, use the equalizer on your device to turn up the bass. Even by turning down the volume, you’ll still get the feeling that pleases you.

That said, safe hearing levels are all based on older research. We used to think that muffled hearing and tinnitus (ringing in the ears) that we experienced after a great concert or club was just temporary hearing loss from loud music. We now know that even a limited amount of noise exposure can cause permanent damage to delicate ribbons between the hair cells in our ears. The damage only becomes obvious a decade or two later when we start having trouble hearing conversations with noise in the background. Remember: Less noise = better hearing.

Here’s What You Need to Know about Earbuds and Ear Infections

Ear canals have wax and bacteria in them. That’s not a problem unless it becomes infected. Earbuds trap wetness in the ear canal, which is worse if you’re hot and sweaty from a workout. Bacteria and fungi love moist, warm, dark areas like your ear canal, and studies show that earbuds can cause an 11-fold increase in the bacteria in the ear canal.¹

You shouldn’t share your earbud with anyone because that can increase your exposure to new bacteria or fungi. If you store your earbuds in your bag or pocket, they can also pick up outside germs that then get transported to your ear canal when you put them back in. And if you have a scratch or cut in your ear, those new germs or bacteria can lead to a serious infection.

Remember: Make sure to clean your earbuds once a week, particularly after sweating and especially if you’ve shared them with someone else. Use a cotton ball dampened (not soaked) with rubbing alcohol, and clean off any wax or debris. Store your earbuds in a clean, dry case and not loose in your bag.

Here’s How to Avoid Outer Ear Pain from Headphones

Headphones worn over or around the ear can cause pressure damage to the outside part of your ear, called the pinna. Bending or squeezing the delicate cartilage of the pinna under headphones can cause pain, and you run the risk of causing a skin abrasion that could get infected. You can also cause inflammation of the cartilage, called chondritis, which can be difficult to treat. You could even end up with a permanent deformity.

Remember: Your headphones should fit snugly but not too tight. Pain is an important indicator telling you when something is wrong. If your headphones hurt, loosen them or get another kind of headphone.

Here’s How to Maximize Your Safety with Ear Gear

It’s great to lose yourself in your favorite music or a great podcast or audiobook, but jeopardizing one of your most important senses—hearing—as you navigate the world may not be worth it. Cycling, particularly city cycling, is dangerous. Dodging cars, open doors, potholes, pedestrians, and other obstacles while pedaling is challenging with all your senses, and even more so if you eliminate or even reduce your hearing by wearing earbuds or headphones.

A 2011 study revealed that two-thirds of cyclists who wear earbuds while cycling cannot hear sirens, automobiles honking, or cars whizzing by in traffic. However, the study did find that listening to music with a single earbud and keeping one ear free of any distracting noise did not affect a cyclist’s auditory perception.²

Remember: Don’t use earbuds or headphones while walking, biking, or driving. Enjoy your surroundings! But if you must, use only one earbud or headphone at a time. Or, you can get a bone conduction headset that sits behind your ears, so you can hear music and still be alert to all that’s around you.

References

¹Mukhopadhyay C, Basak S, Gupta S, Chawla K, Bairy I. A comparative analysis of bacterial growth with earphone use. Online J Health Allied Scs. 2008;7(2):4

²de Waard D, Edlinger K, Brookhuis K. Effects of listening to music, and of using a handheld and handsfree telephone on cycling behavior. Transportation Research Part F: Traffic Psychology and Behaviour, Elsevier, November 2011.

Related Conditions

Benign Paroxysmal Positional Vertigo (BPPV)

Ears and Altitude (Barotrauma)

How to Find the Right Hearing Aid for You

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Your Ear Gear and Hearing Health appeared first on ENT Health.

How Can I Lessen the Impact of Tinnitus?

John Trumbo — Thu, 27 Sep 2018 14:06:14 +0000

How Can I Lessen the Impact of Tinnitus?

Check out These Tips for Reducing the Impact of Tinnitus

Avoid exposure to loud sounds and noises.
Get your blood pressure checked; if it’s high, get your doctor’s help to control it.
Exercise daily to improve your circulation.
Get adequate rest and avoid fatigue.
Use background music/noise or a sound machine to help dampen or eliminate the tinnitus.
Use mental techniques to push the perception of tinnitus to the background; the more you think about the tinnitus, the louder it will seem.
Take steps to reduce stress.
Reduce or eliminate your caffeine consumption.

Frequently Asked Questions about Tinnitus

Can other people hear the noise in my ears?
Not usually. Most of the time, the tinnitus is “subjective,” meaning that it is only heard by you. In rare cases of “objective tinnitus,” others may be able to use a special in-the-ear microphone to hear what you hear.

Why is my tinnitus so loud at night?
Tinnitus is a sound that is “masked” by external sounds such as office or traffic noise, TV or radio, etc. It is also not perceived when the brain is busy elsewhere, such as at work. At night, when external sounds are at a minimum and the brain is not focused on something else, tinnitus often sounds much louder and becomes more bothersome. In general, use of a sound generator at night is very helpful in decreasing the disturbance of tinnitus. If tinnitus is interfering with your sleep, you should inform your doctor.

Can my child be at risk for tinnitus?
It is relatively rare, but not unheard of, for patients under 18-years-old to have tinnitus as a primary complaint. However, it is possible that tinnitus in children is significantly under-reported, in part because young children may not be able to express this complaint. Also, in children with congenital sensorineural hearing loss that may be accompanied by tinnitus, this symptom may be unnoticed because it is something that is constant in their lives. In fact, they may habituate to it; the brain may learn to ignore this internal sound.

In pre-teens and teens, the highest risk for developing tinnitus is associated with exposure to high intensity sounds, specifically listening to music. It can be difficult for parents to monitor the level of sound exposure to teens using personal music devices or hand-held electronic games with ear buds. Therefore, the best and most effective mode of prevention of tinnitus in children is proper education on the risks of excessive sound exposure in combination with proper monitoring by parents or other caregivers. Limits on the maximum volume output can be programmed into many electronic devices.

Related Conditions

Tinnitus

Benign Paroxysmal Positional Vertigo (BPPV)

Ears and Altitude (Barotrauma)

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post How Can I Lessen the Impact of Tinnitus? appeared first on ENT Health.

Are Ear Candles a Safe Option for Removing Earwax?

John Trumbo — Thu, 27 Sep 2018 13:52:58 +0000

Are Ear Candles a Safe Option for Removing Earwax?

No, ear candles are not a safe option of wax removal as they may result in serious injury. Since users are instructed to insert the 10- to 15-inch-long, cone-shaped, hollow candles, typically made of wax-impregnated cloth, into the ear canal and light the exposed end, some of the most common injuries are burns, obstruction of the ear canal with wax of the candle, or perforation of the membrane that separates the ear canal and the middle ear.

The U.S. Food and Drug Administration (FDA) became concerned about the safety issues with ear candles after receiving reports of patient injury caused by the ear candling procedure. There are no controlled studies or other scientific evidence that support the safety and effectiveness of these devices for any of the purported claims or intended uses.

Based on the growing concern associated with the manufacture, marketing, and use of ear candles, the FDA has undertaken several successful regulatory actions, including product seizures and injunctions, since 1996. These actions were based, in part, upon violations of the Food, Drug, and Cosmetic Act that pose an imminent danger to health.

Related Conditions

Earwax (Cerumen Impaction)

Earaches

Swimmer’s Ear (Otitis Externa)

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Are Ear Candles a Safe Option for Removing Earwax? appeared first on ENT Health.