Everyone knows the feeling of having pressure on the ears. The reasons are many and varied. However, if the so-called pressure balance does not work, other ear complaints also occur.
What characterizes pressure on the ears?
If there is negative pressure in the ear, the eardrum bulges inward; the affected person complains of pain and pressure on the ears. The Eustachian tube (also known medically as the Tuba auditiva) plays the largest role in equalizing pressure on the ears. The Eustachian tube provides the connection between the middle ear and the nasopharynx and ensures that the middle ear is “ventilated” so that pressure can be equalized. Furthermore, a secretion flows through the eustachian tube, which comes from the middle ear and is transported further into the pharynx. The eardrum is not impaired in its vibrations only if the middle ear is free of secretions.
Causes
Pressure on the ears occurs when the ventilation of the eustachian tube is impaired and thus pressure equalization to the middle ear cannot occur. Medical professionals always refer to this as “ventilation disorders” or “tubal ventilation disorders.” These problems occur when the eustachian tube is blocked or swollen shut or cannot open properly. If there is negative pressure in the ear, the eardrum bulges inward; the affected person complains of pain and the familiar pressure on the ears. If the eustachian tube is closed in such a way that the secretion accumulates and presses against the eardrum, there is sometimes also pain and pressure on the ear. If the secretion accumulates, a middle ear infection can subsequently develop. Children in particular often suffer from such inflammations, as the eustachian tube is not fully developed here. Other causes of pressure on the ears are infections, allergies, too much earwax, problems with the jaw joint, muscle tension in the area of the jaw and palate, a hearing loss or even a permanently open eustachian tube.
Diseases with this symptom
- Bang trauma
- Allergy
- Hearing loss
- Angina tonsillaris
- Otitis media
- Tubal catarrh
- Nasal septum curvature
- Cold
- Sinusitis
Diagnosis and course
The medical professional must, so that the cause is found out, various examinations. It is important to contact an ear, nose and throat (ENT) specialist here. Otoscopy (earoscopy) can be used to detect changes in the eardrum. Another method is pneumatic otoscopy. During this examination, the doctor uses an otoscope to close the external auditory canal. Air is then introduced through a balloon – directly into the ear canal – and then released. During this process, the physician can observe the eardrum and determine how the pressure ratio develops. During a rhinoscopy (nose examination), any inflammatory processes that are predominantly present in the nasal cavity can be diagnosed. By means of a hearing test, it is possible to determine whether hearing problems exist. While the pressure – in many cases – subsides after a short time, sometimes such severe discomfort can occur that therapy is necessary.
Complications
Pressure on the ears can occur as a symptom of many causes. Possible complications depend on the underlying condition and range from simple accompanying symptoms such as muffled hearing and ear pain to serious complications such as hearing loss. Depending on the causes, there may also be dizziness, discomfort in the area of the ears and auditory canal, and phantom limb pain in the ear. Often, as the disease progresses, there is a “feeling of fullness” in the ear, often accompanied by difficulty concentrating and other secondary symptoms. If ear pressure occurs as a result of a disease, it is often accompanied by colds, allergies or a middle ear infection. In extreme cases, the pressure on the ears is followed by a hearing loss, i.e. partial or complete hearing loss in one or both ears. If a damaged eardrum is the cause, hearing performance may also deteriorate. Similarly with psychological causes such as stress, which can bring further complications such as physical discomfort, insomnia or weakness.If the pressure on the ears is based on an injury or tension of the jaw or cervical spine, there is accompanying headache and jaw pain, while the pressure on the ears increases. Tinnitus can occur and in turn lead to far-reaching secondary symptoms and diseases. A clarification of the complaints by a physician is recommended due to the multifaceted complications and symptoms of ear pressure.
When should you see a doctor?
In most cases, there is no need to consult a doctor for pressure on the ears. For example, if the pressure occurs during a cold or staying at different altitudes, the symptoms should subside after some time without treatment and a visit to the doctor is not necessary. However, in conjunction with other symptoms or if the pressure on the ears is persistent and cannot be compensated, it is advisable to consult an expert to find the cause of the discomfort. Symptoms of concern in connection with ear pressure include severe pain in the ear or in the area around the ear, generally severe headaches, and decreased hearing ability to hearing loss. If any of these symptoms occur, a doctor should be consulted immediately to rule out serious illnesses and to alleviate the discomfort. Even if the pressure on the ears is accompanied by dizziness or visual disturbances, a visit to the doctor is inevitable, since in the worst case a tumor could be responsible for the complaints. Doctors can usually make a diagnosis quickly based on the patient’s symptoms and medical history. If this is not possible directly, further tests are performed to find the cause. With the help of the diagnosis, an appropriate therapy can be initiated to protect the body from possible late effects such as hearing loss.
Treatment and therapy
Classic measures are yawning, swallowing or chewing, although inhaling and a slow exhalation while the affected person keeps the mouth closed and holds the nose shut can also lead to success (so-called Valsalva maneuvers). If the pressure on the ears persists during air travel, decongestant nose drops should be used – before the plane takes off. In this way, the affected person can facilitate the equalization of pressure. However, if diseases are responsible for the pressure on the ears, they must be treated. Various medications are used for this purpose. Doctors mainly prescribe decongestant nasal sprays, antibiotics, anti-allergic agents or glucocorticoids. If the cause is a buildup of fluid behind the eardrum, surgical intervention can provide relief. The physician inserts the tympanostomy tube into the eardrum, which ensures that the fluid can drain away. An exchange of air is made possible. Anatomical conditions can also cause pressure on the ears. In particular, enlarged pharyngeal tonsils or a deviated septum are classic anatomical causes that can be surgically corrected. If, for example, the eustachian tube is narrowed, so that newer methods such as balloon dilatation can be used, the physician will prefer this method. The physician inserts a balloon catheter into the eustachian tube as part of the treatment. The catheter is inserted through the nose of the patient using a special endoscope. The balloon catheter is then inflated with a physiological saline solution and subsequently dilates the narrowed passage. Experts believe that stretching leads to more space being created and the constriction can be eliminated. This treatment may well relieve the pressure in the ear. Sometimes, however, it is not possible to say whether the result will be long-lasting; the procedure is still relatively new or is actually performed in only a few cases. Another method, which is also one of the new procedures, is laser tuboplasty. This is a surgical procedure. The physician uses a laser to remove tissue directly from the entrance to the eustachian tube and can thus increase the space required by the eustachian tube. This space gain is supposed to have a positive effect on the so-called ventilation disorder. However, even with this method, it is not possible to speak of a long-term result, as there are insufficient studies advocating laser tuboplasty here as well.
Outlook and prognosis
Pressure on the ears is usually always associated with a specific situation that triggers it.It can only be treated generally in rare cases and usually disappears again relatively quickly. Therefore, only in very rare cases with this complaint, the affected person must see a doctor or take medication. The pressure on the ears causes an unpleasant feeling, which can make everyday situations more difficult. Also, the affected person can hear worse with this pressure, because the eardrum is not reached well. This therefore leads to a reduced quality of life. For most people, pressure on the ears occurs only for a short time and then disappears again once a certain situation or altitude has been left. Typical examples are flying or diving. Likewise, pressure on the ears can also occur during a flu or cold and is not really treated specifically. If the pressure on the ears occurred very spontaneously and also does not disappear on its own, a doctor can be consulted. Here, an ear, nose and throat doctor is particularly suitable, who is familiar with these complaints and can help the patient. In most cases, this complaint proceeds without any special treatment.
Prevention
If there are anatomical reasons, the pressure on the ears cannot be prevented. It is advisable that – for example, if there is too much earwax – regular rinsing or even medical cleaning of the ear canal.
What you can do yourself
Unpleasant or even painful pressure on the ears usually suggests insufficient pressure equalization between the outer and inner ear, and thus insufficient function of the Eustachian tube, which connects the nasopharynx with the middle ear. The problem often occurs in the airplane cabin and mainly during descent and landing, when the pressure in the cabin returns to normal. Pressure on the ears becomes noticeable when the Eustachian tube is a bit narrow or prevents pressure equalization for other reasons. A few everyday and self-help measures can help overcome the uncomfortable or even painful pressure. In many cases, simulated vigorous yawning already helps. This causes the tissue in the nasopharynx to be pulled apart a little, allowing the tiny amount of air needed to equalize the pressure to pass through. This is usually noticeable by a slight cracking sound and an immediate relief of pressure in the ear. If yawning is not successful, the more effective method is to hold the nose shut and create a kind of overpressure in the nasopharynx with the mouth closed. As a rule, pressure equalization then occurs with felt violent cracking. The procedure can be repeated several times. If too much pressure has built up in the middle ear, it can be easily relieved by swallowing or yawning.
