Just like with headaches, there is tinnitus and there is TINNITUS! And like so many others, my doctor told me that the noise in my head was common and I should learn to live with it because nothing could be done. But he wasn’t awake most of the night, fatigued, stressed-out, irritable, and depressed. It got worse and worse until I saw an ear specialist who did a complete evaluation. I felt better just knowing that there was no dangerous underlying cause. Just avoiding caffeine and aspirin reduced the severity by half. Working out each day and avoiding naps helped me sleep at night and gradually I began to feel healthy again. I learned about sound therapy for tinnitus, but I was already in good shape.
Sometimes misinformation is worse than no information at all, especially if it leads to misunderstanding and poor medical care. The following are some common myths that may lead to injury, delayed treatment, and unnecessary expense.
MYTH Oral antibiotics are necessary to treat outer ear infections such as swimmer’s ear.
FACT Not true. Most outer ear infections, also called external otitis (see chapter 12), occur on the surface of the skin of the ear canal. Because the blood supply is poor there, oral antibiotics may not reach the infection in high enough concentrations to be effective. Antibiotic ear drops are a better choice because they contain high concentrations of powerful antibiotics that are applied directly to the infected area. Ear drops are also slightly acidic, reducing the growth of bacteria. Oral or injectable antibiotics may become necessary in people with low resistance to infection (people who have diabetes, transplant or cancer patients, and people who have HIV or AIDS) or when the bacteria begin to penetrate into the deeper layers of skin, cartilage, or bone.
MYTH Ear wax is just dirt.
FACT Not true. Ear wax, also called cerumen, is an important protective substance produced by glands in the skin of the ear canal along with skin cells that are shed daily, just like skin cells everywhere in the body. Cerumen exits the ear canal on its own during showering, swimming, and normal everyday activities and carries with it other matter that may have entered the canal. Cerumen’s main functions are to protect the delicate skin of the ear canal from damage by moisture and to fight outer ear infections such as swimmer’s ear.
MYTH Cotton swabs are necessary to clean the ear canal.
FACT Not true. The ear cleans itself in most cases. Because cotton swabs are about the same diameter as the ear canal, they often act as a plunger, pushing wax back into the ear canal and against the eardrum. Because they are long and stiff, swabs cause injuries to thousands of people every year. Often the skin of the ear canal is damaged by the swab, leading to infections. Sometimes the swab is poked through the eardrum, causing hearing loss, tinnitus, and intense pain. Severe injuries often occur when someone gets bumped on the elbow while using the swab at the bathroom sink; such injuries may require surgery to repair.
MYTH Ear candling removes wax from the ear canal.
FACT Not true. This multimillion-dollar industry is a magic act. Ear candles are hollow and are touted to create a vacuum when the wick is lit and the base is inserted into the ear opening. The vacuum is said to suck out ear wax, and the wax that accumulates in the base of the candle is supposed to be the proof. But careful studies have shown that the wax accumulation in the hollow candle is actually melted from the candle itself and has no cerumen in it. The candles do not create any vacuum and many people have been burned when the candle’s wax drips down into the ear canal.
MYTH Ear pain means ear infection.
FACT Not necessarily true. While ear infections commonly cause ear pain, there are also other important reasons for pain. Temporomandibular joint pain (TMJ) is the most common cause of ear pain that does not come from the ear. TMJ pain is from inflammation or trauma to the joint that connects the jaw to the skull. This joint has pain fibers from the same nerve that serves the ear, so TMJ pain is often mistaken for ear pain. Disorders of the teeth, throat, and voice box may also cause pain that feels like it is coming from the ear, also because they share a common sensory nerve. This is technically called referred pain.
MYTH Children with ear tubes must not go swimming.
FACT True in some cases. While this is true with some types of ear tubes, it is safe for most children with tubes to swim in private, chlorinated, filtered pools. Ear plugs or head bands are not required by most physicians. But there are some limitations. The child’s head should not be submerged more than 6 inches. And the ears should not be submerged in bathwater, lakes, rivers, kiddie pools, hot tubs, or at the beach. Your ear doctor will advise you on a case-by-case basis.
MYTH Parents or the pediatrician will know if a child has hearing loss by two or three months of age.
FACT Not true. Before the era of universal newborn hearing screening, the average age at which children were identified with severe hearing loss was two to three years. Children with mild hearing loss were usually not discovered until age four. Delay in diagnosis can hinder language development, and the results can be permanent. Today, hearing loss is usually diagnosed before twelve months of age. According to the Centers for Disease Control and Prevention, in 2011, 98 percent of American newborns were screened for hearing loss.
MYTH Loud sound is not dangerous if it does not hurt.
FACT Not true. Sound will damage hearing at 85 decibels (moderately loud machinery for eight hours) but pain may not be noted until levels of 110 decibels or more (jet plane taking off at 150 feet).
MYTH Health food supplements can improve hearing and reduce tinnitus.
FACT Not proven. Many supplements such as bioflavonoids, zinc, ginkgo biloba, and other antioxidants have been promoted as over-the-counter remedies for decades. Many studies have failed to show that these treatments work better than a placebo. However, it has been shown that any treatment for tinnitus that promotes a sense of well-being or reduces anxiety will also lessen the perception of tinnitus. The placebo effect is around 30 percent for tinnitus, so most supplements have helped someone.
MYTH There is no treatment for tinnitus.
FACT Not true. Tinnitus is a symptom, not a disease, and may be caused by several different disorders. Although there is no known cure for most tinnitus, it can be effectively treated (just as high blood pressure and diabetes can be treated if not cured). Most people can be helped, especially with early diagnosis. Most tinnitus is responsive to cognitive behavioral therapy, use of hearing aids, or other sound-based treatment. In rare situations, tinnitus may be caused by a dangerous underlying condition (such as a tumor or aneurysm) and require medical or surgical treatment. Individuals with pulsating tinnitus or tinnitus that is louder in one ear than the other should consult the doctor immediately since these are red flags.
MYTH There is no treatment for nerve deafness.
FACT Not true. Both hearing aids and cochlear implants can be very helpful for people with nerve deafness. Hearing aids are useful for mild-moderate-severe hearing loss and cochlear implants are safe and effective treatment for moderate-severe-profound hearing loss (see chapter 5).
MYTH Hearing aids weaken the ear.
FACT Not true. Hearing aids do not act like crutches. This is because the ear is not a muscle. It does not get weaker or atrophy when you use hearing aids.
MYTH It is necessary to spend $4,000 to $6,000 to buy a good pair of hearing aids.
FACT Not true. It is a fact that hearing aids are expensive, which probably explains why only about 10 percent of people who need them make the purchase. But here’s a tip to saving. A built-in charge for long-term service is often bundled into your initial cost. When you purchase hearing aids, ask your specialist if you can unbundle the price and pay only for service if it is required. Since hearing aids are often replaced every four years, you may see significant savings.
Alternatively, good hearing aids can now be purchased online for about half the usual retail cost. Like all hearing aid purchases, online hearing aids may be returned for a refund within one or two months if you don’t like them.
Also, keep in mind that hearing aid manufacturers invest a lot of money on research to improve hearing aids, but not everyone requires the latest innovations. Depending on your needs, simplified hearing aids may work as well or better than complicated ones, just as we may find with automobiles, cell phones, and computers.
MYTH Children younger than twelve months old cannot use hearing aids.
FACT Not true. Children may use hearing aids by one month of age. When an infant has a hearing loss, it is important to use amplification as soon as possible to minimize delays in language development.
MYTH Cochlear implants do not work for children who are born deaf or for adults with nerve deafness.
FACT Not true. The best results with cochlear implants for many children who are born deaf occur when implantation is done at or prior to twelve months of age. Cochlear implants are also very successful in adults who have become deaf later in life.
MYTH People with cochlear implants hear only buzzing and clicking noises.
FACT Not true. Cochlear implants are designed to help people understand speech. The average cochlear implant recipient comprehends about 80 percent of what is said and many understand 100 percent in quiet surroundings. Users recognize the voices of friends and relatives and many appreciate music. Nonetheless, hearing achieved with a cochlear implant is not entirely normal, and background noise can interfere with comprehension. Worse results are expected in babies born deaf who do not receive an implant by twelve months of age, people who primarily communicate with American Sign Language, and older adults who also have memory loss or dementia.
MYTH Most dizziness is caused by stroke or other brain disorder.
FACT Not true. Most cases of dizziness and vertigo are caused by ear disorders, including the most common cause of vertigo, benign positional vertigo (see chapter 10). Other common inner ear balance disorders include Ménière’s disease and labyrinthitis. Disorders of the cardiovascular system are the next most common, followed by brain disorders.