- In this video, I'm gonna show you how I test
to find out what's causing your clogged ears,
coming up.
(upbeat music)
This video is sponsored by Natus,
formerly Otometrics, the preferred diagnostic
equipment supplier of Dr. Cliff AuD.
Since the 1950's,
Otometrics has been one of the most innovative
manufacturers of hearing aid fitting equipment,
and diagnostic hearing and balance equipment
in the industry.
When it comes to testing and treating my patients,
I only want to work with the best.
This is why I use Natus in my clinic.
Some of the most popular videos that I have
on my YouTube channel are the ones where people
are trying to figure out how to clear
their clogged ears.
But every time that someone reaches out to me
asking me why their ears are clogged,
I have to tell all of them the exact same thing,
which is I have no idea
unless I can do a proper evaluation.
So I'm gonna review three common conditions
other than earwax that can cause the sensation
of your ears being clogged,
and show you how I use my Madsen Zodiac tympanometer
to figure out exactly which one that you have.
The first step that always needs to take place
when your ears feel clogged is otoscopy.
This is where your hearing care professional
will actually look inside of your ears to see
if there's an actual obstruction blocking sound.
If you're lucky, your hearing care professional
will also have a video otoscope,
like the Aurical Otocam 300,
so you can see what's actually
inside of your ear canals as well.
Now if there's nothing obvious blocking
your ear canal like earwax or a foreign object,
then it's time to break out the Madsen Zodiac tympanometer
so we can perform tympanometry to see exactly
what else could be causing the sensation
of your clogged ears.
The whole purpose of tympanometry
is to test the function of your middle ear space
and your eardrum by evaluating ear canal volume,
middle ear pressure, and compliance,
which is the movement of your eardrum.
The combination of these three measures
along with otoscopy can usually tell us
enough information to identify
what's causing your clogged ears.
When performing tympanometry,
your hearing care professional
will insert a silicone probe tip
inside of your ear canal.
This probe tip must create a good seal
because the tympanometer will be increasing
and decreasing air pressure in your ear canal
to move your eardrum,
giving you a mild sensation of going up and down
in an airplane.
At the same time,
the probe tip will be emitting a 226 hertz tone
into your ear canal and measuring the reflection
of that tone off of your eardrum.
All right, let's go ahead and take a look
at the measurements from a normal ear.
First, let me show you the ear canal volume,
which is typically abbreviated ECV.
This is the amount of actual space
between the opening of your ear canal
and your eardrum.
A normal adult ear canal volume
is typically between 0.6 to 1.5 cubic centimeters.
You can see that the volume
of this ear canal is 1.3 cubic centimeters,
which is within the normal range.
Next, let's talk about eardrum static compliance.
This is how much movement your eardrum has.
An eardrum with normal movement
has a compliance of 0.3 to 1.5 milliliters.
You can see that the compliance
of this eardrum is 1.5 milliliters,
which is within the normal range as well.
Finally, we have middle ear pressure,
which is otherwise known as tympanometric
peak pressure or TPP.
This is the air pressure inside of your middle ear space.
Depending on which norms you use,
middle ear pressure typically ranges
between negative 150 and positive 50 dekapascals.
You can see that this ear canal
has a normal middle ear pressure
of negative eight dekapascals.
When this pressure is at zero,
the pressure inside your middle ear is the same
as the pressure outside of your middle ear.
You know that pressure sensation that you feel
in your ears when you're descending on an airplane
or you're coming down in an elevator
from a really tall building?
That is essentially being caused by the pressure
inside of your middle ear space.
And until you can regulate that pressure
back to zero by yawning or swallowing,
it typically can cause you to feel clogged.
Now, tympanometry results are often illustrated
and categorized based on their shapes.
A tympanogram on an ear with normal pressure
and normal compliance is considered a Type A,
which gives us a nice compliance peak
around the zero pressure line.
Now if you have the sensation of a clogged ear
but your tympanometry results look normal,
then you absolutely need to have a hearing test
because you might actually have
a sudden sensorineural hearing loss,
which is a sudden drop in your hearing
that needs medical treatment.
So you need to get that hearing test done right away.
All right, so now that you know
what a normal tympanogram looks like,
let's go ahead and show you a couple of different
tympanograms for ears that have conditions
that might make them feel clogged.
For this one, we have an individual
with an ear canal volume of 7.7 cubic centimeters,
which is significantly larger
than the 1.5 cubic centimeters that we would expect
for a typical ear canal volume.
We also don't have a recorded
static compliance of the eardrum,
or a recorded pressure reading.
This individual has a Type B tympanogram
which is illustrated by a flat line.
This reading suggests that this individual
actually has a hole in their eardrum.
And as you can see here,
this is confirmed by visualization of the eardrum
using video otoscopy.
When we measure a large ear canal volume
without a recorded static compliance or pressure reading,
it suggests that the eardrum is not intact
and the air pressure from the Zodiac
is entering the middle ear space
without moving the eardrum at all.
Next, we have a tympanogram with a normal
ear canal volume of 1.1 cubic centimeters,
a normal static compliance of 1.4 milliliters,
but a middle ear pressure of negative 156 dekapascals.
This individual has what we call a Type C
tympanogram which is illustrated by a defined peak,
but with a tympanometric peak pressure
below the normative range of negative 150 dekapascals.
This is a case of eustachian tube dysfunction,
which is when the eustachian tube
that connects your middle ear to your throat
does not function properly,
causing a negative middle ear pressure
where it pulls on your eardrum.
Again, giving you the perception
that your ear is clogged.
And last but not least,
we have the results of an individual
with an ear canal volume of 1.2 cubic centimeters,
which is within the normal range,
but again, no static compliance reading
or pressure reading.
They also have a flat Type B tympanogram.
However, we know it isn't a perforation
because the ear canal volume would be much larger.
In this case, it's either fluid behind the eardrum
restricting eardrum movement,
or something even more serious like a cholesteatoma,
which is a benign growth of skin cells,
like a cyst, behind the eardrum.
Visualization of this ear canal
suggests that it is actually a cholesteatoma,
which was eventually confirmed by a physician.
All right, there you go.
As you can see,
having a clogged ear isn't always what is seems.
So the next time that you have a clogged ear
that you are not able to get rid of,
you need to make sure that you contact
an audiologist so you can get your ears
checked right away.
Because without performing tympanometry
and possibly a comprehensive auditory evaluation,
you could be suffering from a serious
medical condition that requires medical treatment.
That's it for this video.
If you have any questions,
leave them in the comments section below.
If you liked the video, please share it.
And if you wanna see other videos just like this one,
go ahead and hit that Subscribe button.
Also feel free to check out my website, drcliffaud.com.
(upbeat music)