If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

I work at a loud club and it is affecting my hearing

Question:
Hi there,
I am a bartender at a loud club. Even though I am constantly asking the DJs to turn down the music, we have an old sound system that is not that sensitive to small adjustments, and it is a club after all and people like it loud. Not only do I have trouble hearing people ordering drinks, but I feel that working there has permanently and detrimentally affected my hearing. I wanted to see about getting ear plugs that would bloc out the most harmful frequencies while still allowing me to hear patrons’ orders over the bar. Do you have any recommendations? Is this something insurance would cover? If not, how much would this service cost? Thank you so much! –

Answer:

Noise can definitely affect the hearing.  When you have a ringing in the ears after noise exposure, that is a sign of damage to the hearing nerve.  Prolonged loud exposure- or even a single loud blast- can cause permanent noise induced hearing loss.  The government regulations (OSHA) limits noise to 85 dB over an 8 hour period-  but even that has been shown to cause losses.

Certain things can be done- relatively easily- even at most clubs.   We used to see musicians with horrible hearing losses.  They typically placed the amps behind them-  Today we know that the amps should be placed stage forward, and the musicians can use either small monitors- or in the ear systems to hear themselves.

Clearly, this is not what is going on at your bar-  However,  changing the placement of the speakers, so that they are away from the bar, or lowering the sound on speakers near the bar can help.  Placing a small baffle (soundproof divider) can also significantly lower the noise exposure.

Alternatively,  you can have ear plugs made professionally, to help.   They are molded to your ear canals, and can help lower the noise level significantly.   They should help further by lessening the high pitches more than the sounds used for speech.  Hopefully, they will not interfere significantly with your hearing for speech.

You should probably have your hearing monitored, to make sure you are not developing a significant hearing loss from your job.

We make noise attenuating ear plugs at the NY Hearing Center.  These are usually not covered by insurance- (?- not sure why) and can run about $200 or so.

I hope this clears things up.

Robert Pincus MD

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

I have had an ear infection and echoing for 7 weeks

Question:

My name is Don, 43 had an ear infection in both ears. Started in my left ear and my family doctor gave me ear drops than my right ear got infected. So the doctor prescribed antibiotics. The infection went down but she prescribed another round of antibiotics. The infection went away but was having echo noises. She prescribed steroids, but still the echo still there. Then I went to an ENT and she gave me steroid injection. It’s been 4 day now an I’m still have the echo noises. From the day I had an infection it now it’s been 7 weeks. Also, I had no pain during my infection. Please help.

Thank you,
Don

Answer:

Don,

Thank you for your question.   I wish I could give you an easy answer.  There are three different types of ear infections.  An infection in the outer ear- otitis externa, (ear canal),  the middle ear- otitis media (where the hearing bones are)  and the inner ear (where the hearing nerve is).   Each has a different presentation, a different set of symptoms, a different cause and different treatment.

An outer ear infection  (otitis externa) is an infection of the skin lined tube which makes up the ear canal.  This is often called swimmer’s ear.  There will frequently be pain when you pull on your ear lobe.  It is generally treated with ear drops and keeping the ear dry.

A middle ear infection (otitis media) is caused by a blocking of the tube that drains fluid from the space behind the ear drum.  This is common in children, or in adults after flying with a cold.  There is usually a hearing loss associated.  It is frequently, but not always painful, and  pulling on the ear does not cause discomfort.  It is usually treated with antibiotics and nasal sprays or decongestants to open up the eustachian tube that drains the middle ear.

An inner ear infection is usually caused by a viral infection of the nerve.  It can cause a sudden hearing loss, spinning vertigo, or both.  There usually is no pain  It is generally treated with steroids- either by mouth or now by injection into the ear. (trans-tympanic steroid injection)

I am not sure which type of infection you have-  or perhaps a  combination of more than one.  If you had a steroid injection, it sounds likely that this was an inner ear infection.  I would speak to your ENT doctor further so that you can get a better understanding of what has been going on and what your treatments and course should be.

Of course, if you’re in the area, we would be more than happy to see you here at the NY Otolaryngology Group and  help clear things up.  Bringing any hearing test you might have had would be quite helpful.

Robert L Pincus MD

NY Otolaryngology Group

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

What is Causing This Pain in My Ears?

Question:

Hello,

I have had this ear infection for more than a week. It causes me headaches, and the pain on both of my ears is unbearable. I was hoping you could help me by telling me the possible causes of this pain.

Answer:

I wish I could give  you the answer without knowing more about your problem.   Unfortunately, there are many different causes of ear pain, most can also cause facial pain as well.

An outer ear infection is a skin infection of the ear canal.  Often, there can be a discharge, but not always.  Typically, pulling hard on one’s ear lobe will be painful if that is the problem.  This ususally is treated with ear drops.

A middle ear infection is an infection in the space behind the ear drum.  That typically comes with nasal congestion, such as from a cold, or can occur with change in pressure- such as in air plane flights.  Usually, the hearing will be diminished, and you won’t be able to “pop” your ears- that is opening the eustachian tube that goes to the back of the nose from the ear.  It is usually (but now not always) treated with antibiotics and medications to open the nasal passages.

An inner ear infection is deep to these structures, commonly viral, and frequently presents with a hearing loss, with or without feeling dizzy.

There are also non infectious causes of ear and facial pain.

Commonly people can have persistent pain in the ear and face from the jaw joint.  That is the space just in front of the ear.  If you push there and open and close your jaw, people with such problems, (TMJ) will experience tenderness and often pain.  This pain can be quite severe (think of your back “going out”) and typically is worse with chewing.  That is treated with warm compresses, a soft diet, and an anti-inflammatory such as advil or aleve.

Finally, one can have what we call “referred ear pain”.   That is like when someone has a heart attack and they get left shoulder pain.  The nerves that go to the throat also go to the ear, so something like a bad sore throat, or rarely a tumor, can cause ear pain.

Unfortunately, it seems like the best idea would be to have your ear examined by someone who can help you find out which problem you have.

Robert Pincus MD

Co-director NY Sinus Center

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

Can ear pain be from my teeth?

Question:

I found your Web Page while trying to figure out what is wrong with me, if you were closer to California I’d book an appointment.

I’m a 41 yrs old and I started having trouble with my right ear they keep our offices very cold I sit directly under three vents I have been sitting under the vents for about three years now I do come down with the minor head cold occasional flu sometimes I believe that contributes to it since I wash my hair in the mornings and it’s too thick to completely dry with a blow dryer so my hair remains damp and having the cold air blast down on me all day at work does not help.

Well, with the holidays fast approaching and too much to get done before our holiday break I didn’t have time to be sick so I kept ignoring the fact that my ear was hurting … my ear pain was not tolerable it was hurting so bad I looked up some ear remedies I found online I poured in a few drops of Hydrogen peroxide into the infected year and it seemed to have helped a bit until that night I woke up with the worst pain my that shot from my ear to my teeth so Sunday morning I was in urgent care the Dr. or PA whatever he was asked a lot of questions even took an EKG to my surprise and diagnosed me as having facial arthritis and recommended I go see my dentist about my teeth, I was shocked.

So I went to see my dentist he took x-rays tapped on teeth, did a cold test that did eventually result in major pain and referred me to an Endodontic I have an apt with him tomorrow. But still refuse to believe it’ my teeth all this started with an earache that is still present and a swollen gland all of this by the way is on the right side, maybe I should believe it might be facial arthritis I highly doubt since I have no history of arthritis, and I believe I would probably be getting it in my hands before my face since I tend to use my hands more.

Answer:

Thanks for your question.  While I can’t tell for sure what is causing your ear pain without examining you , it certainly can be from your teeth- or more likely your jaw joint.   The back wall of the jaw joint is also the front wall of the ear canal.  Pain from the jaw joint typically presents as ear pain- and usually much more painful than what one gets from an actual ear infection-  it creates a muscle spasm pain like when your back goes out.-

This can occur from a dental infection- but most commonly is from grinding one’s teeth (bruxism).

Put your finger just in front of the ear and open your mouth-  if that is painful, you are likely to have what is often called ” TMJ”.  You don’t need to have true arthritis-

The treatment is first making sure there is in fact no ear infection.   If the problem is from the jaw- we recommend a warm compress, a soft diet and an anti-inflammatory (motrin, advil, aleve etc)-  Should this persist, then we suggest following up with your dentist-  If you are indeed grinding your teeth, you may find a bite plate at night (either from your dentist- or there are some availble at the drug store for this purpose)  helpful.

R Pincus MD

NY Sinus Center

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