Most people would agree that few symptoms are as bothersome as a blocked ear. The sensation of a blocked ear, often described as fullness, pressure, or reduced hearing, is a very common symptom that can appear at any age. Although it is not always accompanied by pain, it causes significant discomfort and affects quality of life. In every case, resolving the problem depends on its underlying cause.
The anatomy of the ear and its importance
The ear consists of the outer ear, the middle ear, and the inner ear. The outer ear includes the auditory canal and the eardrum. The middle ear is an air-filled space that contains the tiny ossicles (malleus, incus, and stapes). The inner ear houses the organs of hearing and balance.
The Eustachian tube is the channel that connects the middle ear with the nasopharynx and regulates the pressure between the middle ear and the external environment. When the pressure cannot be equalized, negative pressure builds in the middle ear, pulling the eardrum inward and creating the sensation of blockage.
Causes related to a blocked ear
A blocked ear can result from various mechanisms, such as:
- Fluid in the middle ear (otitis media with effusion)
- Accumulation of earwax (cerumen)
- Sudden changes in atmospheric pressure (e.g., flying, diving)
- Presence of a foreign body in the ear canal
- Obstruction or dysfunction of the Eustachian tube due to infection or allergy
- More rarely, inner ear disorders such as Ménière’s disease or sudden sensorineural hearing loss.
An accurate diagnosis is important, as treatment differs depending on the cause.
Eustachian tube obstruction
Obstruction of the Eustachian tube is one of the most common causes of fullness in the ear. This tube allows ventilation and drainage of secretions from the middle ear while helping maintain pressure balance. When it becomes blocked, negative pressure develops in the middle ear, leading to fluid buildup and the sensation of fullness.
Common causes of obstruction include:
- Upper respiratory infections (cold, flu, sinusitis)
- Allergic rhinitis
- Sudden changes in altitude
- A mass in the nasopharynx
Altitude changes and blocked ear
Many people temporarily feel their ears blocked when flying, driving at high altitudes, or diving. The sudden change in pressure cannot be equalized quickly enough by the Eustachian tube, resulting in the characteristic feeling of fullness.
The Eustachian tube and the eardrum attempt to compensate, but obstruction or delayed opening may cause discomfort and partial hearing loss.
Blocked ear due to earwax (cerumen plug)
Earwax plays a protective role, cleaning the auditory canal from dust and microorganisms. Usually it is soft and exits on its own, but it can harden and form a plug that blocks sound and causes hearing loss. It should be noted that using cotton swabs does not remove the wax but pushes it deeper, worsening the obstruction.
Foreign bodies
In children, the presence of a foreign body in the ear canal is a frequent cause. Small objects inserted out of curiosity may lead to irritation, inflammation, and blockage.
In these cases, the object is removed with special ENT tools, and in children sometimes under general anesthesia.
Ménière’s disease and balance disorders
Ménière’s disease is a rare inner ear condition characterized by episodes of fullness, hearing loss, and vertigo. These symptoms result from abnormal fluid circulation in the inner ear and require specialized diagnosis.
Other causes behind a blocked ear
Beyond the usual causes, a blocked ear may also be linked to:
- Acute otitis media (infection behind the eardrum)
- Acute otitis externa (infection of the ear canal)
- Sudden sensorineural hearing loss
- Benign tumors such as acoustic neuroma
- Temporomandibular joint (TMJ) dysfunction.
How is a blocked ear treated?
Management generally depends on the cause:
- Cerumen buildup: treatment involves careful cleaning by an ENT specialist. Do not use cotton swabs, as they can push the wax deeper or injure the eardrum.
- Foreign body: diagnosis is made with otomicroscopy, and removal is performed with specialized tools. In uncooperative children, this may require anesthesia.
- Otitis media with effusion: initially, pressure equalization exercises are recommended, such as the Valsalva maneuver (gentle exhalation with the nose and mouth closed). In children, blowing up balloons or using special devices can help. If fluid persists, corticosteroids may be given, or surgery may be necessary—usually tympanotomy with placement of ventilation tubes.
- Eustachian tube dysfunction due to infection or allergy: management is conservative and may include nasal decongestant sprays, antihistamines, or nasal corticosteroids.
- Altitude or air travel: chewing gum, yawning, or performing the Valsalva maneuver often relieves the sensation of fullness. Preventively, decongestants may be used before flights or dives.
- Ménière’s disease: requires specific treatment, which may include diuretics, a low-salt diet, and other therapies depending on the symptoms.
When should patients see a doctor?
Patients should consult an ENT specialist if:
- The blocked ear persists for days or weeks
- There is sudden and severe hearing loss
- There is severe pain, dizziness, or fluid discharge
- The symptom is accompanied by facial weakness or follows trauma.
Timely diagnosis ensures better treatment and faster recovery.
A blocked ear is a common and often temporary symptom, but it can result from many different conditions, ranging from simple wax buildup to more serious disorders. Understanding the cause is the key to proper management. ENT Surgeon in Athens Dr. Olga Papadopoulou can identify the reason behind the sensation of fullness in the ear and apply the appropriate treatment strategy.