A Word with the DOCTOR
by Dr John Winsor
The Sunday Times of Malta

WAX IN THE EARS is possibly the most common cause of a gradual loss of hearing but it is also a protective excretion from the lining of the ears.

Patients who work in dusty jobs certainly get trouble more often. This may be partly due to particles piling up in the ear passages, but it is also because the secretion of wax actually collects dust particles.

Wax can partly block the ear channels so that soundwaves are limited in the effect, but the delicate, complicated mechanism of the middle ear can also seize up if “wax gets into the works". This mechanism includes three very tiny bones which must be able to move very freely if their owner is to hear properly.

Wax is sometimes pushed on to these bones by an over-enthusiastic patient using various tools to try to get the wax out. I have even heard a patient say he uses a toothpick to clean his ears.

This is dangerous and can damage the walls of the passages and allow infection to get in, as well as push the wax further along. If you think your trouble is wax go to the doctor and he or she will be able to syringe the wax out of the ear safely.

After syringing it is a good plan, especially in cold or windy weather, to keep a small plug of cotton wool in the ear until you get home.

Elderly patients should not go for a syringing appointment alone. They frequently go very dizzy for a few minutes after the ears have been cleared out, which can be dangerous once they get outside the surgery and have to travel home.

Quite often, an early sign of wax may be an itching just inside the ear, as well as a slight loss of hearing. But do not be disappointed if syringing does not cure your deafness.

There any many other causes for loss of hearing, such as nerve deafness often due to working in constant loud noise or after being exposed to a loud bang or explosion - or otosclerosis, a complaint where tiny bone deposits form in the middle ear which prevent the bony mechanism moving properly.

The main thing to remember is that constant poking and prodding by the patient can do more harm than good.