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The Pharmacist Answers Podcast

Have a question for the pharmacist? Get your answers here! Clear explanations about complicated medical topics that anyone can understand. Disclaimer: The information contained in this blog and related podcast are not to be taken as medical advice, they are for informational and educational purposes only. If you resemble anything that is mentioned in this blog or related podcast, contact your doctor. The information contained in this blog and related podcasts is the opinion of the author and does not relfect the views of her employer, Walgreens. If you want to know what Walgreens thinks, ask Walgreens!
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May 8, 2017

PSA:  Please don't stick things in your ear any larger than your elbow...and that includes your finger.

Outer ear = the part that you can touch
Middle ear = the area being the ear drum
Inner ear = the cochlea and area responsible for your balance

3 common ear issues
- Ear infections (otitis media)
- Vertigo (and motion sickness)
- Tinnitus (ringing in your ear)
*Ear wax?  <-- Go here

The area behind your ear drum has air in it and that pressure is equalized through the eustachian tube.  If that area gets fluid in it, that fluid can grow bacteria and that leads to infection.  The natural motion of opening and closing your jaw helps massage the eustachian tubes and moves air in and out (like when you fly or drive in the mountains and you chew gum or yawn).

Cold and allergies can be the source of the fluid build up that leads to ear infection.  You may have decreased hearing, pain, decreased balance - infection can require antibiotics.

Vertigo = the sensation of spinning, dizziness, being off balance
The semi-circular canals are responsible for your balance.  If it get sloshed too much, or doesn't level out exactly right, then the signals sent to the brain may translate to being off balance even though your body is upright.  The signal confusion is what can lead to nausea (it's not actually happening in your stomach - at least not until you vomit!)
The fluid moving around in these canals are why kids can induce dizziness when they spin around in circles (think about the clothes in your washer during the spin cycle - they get pushed to the outside).
Medications  for vertigo are the same as some medications for nausea - plus they have drowsy side effects, so maybe you just sleep it off.
There are many suspected causes, but nothing definite or proven.

Tinnitus = ringing, buzzing, roaring, whooshing sound when nothing is actually making that noise.
Causes: hearing loss (either due to aging or exposure to loud noises); high blood pressure (pulsating); medications
One theory: the hairs in the cochlea are damaged so those frequencies of sound (usually high pitched sounds) can't be picked up anymore; the brain fills in the gaps with "made up sound".  This is NOT PROVEN!
High blood pressure can cause you to hear the blood pulsing through the blood vessels in your ears.
Medications that causing ringing in the ears
- Aspirin (acute over-use)
- Aminoglycosides (i.e. Gentamicin = antibiotic) - it has a small therapeutic window, too much can lead to ear damage, it stopped in time, permanent ear damage can be avoided
- Quinine = usually asked for to help leg cramps, also medically prescribed to prevent malaria.  Can only be readily consumed by drinking tonic water.

Flavonoids are put in vitamins and advertised to help tinnitus.  Flavonoids are phytonutrients (nutrients you get from plants).  These nutrients can't grow the hairs back in the cochlea.  Most of the vitamins and nutrients in the flavonoid vitamins have anti-oxidative properties, but I doubt that tinnitus is a major oxidation problem.

Can being slapped over time cause ringing in the ears?
- being bopped in the face and head can probably cause permanent damage to the structures on the inside and outside of your head.  Being hit in the side of the head can cause pressure build-up in the ear where the air causes the ear drum to rupture.
- Slaps to the face (like "you jerk!" kind of slaps) don't affect the ears, but punches or slaps to the side of the head near or on the ears can possibly cause damage.

Be nice to your ears!

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"Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

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