Many people are worried when water gets into their ears and rush to make their hands more strangled with the hope of getting water out of your ears. What should be done?
Two situations need to be evaluated.
A) we are sure that our ears are clean (for example we have just left the office of an otolaryngologist who did a wash).
B) We are NOT sure how clean our ears are and we may have ear wax.
A) If we are sure that our ears are clean and only water has entered, we don’t have to do ANYTHING. The water, with the temperature of our body, slowly evaporates.
Getting water out of your ears is a topic that is attracting a lot of interest from DIY enthusiasts. If we browse the internet we find an infinite number of people who spread the most disparate advice to free the ears from water. With this article I hope to make it clear that any maneuver done on oneself, without being able to look in the ear, is risky and wrong.
There is also the misconception that water in the ears is harmful to some people. Water, obviously clean water from an apartment or a shower or from the sea or a lake does not involve any risk. If after a bath you have more or less intense discomfort you will have to check that you have not had contact with polluted water or do not have a pre-existing disease and the water (or rather the humidity) has activated it. In the latter case, a specialist visit will have to be made because the patient will easily have bacterial or fungal otitis externa.
Let me now examine the most common situations that, after a bath or shower, lead to the sensation of having water that has entered the ears and does not come out.
- Patient with clean ears and normal external auditory canal.
- Patient with clean ears, but with anomalies or pathologies that narrow the duct.
- Patient with ear wax in the ears.
- Bacterial external otitis.
- Fungal external otitis.
- Eczematous dermatitis of the external ear canal (eczema)
- Foreign body in an ear
1 – Patient with clean ears and normal external auditory canal.
The person with clean ears doesn’t have to do anything, they just have to wait. If you have taken a swim in the sea or in the outdoor pool during the day, just stay in the sun and wait. If you have taken a bath in the pool and the sun is not there, you can help yourself with the hairdryer (obviously used at a safe distance from your ears). Hot air facilitates the evaporation of water. If you have done the stunt of swimming in the sea at midnight and the water in your ears is giving you a lot of annoyance, you can look for a hairdryer or be patient and let the water evaporate slowly.
Other simple ways are to keep your head tilted to the side of your ear where you think you have residual water, or lie on the bed and keep your ear resting on the mattress. Another simple attempt is to pull the pavilion back and up. This makes the duct straight and the water can flow out easily.
A final idea, only if you are young, is to keep your head straight, possibly stretch the pavilion backwards and upwards, and jump on one foot, the one on the side of the wadding.
The problem may be another: how can you be sure your ears are clean? People feel clean because they shower every day, but this is irrelevant to the ears. By subject with clean ears we mean a patient who has had his ears seen by a doctor, who with a special instrument, has seen the tympanic membranes well and said that the ears are clean.
From these first considerations derives a very simple behavioral rule: if you have the habit of going to the sea or swimming pool, before throwing yourself into the water, have your ears seen by a specialist, at least once a year.
Otoscopy is important because there are situations where the water will have a hard time coming out and the specialist will tell you immediately.
2 – Patient with clean ears, but with anomalies or pathologies that narrow the duct.
This group includes those who have undergone an ENT examination and have been told that they have a narrowing of the duct, normal membrane and absence of earwax. The main diseases that narrow the duct are: duct exostoses, stenosis (or narrowing) of the duct, the presence of polyps or any other benign (or even malignant) neoformation of the duct.
The specialist, based on what he has seen, will explain what you should do and what you should expect. For example, if your problem is a stenosis or an osteoma, go to the sea calmly, clearly after a swim you will find it difficult to free your ears from the water, you will have to wait longer than the others. If your problem is an expansive polyp or tumor process, then it will be good to think about excision.
Any narrowing of the duct can improve with adequate surgical treatment. With regard to bone narrowing (e.g. exostosis), the operation is not of an urgent nature. You can also go to the sea or the pool, but you must be aware that this problem will keep the water in the bottom of the ear canal and you will only have to wait a long time for it to evaporate. You won’t have to do anything, just wait even more than a day.
3 – Patient with ear wax in the ears.
Here we are faced with people who did not show their ears before going to the beach. These people after their first bath or even after a shower will complain because they think the water has stopped in their ears. The problem is completely different. Water entered the ear canals and found ear wax. Earwax is hygroscopic, has absorbed water and has increased in volume. The effect is logical, after a bath or shower the patient with earwax perceives discomfort and a noticeable loss of hearing. Thinking that it is the water left inside the conduit is simply a mistake. It is the earwax which, with water, has increased in volume.
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4 – Bacterial external otitis.
Even these people in most cases did not undergo a visit before going to the beach or swimming pool. These people have germs in their ears. They often have minimal secretions. With the arrival of summer and water in the ears, a warm humid environment is created that favors the development of germs. In these cases the problem will not occur with the first bath as for the earwax plug, but days will have to pass. The germs will develop otitis externa, the duct will become inflamed, the inflammation will involve the tympanic membrane, there will be pain and a feeling of a closed ear. Also in this case a visit is essential. The specialist must understand that it is bacterial otitis, he will have to exclude a plug or a mycosis or a foreign body.
In many cases, germs may not be present in the ear and may penetrate with sea or swimming pool water. Care must be taken when doing the welcome. You must choose a place that is not polluted or, if you go to the swimming pool, it is important that the water is properly treated with chlorine.
If your problem is an inflammatory fact that involves edema, then a narrowing, then you will need to undergo anti-inflammatory and antibiotic therapy before going on vacation.
5 – Fungal external otitis – otomycosis.
The mycosis of the ear is all able to rara mahal acar atheristic to develop facility in the summer period. In many people, fungi are silent in the external ear canal. The subject does not notice anything. He goes to the sea or the river or even to the swimming pool and shortly afterwards he starts feeling a closed ear, pain and sometimes even a foul-smelling discharge. The patient thinks that it is the water that has stopped in the ear and does not want to go out. It is not so. The water created a humid and warm environment, very conducive to the growth of fungi. In the example I made, the fungi were pre-existing in the bathroom, but in many cases it is the water that brings the fungi into the duct. It is not essential to establish how the fungi got into the ear. It is important that otomycosis develops. The remedies proposed by non-doctors such as injecting water in the ears or other devilry of this type are completely useless. Otomycosis is a serious disease, difficult to counter even for the best specialists. The advice you can find on the Internet is just nonsense, it only serves to delay the diagnosis and consequently delay the treatment, making the result even more uncertain.
6 – Eczematous dermatitis of the external auditory canal (eczema)
It is a skin disease that lines the external ear canal. It affects allergy sufferers with particular frequency. The skin tends to peel, hence also the name of desquamative dermatitis, and small flakes of skin, white / yellowish, are deposited in the duct. When you take a bath and water enters your ear, it is absorbed by the skin scales with a tendency to form a plug. In some cases, a mixture of ear wax and skin scales is observed. A characteristic plug is thus formed where the scales are on the outside and there is ear wax inside. Obviously as these people get out of the water or finish the shower they have the sensation that their ear is plugged, they think there is water left in the ear, but this is a mistake. An ENT examination is required, cleaning of the ear canal and appropriate therapy. The most often used products are cortisone based. Often combinations (cortisone + antibiotics) are used because there may be associated infections. Obviously the choice of the type of drops to be used is strictly specialized competence, and must be made on the basis of otoscopic picture. If, for example, there is a membrane perforation, the range of usable antibiotics will be very limited.
Some doctors recommend ointments or ointments to be introduced into the ear canal; I am against the use of these substances because they are easily deposited in the duct and cause unpleasant sensations.
7 – Foreign body in an ear.
Here we love in the face of very rare situations, but not exceptional. It sounds strange but it can happen that a foreign body enters the ear. The bodies that are most often found in the ears are balls, plastic fragments of small toys, bits of wood, bits of leaves. In all these cases otoscopy is essential. This alone should make it clear that DIY will never solve this problem. In reality, water has a marginal function. When there is a foreign body and the patient takes a bath, it is easy for water to get trapped in the duct. In some cases, such as in fragments of sponge or wood, the water increases the volume of the foreign body and this remains well inserted in the duct.
Spherical foreign bodies are very dangerous. They can be beads from a necklace, small beads from a game that has broken, etc. The sphere almost completely occupies the duct, gives a feeling of closed ear and if there has been a bath or a shower it is easy for the liquid to get between the ball and the tympanic membrane. Hearing loss and discomfort are the dominant symptoms. The incongruous maneuvers to try to free the ear are useless, but which are always harmful. All the maneuvers that involve the introduction of something into the duct such as the introduction of a wax cone, or the introduction of the tip of a pear or a syringe without a needle, do nothing but push the ball deeper and deeper. Extracting a foreign body from the external ear canal is a difficult specialized maneuver.
As you can see, the sensation of a closed ear that you feel after a bath is not the symptom of a single pathology, but can derive from very different causes. The fundamental point is that the ears are an easily visible organ and therefore when there is a problem someone must be competent (general practitioner or ENT specialist) to look at the ears. All these strange ideas that are rampant on the WEB related to self-diagnosis and self-treatments are always to be excluded.
For the diagnosis it is important to know what he has done and what the patient perceives, but it is not enough. It is of paramount importance to look inside the ear.
