Article by Hearing Partners, contributed by Mandy Mak, Clinical Audiologist at Hearing Partners
Muffled hearing typically feels like sounds are distant or obstructed, as though you’re underwater or using earplugs. This condition can make it challenging to hear clearly, distinguish specific noises, or follow conversations. In many cases, muffled hearing can resolve on its own once the underlying cause is addressed.
The article will cover the causes of muffled hearing, when to seek medical help and possible treatment methods.
Causes of Muffled Hearing
In this section, we’ll explore common causes of muffled hearing, including ear infections, earwax buildup, hearing loss, and more.
Cold/flu
When you have a cold or flu, the congestion and inflammation in your nasal passages and throat can extend to your Eustachian tube, which connects your middle ear to the back of your throat. This blockage prevents pressure regulation in the middle ear, leading to muffled hearing.
Additionally, fluid/mucous buildup from the cold or flu can travel up the Eustachian tube and accumulate in the middle ear, further affecting your hearing abilities. Fluid accumulation in the middle ear is an optimal breeding ground for bacteria growth and can lead to an ear infection.
Buildup of earwax
Earwax buildup happens when earwax accumulates in the ear canal, often due to factors such as overproduction or narrow ear canals. Using Q-tips to clean your ears may also push earwax deeper into the ear canal, potentially causing impaction.
As a result, the earwax can block the ear canal, disrupting the normal flow of sounds to the eardrum. Subsequently, sounds may become muffled. Other symptoms of earwax blockage include earache, fullness in the ear, itching and tinnitus. Prolonged earwax accumulation may promote bacteria and fungus growth, causing an ear infection.
Ear infections
Ear infections, such as otitis media and otitis externa, can lead to muffled hearing. Otitis media, an infection of the middle ear, involves inflammation of the fluid built up behind the eardrum, usually due to bacteria or viruses. This fluid disrupts normal sound transmission and causes sounds to seem muffled.
Otitis externa affects the ear canal and is often caused by bacterial or fungal infections. The resulting inflammation and swelling can block the ear canal, preventing sound waves from reaching the eardrum effectively. This blockage also leads to muffled hearing, along with potential symptoms like ear pain, itching, and discharge.
Age-related hearing loss
Age-related hearing loss, or presbycusis, is a gradual decline in hearing that occurs as people age. It primarily results from the wear and tear of hair cells in the inner ear, leading to reduced hearing sensitivity, especially at high frequencies, which causes sounds to be muffled.
Accompanying symptoms of age-related hearing loss include:
- Difficulty hearing high-pitched sounds
- Difficulty following conversations in noisy settings
- Potential onset/increase in tinnitus
- Frequently asking for repetitions
- Withdrawing from social interactions due to communication challenges
- Having a skewed perception of loudness growth (i.e. sounds become uncomfortably loud when intensity increases by just a little bit)
Noise-induced hearing loss
Noise-induced hearing loss (NIHL) happens when loud noises damage the hair cells in the inner ear. This can occur from sudden, intense sounds like explosions or prolonged exposure to loud environments, such as concerts or construction sites. Over time, this damage leads to reduced hearing and muffled sensations.
Symptoms of NIHL are similar to those of age-related hearing loss. These include problems hearing high-pitched sounds, tinnitus, and reduced ability to understand speech in noisy settings. People might also experience reduced tolerance to loud sounds.
Changes in environmental pressure
Changes in environmental pressure, commonly experienced during activities like plane takeoffs and landings or while diving, can lead to muffled hearing. When a plane ascends or descends, or when a diver changes depths, the pressure inside the middle ear can become imbalanced relative to the external pressure. This imbalance puts tension on the eardrum, resulting in poor sound transmission.
Typically, this pressure imbalance can be alleviated through simple actions such as yawning, chewing, or swallowing. These actions open up the Eustachian tube to equalise the pressure in the middle ear.
However, if the muffled hearing persists or is accompanied by significant pain, it may indicate a more severe issue like a dysfunctional Eustachian tube or perforated eardrum. In such cases, a visit to an Ear, Nose and Throat (ENT) specialist is required for further evaluation and treatment.
Ruptured eardrum
Infections in the middle ear that create pressure behind the eardrum, direct trauma to the ear, rapid changes in air pressure, or exposure to extremely loud noises can pierce or tear the eardrum.
When this happens, the eardrum’s ability to vibrate and transmit sound effectively is reduced. Consequently, sound waves are not properly conducted to the middle and inner ear, resulting in muffled or diminished hearing.
Meniere’s disease
Ménière’s disease is a chronic condition associated with abnormal fluid buildup in the inner ear. It interferes with the normal movement of sound waves through the inner ear structures, resulting in symptoms such as muffled hearing, severe episodes of vertigo, fluctuating hearing loss, tinnitus, and a sensation of fullness in the ear.
Growths
Abnormal growths in the ear can lead to muffled hearing by interfering with the ear’s normal structure and function. For example, ear canal exostosis (surfer’s ear), which is an abnormal bone growth in the ear canal, can narrow the ear canal and affect earwax migration, leading to earwax buildup and altered ear canal shape.
Additionally, a cholesteatoma, a benign growth made up of abnormal skin cells, can damage the middle ear structures and prevent sound waves from reaching the inner ear.
When to See a Doctor for Muffled Hearing
If you experience persistent muffled hearing with the following symptoms, it’s advisable to seek medical attention immediately:
- Sudden hearing loss
- Severe ear pain
- Ear discharge
- Dizziness or balance problems
These symptoms could indicate more serious issues, such as infections and tumours.
Prolonged muffled hearing can have severe consequences, including permanent hearing loss or worsening of an underlying condition. As such, early diagnosis and treatment are essential for effective management and swift recovery.
To diagnose the cause of muffled hearing, doctors typically start with an otoscopy to examine the ear canal and eardrum. Hearing tests are subsequently conducted to assess the degree of hearing loss. Additional diagnostic tools, like nasoscopy, CT scans or MRIs, may be employed to identify any structural abnormalities or growths.
By looking at the results, doctors can accurately identify the cause of the muffled hearing and recommend appropriate treatments.
Treatment for Muffled Hearing
Treatment for muffled hearing depends on the underlying cause and severity of the condition. This section explores various treatment options, ranging from medication to surgical procedures.
Cause: Buildup of earwax
- Earwax removal: ENT specialists have access to specialised tools and equipment to safely and effectively remove impacted earwax. They can carefully remove the wax using instruments such as suction devices, curettes, or ear irrigation systems, ensuring that the procedure does not damage the ear canal or eardrum.
Cause: Cold/flu
- Medication: If muffled hearing is caused by a cold or flu, a doctor may prescribe medication to treat the underlying infection. As the illness resolves, the muffled hearing should improve.
Cause: Age-related / noise-induced hearing loss
- Hearing aids: Using hearing aids is a method to manage symptoms of hearing loss rather than cure it, as hearing loss is often irreversible. Hearing aids work by amplifying sounds and enhancing speech clarity, thereby improving overall hearing for the user.
Cause: Ear infections
- Antibiotics: Antibiotics are often used to treat ear infections by targeting and eliminating the bacteria responsible for the infection. Effective treatment can help restore normal ear function and alleviate symptoms such as muffled hearing.
- Myringotomy: This is a simple and quick surgical procedure to drain the fluid accumulated in the middle ear.
Cause: Changes in environmental pressure
- No treatment is needed in most cases; in severe cases, you may need to see a doctor
Cause: Ménière’s disease
- Medication: Medication is used to manage symptoms of Ménière’s disease such as dizziness, tinnitus, and hearing loss. Treatments may include diuretics to reduce fluid retention and anti-nausea drugs to alleviate vertigo. Corticosteroids can also be used to decrease inflammation.
- Lifestyle changes: Diet, exercise and stress relief techniques may help to manage the recurrence of Meniere’s disease.
- Hearing aids: Although they do not address the underlying causes of Ménière’s disease, hearing aids enhance auditory function, making it easier to hear and understand conversations.
- Therapy: To help manage tinnitus caused by Ménière’s disease, several types of therapy may be used. Sound therapy involves using white noise or background sounds to mask the ringing or buzzing in the ears. Another form of therapy, cognitive-behavioural therapy, helps individuals manage the emotional and psychological impact of tinnitus by changing negative thought patterns and reducing stress.
- Vestibular rehabilitation: Vestibular rehabilitation helps treat Ménière’s disease by focusing on exercises and therapies designed to improve balance and reduce dizziness. This type of therapy involves specific head and body movements to strengthen the vestibular system. This treatment can help alleviate vertigo symptoms and improve stability for individuals with Ménière’s disease.
Cause: Ruptured eardrum (that cannot heal on its own)
- Surgery: Tympanoplasty is a surgical procedure used to treat a ruptured eardrum by repairing the damaged tympanic membrane. During the surgery, a surgeon grafts a small patch of tissue, often taken from the patient’s own body, over the perforation in the eardrum. This graft aims to heal the rupture and restore normal ear function.
Cause: Growths
Surgery: Surgery is used to treat tumours such as cholesteatoma by removing the abnormal growth of skin cells and other tissues from the middle ear and mastoid area.
FAQs About Muffled Hearing
What are some symptoms accompanying muffled hearing?
Muffled hearing is often accompanied by other symptoms, depending on its underlying cause. These symptoms may include a feeling of fullness or pressure in the ear, tinnitus, difficulty hearing soft sounds or understanding speech, ear discomfort or pain, dizziness or imbalance, and fluid drainage.
Will muffled hearing go away on its own?
When it comes to muffled hearing, whether the issue is temporary or permanent largely depends on its root cause.
For example, if the muffled hearing is due to something like earwax buildup or a mild ear infection, these conditions can often be treated effectively, leading to a return of normal hearing once the underlying issue is resolved. In these cases, the hearing loss is usually temporary.
On the other hand, if the muffled hearing is caused by more serious issues such as age-related hearing loss, the muffled hearing might be permanent.
Can muffled hearing be prevented?
The development of muffled hearing depends on its underlying cause, and unfortunately, not all causes are preventable. However, there are proactive steps you can take to help manage and potentially reduce the risk of hearing issues.
One effective way to address potential hearing problems early is by taking hearing tests regularly. These tests can help identify any hearing concerns before they become more severe, allowing for timely intervention and treatment.
Another preventive measure is to avoid exposure to loud noises whenever possible. Prolonged or repeated exposure to loud sounds can damage the delicate structures in the ear, leading to hearing loss. Using ear protection in noisy environments and being mindful of your noise exposure can help protect your hearing over the long term.
