“My ear feels blocked.” It is a common complaint in an ENT clinic, and often the first assumption is that there must be wax deposition in the ear. Sometimes there is. But, when the sensation persists for weeks, the ear itself may not be the real source of the issue.
The feeling of blockage can come from the ear canal, the middle ear, the Eustachian tube or even the nose. Understanding that distinction is important because treating the wrong cause may not make the sensation go away.
It may have more to do with your nose than your ear
One of the most common reasons for persistent ear fullness is a problem with the Eustachian tube, the narrow passage connecting the middle ear to the back of the nose. It opens when we swallow, yawn or chew, helping to equalise pressure on either side of the eardrum and allowing fluid to drain from the middle ear.
When this tube does not open properly, the ear can feel full or 'underwater'. Hearing may seem muffled, and some people notice popping or clicking when they swallow or yawn.
A cold can temporarily cause this because inflammation and mucus around the nose and throat affect the tube. The same can happen with allergies and persistent nasal congestion. In children, enlarged adenoids can also interfere with the opening of the Eustachian tube.
This is why an ENT expert may ask about a blocked nose, sneezing, allergies, sinus symptoms or frequent colds when the complaint is actually about the ears.
Sometimes it really is earwax
Earwax is there for a reason. It protects and lubricates the ear canal, and normally makes its way out without any help. But when it accumulates, it can cause a blocked sensation, muffled hearing, ringing or discomfort.
One of the most common mistakes is trying to solve this by repeatedly putting cotton buds or other objects into the ear. This can push wax deeper into the canal and make the problem worse.
More importantly, not every blocked ear is caused by wax. If the ear looks clear but the sensation remains, another explanation needs to be considered rather than repeatedly cleaning the ear.
What happens during a flight and sudden pressure changes?
Some people notice blocked ears mainly during take-off and landing, or after travelling to high altitudes. This happens because the pressure around us changes faster than the middle ear can equalise it. The Eustachian tube normally takes care of this, but if it is congested or not opening properly, the pressure difference can cause fullness, discomfort and muffled hearing.
For someone who already has a blocked nose or Eustachian tube dysfunction, flying can make the symptoms much more noticeable.
When a 'blocked ear' needs more than reassurance
A blocked sensation that follows a cold may settle as the inflammation improves. But persistent or recurrent symptoms deserve an examination, particularly when there is noticeable hearing loss, tinnitus, dizziness, pain or discharge.
There is one situation that should never simply be assumed due to wax or congestion: a sudden reduction in hearing. Sudden sensorineural hearing loss can initially feel like a blocked ear, even when there is no obvious abnormality in the ear canal. It requires prompt medical assessment because early treatment can matter.
The important thing is not to focus only on the sensation of blockage, but to find out why it is happening. The ear, nose and throat are closely connected, and sometimes the answer to an ear complaint is found by looking somewhere else.
If an ear has felt blocked “for as long as anyone can remember”, keeps blocking and unblocking, or never quite returns to normal after an infection or flight, it is worth having the ear properly examined rather than simply assuming it is wax.
A blocked ear is a symptom, not a diagnosis. And sometimes, finding the reason for that sensation is what finally makes the ear feel normal again.
(The author is a consultant ENT surgeon at KIMS-Arete Hospital)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
