The Ins and Outs of Ears and Allergies

When people think of allergy problems, what comes to mind most often are the classic symptoms of sneezing, runny nose, and itchy eyes. Many people don’t realize that the ears can be affected by allergies, too.

The ear can be divided into three sections: outer, middle and inner.

The outer ear is made up of the ear we see, called the pinna, and the ear canal. The pinna and canal help catch and funnel sound vibrations toward the middle ear. The middle ear begins with the eardrum or tympanic membrane and contains the auditory bones-hammer, anvil, and stapes(STAY-peas)- which transmit sound vibrations to the inner ear or cochlea (COKE-lee-uh). The cochlea converts those vibrations into nerve impulses which can be interpreted by the brain as sound. The cochlea also contains the body’s balance apparatus- the vestibular (ves-TIB-you-luhr) system.

Allergies primarily affect the middle ear. As you can see, the middle ear has a drainage tube or pressure release valve called the eustachian (you-STAY-shun) tube. If this tube is clogged with mucus or its opening is blocked by allergy swelling, then pressure and fluid can build up in the middle ear. This gives us the sensation of being down a well, having the need to “pop” our ears frequently, and can result in diminished hearing. Fluid build-up also creates a good environment for infection to occur. Middle ear infections, called otitis media or OM, occur commonly in early childhood and are a frequent reason for antibiotic treatment and missed school days. Allergies are a well recognized cause for recurrent OM and kids who have more than their share of middle ear infections should be allergy tested.

Disorders affecting the inner ear, such as Meniere’s disease, may have an allergic component as well. Patients who fail to respond to conservative therapy may benefit from allergy desensitization, though evidence to support this comes largely from case series and anecdotal evidence.

External ear infection, otits externa (OE) or swimmer’s ear, is usually caused by a water loving bacterium called pseudomonas (soo-duh-MOAN-us). It is usually not related to allergies.

Finally, a word about itchy ears. You really want to scratch them, don’t you? Well, remember what your mom said: Never put anything in your ear smaller than your elbow! The skin in the ear canal is paper thin and very easy to irritate. Although sticking a Q-tip in there might feel good for a few seconds, it will just make the ears itch more afterward.

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The Ins and Outs of Ears and Allergies

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