– In this video, I'm
gonna show you how I test to find out what's
causing your clogged ears, coming up. (upbeat music) This video is sponsored by Natus, formerly Otometrics,
the preferred diagnostic equipment supplier of Dr. Cliff AuD. Since the 1950's, Otometrics has been one
of the most innovative manufacturers of hearing
aid fitting equipment, and diagnostic hearing
and balance equipment in the industry. When it comes to testing
and treating my patients, I only want to work with the best. This is why I use Natus in my clinic. Some of the most popular
videos that I have on my YouTube channel
are the ones where people are trying to figure out how to clear their clogged ears. But every time that
someone reaches out to me asking me why their ears are clogged, I have to tell all of
them the exact same thing, which is I have no idea unless I can do a proper evaluation. So I'm gonna review
three common conditions other than earwax that
can cause the sensation of your ears being clogged, and show you how I use my
Madsen Zodiac tympanometer to figure out exactly
which one that you have.
The first step that
always needs to take place when your ears feel clogged is otoscopy. This is where your
hearing care professional will actually look inside
of your ears to see if there's an actual
obstruction blocking sound. If you're lucky, your
hearing care professional will also have a video otoscope, like the Aurical Otocam 300, so you can see what's actually inside of your ear canals as well. Now if there's nothing obvious blocking your ear canal like earwax
or a foreign object, then it's time to break out
the Madsen Zodiac tympanometer so we can perform
tympanometry to see exactly what else could be causing the sensation of your clogged ears. The whole purpose of tympanometry is to test the function
of your middle ear space and your eardrum by
evaluating ear canal volume, middle ear pressure, and compliance, which is the movement of your eardrum.
The combination of these three measures along with otoscopy can usually tell us enough information to identify what's causing your clogged ears. When performing tympanometry, your hearing care professional will insert a silicone probe tip inside of your ear canal. This probe tip must create a good seal because the tympanometer
will be increasing and decreasing air
pressure in your ear canal to move your eardrum, giving you a mild sensation
of going up and down in an airplane. At the same time, the probe tip will be
emitting a 226 hertz tone into your ear canal and
measuring the reflection of that tone off of your eardrum. All right, let's go ahead and take a look at the measurements from a normal ear.
First, let me show you
the ear canal volume, which is typically abbreviated ECV. This is the amount of actual space between the opening of your ear canal and your eardrum. A normal adult ear canal volume is typically between 0.6
to 1.5 cubic centimeters. You can see that the volume of this ear canal is
1.3 cubic centimeters, which is within the normal range. Next, let's talk about
eardrum static compliance. This is how much movement
your eardrum has. An eardrum with normal movement has a compliance of
0.3 to 1.5 milliliters. You can see that the compliance of this eardrum is 1.5 milliliters, which is within the normal range as well. Finally, we have middle ear pressure, which is otherwise known as tympanometric peak pressure or TPP. This is the air pressure inside
of your middle ear space. Depending on which norms you use, middle ear pressure typically ranges between negative 150 and
positive 50 dekapascals. You can see that this ear canal has a normal middle ear pressure of negative eight dekapascals.
When this pressure is at zero, the pressure inside your
middle ear is the same as the pressure outside
of your middle ear. You know that pressure
sensation that you feel in your ears when you're
descending on an airplane or you're coming down in an elevator from a really tall building? That is essentially being
caused by the pressure inside of your middle ear space. And until you can regulate that pressure back to zero by yawning or swallowing, it typically can cause
you to feel clogged. Now, tympanometry results
are often illustrated and categorized based on their shapes. A tympanogram on an ear
with normal pressure and normal compliance
is considered a Type A, which gives us a nice compliance peak around the zero pressure line. Now if you have the
sensation of a clogged ear but your tympanometry results look normal, then you absolutely need
to have a hearing test because you might actually have a sudden sensorineural hearing loss, which is a sudden drop in your hearing that needs medical treatment.
So you need to get that
hearing test done right away. All right, so now that you know what a normal tympanogram looks like, let's go ahead and show
you a couple of different tympanograms for ears that have conditions that might make them feel clogged. For this one, we have an individual with an ear canal volume
of 7.7 cubic centimeters, which is significantly larger than the 1.5 cubic centimeters
that we would expect for a typical ear canal volume. We also don't have a recorded static compliance of the eardrum, or a recorded pressure reading. This individual has a Type B tympanogram which is illustrated by a flat line.
This reading suggests that this individual actually has a hole in their eardrum. And as you can see here, this is confirmed by
visualization of the eardrum using video otoscopy. When we measure a large ear canal volume without a recorded static
compliance or pressure reading, it suggests that the eardrum is not intact and the air pressure from the Zodiac is entering the middle ear space without moving the eardrum at all. Next, we have a tympanogram with a normal ear canal volume of 1.1 cubic centimeters, a normal static compliance
of 1.4 milliliters, but a middle ear pressure
of negative 156 dekapascals.
This individual has what we call a Type C tympanogram which is
illustrated by a defined peak, but with a tympanometric peak pressure below the normative range
of negative 150 dekapascals. This is a case of
eustachian tube dysfunction, which is when the eustachian tube that connects your
middle ear to your throat does not function properly, causing a negative middle ear pressure where it pulls on your eardrum. Again, giving you the perception that your ear is clogged. And last but not least, we have the results of an individual with an ear canal volume
of 1.2 cubic centimeters, which is within the normal range, but again, no static compliance reading or pressure reading.
They also have a flat Type B tympanogram. However, we know it isn't a perforation because the ear canal
volume would be much larger. In this case, it's either
fluid behind the eardrum restricting eardrum movement, or something even more
serious like a cholesteatoma, which is a benign growth of skin cells, like a cyst, behind the eardrum. Visualization of this ear canal suggests that it is
actually a cholesteatoma, which was eventually
confirmed by a physician. All right, there you go. As you can see, having a clogged ear isn't
always what is seems. So the next time that
you have a clogged ear that you are not able to get rid of, you need to make sure that you contact an audiologist so you can get your ears checked right away. Because without performing tympanometry and possibly a comprehensive
auditory evaluation, you could be suffering from a serious medical condition that
requires medical treatment. That's it for this video. If you have any questions, leave them in the comments section below. If you liked the video, please share it. And if you wanna see other
videos just like this one, go ahead and hit that Subscribe button.
Also feel free to check out
my website, drcliffaud.com. (upbeat music).