Why Do My Ears Feel Clogged?

The feeling of clogged ears, also called aural fullness, can occur for a variety of reasons. Sometimes aural fullness can be temporary and resolve on its own while other causes of aural fullness may require medical treatment.  Here is an overview of the possible causes of clogged ears.

Impacted Earwax

Earwax, also called cerumen, is naturally produced in the ear canal and has antibacterial, antifungal, and lubricating properties. Different people produce different amounts of earwax. Some people produce excessive earwax that clogs the ear canal and results in a feeling of fullness in the ear. Impacted earwax can also cause temporary conductive hearing loss.

Treatment

Your doctor can look in your ears and see if there is impacted earwax and remove it. There are also ways to manage earwax at home. Some common remedies include putting drops of hydrogen peroxide, mineral oil, or saline solution into the ear to soften and loosen the earwax so that it can drain out of the ear canal. You can find over-the-counter solutions at a local pharmacy. Use of cotton swabs is not recommended to manage earwax. On the contrary, many people who frequently use cotton swabs cause impacted earwax by pushing it deeper into the ear canal.

Eustachian Tube Dysfunction

The middle ear is an air-filled space behind the eardrum and it contains three small bones called the ossicles. In order for the ear to function optimally, the pressure in the middle ear should be equal to the pressure in the atmosphere. When that is not the case, it causes a sensation of aural fullness. It is possible to have negative pressure (i.e., the pressure in the middle ear is less  than that in the atmosphere) and positive pressure (i.e., the pressure in the middle ear is greater than that in the atmosphere). The Eustachian tube runs from the middle ear space to the back of the throat and is responsible for equalizing the pressure in the middle ear space.

A feeling of clogged ears is common during air travel or when driving through the mountains because the air pressure changes as the altitude changes. In those situations, the Eustachian tube must constantly work to adjust the pressure in the middle ear space to match the changing pressure in the environment. Swallowing, flexing your jaw, and performing the valsalva maneuver can help alleviate pressure by opening the Eustachian tube.

If a person experiences Eustachian tube dysfunction, the pressure in the middle ear is not appropriately regulated which would result in a persistent feeling of aural fullness. The Eustachian tube may temporarily open, giving the perception of “popping” ears, and the pressure feeling may go away for a few minutes to a few hours only to start building up again.

Treatment

Evaluation and treatment by a medical professional, such as a primary care physician or ear nose & throat (ENT) physician, is necessary to diagnose and manage Eustachian tube dysfunction (Johns Hopkins Medicine, n.d.). Home remedies include taking a decongestant to reduce swelling in the tube lining or if allergies are the suspected cause of ETD, taking an antihistamine or steroid nasal spray may provide some relief.  

Otitis Media (Middle Ear Infection)

Otitis media is an infection of the middle ear and often occurs as a result of Eustachian tube dysfunction. Otitis media is often accompanied by effusion, or fluid in the middle ear space. The inflammation and fluid often results in a clogged feeling in the ear and may be accompanied by pain and hearing loss.  

Treatment

A primary care or ENT physician can diagnose and treat otitis media. Otitis media may be treated using antibiotics; however, if the patient has chronic recurring ear infections, the physician may recommend a myringotomy and placement of pressure-equalization tubes to drain the fluid and prevent future ear infections with fluid build-up (National Institute on Deafness and Other Communication Disorders [NIDCD], 2022).

Sinus Pressure

Sinusitis causes swelling and inflammation of the spaces in the nose. It may be caused by a virus or bacteria. Aural fullness is a common side effect of sinus congestion and pressure. 

Treatment

A medical professional can diagnose and treat sinus congestion and related effects with medication or surgery, if necessary. Once the sinus congestion has been resolved, the pressure feeling in the ear should resolve as well. 

Noise-Induced Hearing Loss

It is common to experience a feeling of aural fullness after being exposed to loud sounds. In those cases, the feeling of fullness is a result of sensorineural hearing loss due to damage to the outer hair cell in the cochlea, the organ of hearing. The hearing loss and aural fullness may also be accompanied by tinnitus, or ringing/buzzing in the ears. Exposure to loud noises can result in a temporary hearing loss that generally recovers within one to two days. However, repeated exposure to hazardous noise levels can cause the temporary hearing loss to become permanent. 

Treatment

If you experience aural fullness after being exposed to loud sounds, it is best to stay away from any loud sounds for at least a few days so the ears have time to recover. The best way to treat noise-induced hearing loss is to prevent it altogether by using hearing protection. If you are noticing difficulty hearing (e.g., people sound muffled when they talk), it is recommended that you get a hearing test to rule out permanent hearing loss.

Less Common but Possible Causes

Foreign Object in the Ear Canal

Foreign objects in the ear canal are seen most often in children; however, it is possible for adults to unintentionally get foreign bodies in their ears as well. For example, a bug could possibly crawl into the ear canal and cause a feeling of aural fullness and discomfort. In order to confirm the presence of a foreign body that is deep in the ear canal, a healthcare professional would need to look in the ear. If there is a confirmed foreign object in the ear canal, a healthcare professional can remove it with specialized tools, such as forceps or a curette.

Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss, or sudden deafness, occurs due to an issue with the organ of hearing.  In such cases, people experience significant, unexplained hearing difficulty that can be accompanied by aural fullness. If you experience sudden sensorineural hearing loss along with aural fullness, it is important that you seek medical treatment immediately. The otolaryngologist may provide a steroid treatment in an attempt to reverse the hearing loss; however, the medication must be administered as soon as possible to yield maximum benefits.

Meniere’s Disease

Meniere’s Disease typically involves one ear and is a potential cause of fluctuating aural fullness. Meniere’s Disease is usually accompanied by tinnitus in the affected ear, as well as vertigo. 

Swimmer’s Ear (Otitis externa)

Otitis externa is an infection of the outer ear (ear canal and pinna) that can be bacterial or fungal in nature. It often occurs as a result of exposure to water containing bacterial or fungal organisms; hence the name, “Swimmer’s Ear.” It may be accompanied by itching, pain, drainage and a clogged feeling in the ear. It can be treated by applying prescription ear drops to the affected area. Evaluation by an ENT specialist is recommended to ensure that the infection is limited to the outer ear and that the appropriate treatment is provided.

Surfer’s Ear (Exostoses)

Exostoses are benign bony tumors that grow in the ear canal as a result of repeated exposure to cold water. For that reason, the condition is often called “Surfer’s Ear.” Although exostoses typically do not cause symptoms, it is possible for individuals with exostoses to experience a sensation of clogged ears in some cases. Surgery is the only way to remove exostoses. However, surgical intervention is reserved for people who are experiencing significant symptoms due to the possibility of complications.

Temporomandibular Joint (TMJ) Disorder

The temporomandibular joints connect the lower jaw (mandible) to the skull, specifically the temporal bone. The mandible and the TMJ are essential for talking and chewing. TMJ disorder causes pain and discomfort in the jaw. However, it has also been associated with aural fullness, tinnitus, and ear pain. A medical professional can determine how to address TMJ disorder and the associated symptoms. Some treatments may include medication, behavioral changes, physical therapy, or surgery.

Cholesteatomas

Cholesteatomas are benign skin cysts that grow behind the tympanic membrane in the middle ear space and mastoid bone. In addition to aural fullness, they also are associated with recurrent ear infections, ear drainage, and hearing loss. Surgery is needed to remove the skin cyst and subsequent medical management by an ENT physician is typically required to prevent the growth from returning.

Cholesterol Granulomas

Cholesterol granulomas are also benign cysts that grow in the middle ear space and can be associated with aural fullness. However, cholesterol granulomas contain fluids, lipids, and cholesterol crystals. They may be treated with surgical drainage.

Acoustic Neuroma (Vestibular Schwannoma)

An acoustic neuroma, also called a vestibular schwannoma, is a benign tumor that grows on the auditory-vestibular nerve (8th cranial nerve). In addition to aural fullness, acoustic neuromas often cause hearing loss and tinnitus in the affected ear, as well as dizziness. Surgery or radiation may be recommended to treat the tumors.

Glomus Tumor

Glomus tumors are vascular tumors that develop in the middle ear space. They often cause pulsatile tinnitus, hearing loss, ear pain, and aural fullness in the affected ear. Surgery or radiation may be recommended for people who experience symptoms due to the tumors.

Conclusion

In general, the most common causes of aural fullness are Eustachian tube dysfunction and otitis media. However, there are many other potential causes and it is a good idea to seek medical attention if the feeling of clogged ears persists, particularly if it is accompanied by pain, tinnitus, dizziness, and/or difficulty hearing. Because there are so many possible causes of clogged ears, seeking an evaluation by a healthcare professional can help you clarify the cause and get relief sooner. Your primary care physician may refer you to a specialist, such as an audiologist or ENT physician, to get more information about your hearing and the health of your auditory system.

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