Plugged Ears Caused by Fluid in the Ear
Plugged ears can be a result of trapped fluid in the auditory tube. The auditory tube normally carries unwanted debris from the ears to the back to the throat where it is swallowed but sometimes it can become plugged and fluid becomes trapped in the middle ear. Conditions that can cause the auditory tube to become blocked can include enlarged structures such as tonsils, adenoids and turbinates, or severe congestion. It's not uncommon to have plugged ears for a while after you've had a severe cold and it can also be caused by allergies. Fluid in the ear is more likely to be the cause of plugged ears in children because their auditory tube is smaller and naturally more horizontal than adults. Even though your ears may feel plugged, it is not uncommon to have little or no symptoms of fluid in the ear. It can result in hearing loss and if left undiagnosed in small children it can lead to speech delays. In severe cases there can be ear pain or pressure, dizziness or balance loss (vertigo) and gross motor delays.
In the past, chronically plugged ears caused by fluid in the ear have sometimes been treated with decongestants, but the latest research does not support this. If you do not have bothersome symptoms, or if the patient is a child and they are not at risk for developmental delays your doctor may choose to monitor the fluid at 3-6 month intervals to see if it goes away on it's own. If bothersome symptoms occur, developmental delays or decreased hearing, research shows the best treatment for chronically plugged ears to be the insertion of ear tubes via a procedure called a myringotomy. This is a common procedure done under anesthesia in which a tiny hole is made in the ear drum and synthetic tubes are placed in the auditory tube to hold it open, allowing the fluid to drain out of it. The hole in the ear drum heals on its own in a few days and the synthetic tubes fall out without intervention about a year later.
Plugged Ears Caused by Altitude Changes
Plugged ears can be caused by rapid changes in ambient pressure. This is, again, a result of the auditory tube. Along with the ear drum the auditory tube equalizes the pressure between the middle ear and the outer ear. This is why your ears can feel plugged when you are driving up a steep mountain or taking off in an airplane. This can also occur while scuba diving and if precautions are not taken can lead to severe ear injuries (barotrauma). The best way to prevent barotrauma and to help plugged ears from altitude changes is to swallow or yawn frequently. This opens up your normally collapsed auditory tube allowing outside air to enter the ear. If you experience pain, fluid drainage or significant hearing loss see a doctor.
Plugged Ears Caused by Excessive Ear Wax
Occasionally plugged ears can be caused by too much ear wax. This is not a common problem since the ears normally have their own built-in cleaning system, but for unknown reasons a certain percentage of the population may overproduce ear wax. Don't try to remove excessive ear wax yourself, let your doctor remove it with special equipment to avoid rupturing your ear drum or pushing the wax even further into your ear. The FDA has warned against using ear candles as well. Your doctor may use one of several methods to remove the excessive wax: irrigate the ear with water, scoop it out with a special tool called a curette or cerumen spoon, or use ear drops which are designed to dissolve ear wax.
Plugged Ears Caused by a Foreign Object (A.K.A. Your Kid Stuck Rocks in His Ears)
Your eight-year-old son is complaining of plugged ears, he won't stop rubbing them and you swear you saw him grimace. He doesn't have a fever or any cold symptoms and you highly suspect he's stuck something in his ears, but let's face it, after you grounded him for a month in kindergarten for shoving dried beans up his nose there's no way he's going to tell you the truth. What are you going to do? Well you can get your flashlight out and take a look but you shouldn't remove it unless you're absolutely positive you can do so without injuring the ear. Never stick anything sharp inside of the ear in an attempt to remove a foreign object. Really the best thing to do is get in the car and take a trip to the pediatrician's office where specialized equipment can help the doctor see and remove the object safely. If you notice any fluid draining from the ear or a foul odor your child needs to see a physician immediately.
American Academy of Pediatrics. Clinical Practice Guidelines-Otitis Media With Effusion. Accessed: October 24, 2013 from http://pediatrics.aappublications.org/content/113/5/1412.full?sid=93df74e5-83ff-42b5-9cf3-1c90fae277d7
Medline Plus. Wax Blockage. Accessed: January 31, 2011 from http://www.nlm.nih.gov/medlineplus/ency/article/000979.htm
Vernick, D.M. Ear Barotrauma.www.uptodate.com, October 2007. (subscription required).