Let’s start at the outside with something obvious and then work our way towards the inner ear.

Earlier we mentioned the pinna, the part of the ear that sticks out of the side of the head. We said that it catches sounds and funnels them into the earhole. So what happens if someone does not have a pinna or perhaps it is malformed? They will not be able to catch as many sounds, meaning they won’t hear as well.

Sometimes the Ear Canal itself can be malformed, so that it becomes closed off. In Devon and Cornwall surfing is very popular: some surfers develop bony growths in their ear canal due to frequent exposure to the cold.

A more common cause of hearing loss is when the earhole, or somewhere between the earhole and the eardrum, gets blocked. Sound will meet a ‘brick wall’ instead of reaching the eardrum.

Things that can block up the ear canal include:

• Wax
  Most people have wax in their ears. It’s there for a purpose: it cleans our ears by catching bits of dead skin and dirt and pushing them out of our earholes where it can be cleaned away with a facecloth. It also protects our ears from infection and prevents insects from climbing in (apparently it tastes quite bitter to bugs!).

  But sometimes the earwax builds up and becomes hard, forming a floor-to-ceiling wall of wax. This stops the sound from getting through. Sometimes eardrops or olive oil can be used to soften the wax and re-open the ear canal and sometimes your GP will arrange for you to have your ears syringed or vacuumed out. Once done your hearing will substantially improve.

  The worst thing to do with wax is to use a ‘cotton bud’ because it forces the wax back towards the eardrum where it is harder to get out.

• Foreign bodies
  Occasionally things get stuck in people’s ears that shouldn’t be there, e.g. cotton wool, an eraser from the end of a pencil, a pea etc. There have even been rare cases of insects getting in, despite their aversion to the taste of wax!.

  Anything stuck in your ear that shouldn’t be there will stop you hearing properly. You should seek medical attention to have it removed.

• Inflammation or other medical conditions
  If the ear canal becomes inflamed, it may swell to such an extent that it blocks the ear canal entirely. Other medical conditions can include a bony growth within the ear canal.

We have looked at some of the things that can block sound from getting through the outer ear. Let’s now look at the middle ear.

Next subject: Hearing Losses through Problems in the Middle Ear