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5 Surprising Symptoms of Ear Infections

Ear Infections: Beyond Just Ear Pain

Diagnosing an ear infection can be pretty straightforward: Oftentimes, fluid and pus can push against the eardrum, causing throbbing ear pain as well as hearing loss and drainage of fluid from the ear, says Salvatore Caruana, MD, director of the division of head and neck surgery in the department of otolaryngology-head and neck surgery at Columbia University Medical Center in New York City. But ear infections can cause unexpected symptoms, too — ones you might not connect to the ears. Here’s what to watch out for.

Dizziness and Vomiting

Our auditory system is responsible for helping us hear — and it’s also intimately related with our balance systems, Dr. Caruana says. That’s why an ear infection can trigger dizziness, nausea, and vomiting.

Another reason: Your ear infection itself may be linked to a virus that’s affecting your entire body, Caruana says. For example, “you can get a viral infection first, and then the bacterial infection in the ear can follow,” he explains.

Appetite Changes

Blame nausea, ear pain, or just that plain-ol’ sick feeling — all of which can make even the most delicious burger and fries look unappetizing. Plus, Caruana explains, if you had a head cold that led to your ear infection, it might be affecting your upper aerodigestive tract and blunting your ability to taste food.

Or sometimes, it simply hurts to chew. This is more common if you have swimmer’s ear, an infection of the outer ear, he says. But if a middle ear infection is bad enough and spreads to the outside, it can cause painful chewing, too.


If you’re running a fever, that’s a sign that your immune system is trying to fight the infection. And while not everyone with an ear infection will get one, about half of kids will, according to Seattle Children’s Hospital. If your child is younger than 6 months and has a fever and other signs of an ear infection, like excessive crying and fussiness, take him or her to the doctor. You should also see a pediatrician if your child is older and has a temperature over 102° F.

Snoring and Bad Breath

Snoring in kids may be a sign of an ear infection associated with swollen adenoids, tissues that sit at the back of the nose and help fight infection, says Murray Grossan, MD, an ear, nose, and throat doctor in Los Angeles and author of The Whole Body Approach to Allergy and Sinus Health. But if they get infected, they can pass germs to the ears through the Eustachian tubes, according to the National Institutes of Health. Children with swollen adenoids tend to breathe through the mouth, which triggers snoring, Dr. Grossan says. Chronic ear infections and swollen adenoids can also cause bad breath, he notes.

Inattention and Speech Delays

Children with ear infections sometimes appear inattentive at home or school, Grossan says. The fluid blocking the middle ear causes hearing loss, so it seems as though the child isn’t paying attention or is simply ignoring teachers and parents. Hearing loss can also interfere with a young child’s speech and language development, Caruana says. A typical 2-year-old should speak in two-word phrases and be able to follow a two-step command, according to the Nemours Foundation, a nonprofit dedicated to children’s health. A 3-year-old should be able to say three-word sentences and have a vocabulary of 200 words or so. So if your child is not on track, talk to your pediatrician about whether ear infections are interfering with their speech development.

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Hearing aids: How to choose the right one

Perhaps you’ve thought about getting a hearing aid, but you’re worried about how it will look or whether it will really help. It may help ease your concerns to know more about:

  • The hearing aid options available to you
  • What to look for when buying a hearing aid
  • How to get used to it

Hearing aids can’t restore normal hearing. They can improve your hearing by amplifying soft sounds, helping you hear sounds that you’ve had trouble hearing.

How hearing aids work

Hearing aids use the same basic parts to carry sounds from the environment into your ear and make them louder. Most hearing aids are digital, and all are powered with a hearing aid battery.

Small microphones collect sounds from the environment. A computer chip with an amplifier converts the incoming sound into digital code. It analyzes and adjusts the sound based on your hearing loss, listening needs and the level of the sounds around you. The amplified signals are then converted back into sound waves and delivered to your ears through speakers.

Hearing aid styles

Hearing aids vary a great deal in price, size, special features and the way they’re placed in your ear.

The following are common hearing aid styles, beginning with the smallest, least visible in the ear. Hearing aid designers keep making smaller hearing aids to meet the demand for a hearing aid that is not very noticeable. But the smaller aids may not have the power to give you the improved hearing you may expect.

Completely in the canal (CIC) or mini CIC

A completely-in-the-canal hearing aid is molded to fit inside your ear canal. It improves mild to moderate hearing loss in adults.

A completely-in-the-canal hearing aid:

  • Is the smallest and least visible type
  • Is less likely to pick up wind noise
  • Uses very small batteries, which have shorter life and can be difficult to handle
  • Doesn’t contain extra features, such as volume control or a directional microphone
  • Is susceptible to earwax clogging the speaker

In the canal

An in-the-canal (ITC) hearing aid is custom molded and fits partly in the ear canal. This style can improve mild to moderate hearing loss in adults.

An in-the-canal hearing aid:

  • Is less visible in the ear than larger styles
  • Includes features that won’t fit on completely-in-the-canal aids, but may be difficult to adjust due to its small size
  • Is susceptible to earwax clogging the speaker

In the ear

An in-the-ear (ITE) hearing aid is custom made in two styles — one that fills most of the bowl-shaped area of your outer ear (full shell) and one that fills only the lower part (half shell). Both are helpful for people with mild to severe hearing loss.

An in-the-ear hearing aid:

  • Includes features that don’t fit on smaller style hearing aids, such as a volume control
  • May be easier to handle
  • Uses a larger battery for longer battery life
  • Is susceptible to earwax clogging the speaker
  • May pick up more wind noise than smaller devices
  • Is more visible in the ear than smaller devices

Behind the ear

A behind-the-ear (BTE) hearing aid hooks over the top of your ear and rests behind the ear. A tube connects the hearing aid to a custom earpiece called an earmold that fits in your ear canal. This type is appropriate for people of all ages and those with almost any type of hearing loss.

A behind-the-ear hearing aid:

  • Traditionally has been the largest type of hearing aid, though some newer mini designs are streamlined and barely visible
  • Is capable of more amplification than are other styles
  • May pick up more wind noise than other styles

Receiver in canal or receiver in the ear

The receiver-in-canal (RIC) and receiver-in-the-ear (RITE) styles are similar to a behind-the-ear hearing aid with the speaker or receiver in the canal or in the ear. A tiny wire, rather than tubing, connects the pieces.

A receiver-in-canal hearing aid:

  • Has a less visible behind-the-ear portion
  • Is susceptible to earwax clogging the speaker

Open fit

An open-fit hearing aid is a variation of the behind-the-ear hearing aid with a thin tube. This style keeps the ear canal very open, allowing for low-frequency sounds to enter the ear naturally and for high-frequency sounds to be amplified through the hearing aid. This makes the style a good choice for people with mild to moderate hearing loss.

An open-fit hearing aid:

  • Is less visible
  • Doesn’t plug the ear like the small in-the-canal hearing aids do, making your own voice sound better to you
  • May be more difficult to handle and adjust due to small parts

Additional features

Some hearing aid optional features improve your ability to hear in specific situations:

  • Noise reduction. All hearing aids have some amount of noise reduction available. The amount of noise reduction varies.
  • Directional microphones. These are aligned on the hearing aid to provide for improved pick up of sounds coming from in front of you with some reduction of sounds coming from behind or beside you. Some hearing aids are capable of focusing in one direction. Directional microphones can improve your ability to hear when you’re in an environment with a lot of background noise.
  • Rechargeable batteries. Some hearing aids have rechargeable batteries. This can make maintenance easier for you by eliminating the need to regularly change the battery.
  • Telecoils. Telecoils make it easier to hear when talking on a telecoil-compatible telephone. The telecoil eliminates the sounds from your environment and only picks up the sounds from the telephone. Telecoils also pick up signals from public induction loop systems that can be found in some churches or theaters, allowing you to hear the speaker, play or movie better.
  • Wireless connectivity. Increasingly, hearing aids can wirelessly interface with certain Bluetooth-compatible devices, such as cellphones, music players and televisions. You may need to use an intermediary device to pick up the phone or other signal and send it to the hearing aid.
  • Remote controls. Some hearing aids come with a remote control, so you can adjust features without touching the hearing aid.
  • Direct audio input. This feature allows you to plug in to audio from a television, a computer or a music device with a cord.
  • Variable programming. Some hearing aids can store several preprogrammed settings for various listening needs and environments.
  • Environmental noise control. Some hearing aids offer noise cancellation, which helps block out background noise. Some also offer wind noise reduction.
  • Synchronization. For an individual with two hearing aids, the aids can be programmed to function together so that adjustments made to a hearing aid on one ear (volume control or program changes) will also be made on the other aid, allowing for simpler control.

Before you buy

When looking for a hearing aid, explore your options to understand what type of hearing aid will work best for you. Also:

  • Get a checkup. See your doctor to rule out correctable causes of hearing loss, such as earwax or an infection. And have your hearing tested by a hearing specialist (audiologist).
  • Seek a referral to a reputable audiologist. If you don’t know a good audiologist, ask your doctor for a referral. An audiologist will assess your hearing and help you choose the most appropriate hearing aid and adjust the device to meet your needs. You may get best results with two hearing aids.
  • Ask about a trial period. You can usually get a hearing aid with a trial period. It may take you a while to get used to the device and decide if it’s right for you. Have the dispenser put in writing the cost of a trial, whether this amount is credited toward the final cost of the hearing aid, and how much is refundable if you return the hearing aid during the trial period.
  • Think about future needs. Ask whether the hearing aid you’ve chosen is capable of increased power so that it will still be useful if your hearing loss gets worse.
  • Check for a warranty. Make sure the hearing aid includes a warranty that covers parts and labor for a specified period. Some offices may include office visits or professional services in the warranty.
  • Beware of misleading claims. Hearing aids can’t restore normal hearing or eliminate all background noise. Beware of advertisements or dispensers who claim otherwise.
  • Plan for the expense. The cost of hearing aids varies widely — from about $1,500 to a few thousand dollars. Professional fees, remote controls, hearing aid accessories and other hearing aid options may cost extra. Talk to your audiologist about your needs and expectations.
     Some private insurance policies cover part or all of the cost of hearing aids — check your policy to be sure. Medicare doesn’t cover the cost of hearing aids. In many states, private insurers are required to pay for hearing aids for children. Medical assistance covers hearing aids in most states. If you’re a veteran, you may be able to get your hearing aid at no cost through the Veterans Administration (VA).

Getting used to your hearing aid

Getting used to a hearing aid takes time. You’ll likely notice your listening skills improve gradually as you become accustomed to amplification. Even your own voice sounds different when you wear a hearing aid.

When first using a hearing aid, keep these points in mind:

  • Hearing aids won’t return your hearing to normal. Hearing aids can’t restore normal hearing. They can improve your hearing by amplifying soft sounds.
  • Allow time to get used to the hearing aid. It takes time to get used to your new hearing aid. But the more you use it, the more quickly you’ll adjust to amplified sounds.
  • Practice using the hearing aid in different environments. Your amplified hearing will sound different in different places.
  • Seek support and try to stay positive. A willingness to practice and the support of family and friends help determine your success with your new hearing aid. You may also consider joining a support group for people with hearing loss or new to hearing aids.
  • Go back for a follow-up. Providers may include the cost of one or more follow-up visits in their fee. It’s a good idea to take advantage of this for any adjustments and to ensure your new hearing aid is working for you as well as it can.

Your success with hearing aids will be helped by wearing them regularly and taking good care of them. In addition, an audiologist can tell you about new hearing aids and devices that become available and help you make changes to meet your needs. The goal is that, in time, you find a hearing aid you’re comfortable with and that enhances your ability to hear and communicate.

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Winter Ear Tips: 6 Tips To Keep Your Ears Protected This Winter

Winter has arrived! Even if you love the cold weather, it’s important to look after your health in the cooler months. Ears in particular are very sensitive to the cold and are one of the first areas of the body to be affected by the cool weather. Low temperatures can also present challenges for hearing aid users.

Here are six tips to help look after your hearing health this winter.

Protect your hearing aids.
Very low temperatures of under 10 degrees Celsius can cause a reduction in the life of your hearing aid batteries, or even cause battery failure. When it’s very cold outside, wear ear protection (such as a beanie or ear muffs) to prevent batteries getting too cold.

Carry spare batteries.
Make sure you have a spare pair of batteries on you at all times just in case. Keep them in a pocket under your coat, where your body heat will keep them at an optimal temperature. Be aware that if the temperature drops below 0 degrees Celsius, your hearing aid batteries might cease to work altogether.

Dry thoroughly after showering.
Your ear canals will take longer to dry after a shower when the weather is cold. Make sure they’re thoroughly dry before inserting your hearing aids.

Beware condensation.
Condensation can occur inside hearing aids during sudden transitions from cold to warm conditions. These tiny drops of water can get into the electronics and cause damage. Special drying containers can prevent possible damage from condensation. These are usually available for purchase from hearing professionals.

Watch out for ear infections.
The risk of ear infections increases when it’s cold, as less blood is circulated in the ears. Remember to be especially vigilant about ear health during cold and flu season, when ear infections become more common.

Be careful when flying with a cold.
When you have the flu or a sinus infection, air travel can cause severe ear pain. If you find yourself with a head cold and a plane to catch, take precautions to make sure your ears don’t suffer any damage with the changes in air pressure.

For more information on winter ear tips, please click here.

Warning: Cold Weather Can Cause Hearing Loss

Sometimes the cause of hearing loss is something that could have been avoided, like noise, diet, or even cold weather. In the winter, it is important to protect you ears, especially when doing outdoor activities. Abnormal growth of bone into the outer ear canal happens with cold weather sports. This growth blocks the ear, causes ear infections, and can also result in hearing loss.

The medical term for abnormal bony growth is exotosis. Exotosis of the outer ear is usually due to exposure of cold wind and water and is commonly known as surfer’s ear. The use of wetsuits and other gear that promotes cold water surfing means this condition is common among surfers. A study in Japan showed that 80% of surfers had exotosis. Still, surfer’s ear is a misnomer since exotosis is prevalent among people who enjoy cold weather sports like skiing, snowboarding, fishing, kayaking, underwater diving, or sailing.

Outgrowth of bone into the external ear canal might sound like something from a horror movie, but exotosis is the body’s way of protecting ears from cold wind and water. This condition is usually more prevalent in one ear than both. Growth of bone constricts the ear canal, making it difficult to drain water, dirt, and ear wax. This inability to allow the ear to clean itself—which is the basic job of ear wax, means that the person with this condition will suffer from repeated ear infections and results in hearing loss that can be permanent.

Surgery is the only option available for someone with this deviant bone growth due to cold weather sports. Two types of surgery allow for the removal of excess bone. The first is done behind the ear. A small drill is used to make an incision and the bone is then mechanically sloughed away. The second surgery uses a drill as well, but instead of entering from behind the ear, the drill is inserted directly into the ear canal. Both surgeries have risks and extended recovery time where outdoor sports are prohibited. Speak to your surgeon about the option best for you, and when you go back to your outdoor sport remember to protect your ears.

Protecting the ears from extreme weather is essential. Exotosis of the ear develops as the body’s response to cold wind and water, so alleviating these conditions keeps the body from creating abnormal bone in the ear. The best way to protect the ears is to invest in custom ear molds or swim molds. An audiologist can measure and fit your ears for protection that will keep you safe as you enjoy your favorite cold weather outdoor activities.

If you’d like to learn more, see your hearing health provider.

For more information on how cold weather can cause hearing loss, please click here.

10 Tips for Tackling Thanksgiving Dinner With a Hearing Loss

Family With Grandparents Enjoying Thanksgiving Meal At Table

Are you worried about Thanksgiving dinner because of your hearing loss? Thanksgiving has always been one of my favorite holidays — you get to eat, you get to spend time with family, and the leftovers are always a treat. But as my hearing loss has worsened over the years, I sometimes worry how it will all go. Will I be able to follow the conversation at the table? Will I be discounted because I can’t participate like I have in the past?

Rather than wallow in fear, I put together these 10 tips for tackling Thanksgiving dinner with a hearing loss. I hope they help you approach the holiday with more joy and less fear.

Have a great Thanksgiving!

1. Sit in a good spot: For me, it is very helpful if I have a wall behind me and am seated more in the middle of the table. This gives me a better shot at hearing more conversation and not being distracted by background noise behind me. Maybe you have a spot you like better. Don’t be shy about talking to the host so that your seat is in an opportune spot for you.

2. Keep background noise down if possible: I try to keep any background music to a minimum. While your host may like to play music a little more loudly, perhaps you can ask him or her to keep the volume low during dinner.

3. Converse with those next to you: Don’t try to participate in conversations across large distances. If you would like to talk with someone, move closer to him, or ask to continue the conversation when you have a chance to be closer together.

4. Wear your hearing aids: Some of us hate to wear our hearing aids, but they really can help. Experiment with a couple of different settings to find what is optimal. You can even practice at home if you don’t want to spend time experimenting at the event.

5. Try other technologies: There are many new technologies now available that can help you hear in a group setting including personal FM systems or other one to one communication devices. Some of my friends swear by these.

6. Take a break: Don’t be shy about taking a break from the action for a few minutes to give your ears and brain a rest. Head to the restroom, or find a quiet spot in another room. Or go stand outside for a few minutes. It really helps me to clear my head and build up some energy for another round of socializing. Helping in the kitchen can also provide a nice break from the bigger group.

7. Don’t fake it: It is very tempting to just nod along and pretend that you hear what others are saying or laugh just because others are laughing. But it can be dangerous, particularly if someone is asking you a question. Be brave and be honest with others if you are having trouble hearing. It will make your interactions more memorable on both sides.

8. Give visual clues to indicate if you are having trouble hearing: If you are having trouble hearing, you can cup your ear with your hand to indicate to the speaker to speak louder without interrupting the flow of the conversation. I have seen this in action and it is very effective.

9. Have reasonable expectations: You probably won’t hear everything that everyone says, but that is ok. Enjoy talking to the people near you, then seek out others to talk with during other parts of the day. You might even suggest to the host that people rotate seats for desert.

10. Bring your sense of humor: It can be hard to keep it all in perspective during the holidays when you feel like you are missing out on the fun, but try to laugh a little and be grateful for the wonderful friends and family around you. You may not hear every word they say, but you can partake in all of the good feelings around the table. Be sure to enjoy the moment.

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