As the heat of summer winds down, everyone is looking forward to cool fall days and nights. For people who suffer from seasonal allergies, though, fall brings on more allergy symptoms. Ragweed is the biggest allergy trigger in the fall. Though it usually starts to release pollen with cool nights and warm days in August, it can last into September and October. About 75% of people with spring allergies also have reactions to ragweed.
Classic fall allergy symptoms include sneezing, coughing, itchy throat, a runny or stuffed up nose, itchy or watery eyes, headaches, and rashes or hives on the skin. When nasal congestion and itchy throat symptoms are prolonged, many people experience pain or pressure in the ears, diminished hearing, and even a ringing or humming noise in the ears.
People with allergies are often surprised when they realize the allergy problem can affect their ears or hearing ability. The anatomy of the ear can show us how the ears are affected by allergy symptoms.
The ear can be divided into three sections: the outer, middle, and inner ear. The outer ear is the part of the ear we can see, called the pinna, along with the ear canal. The pinna and ear canal help catch and funnel sound vibrations toward the middle ear. The middle ear contains the eardrum, or tympanic membrane, with its connected auditory bones (hammer, anvil, and stirrup), which sit in the middle ear space and transmit sound vibrations to the inner ear, or cochlea. The cochlea converts those vibrations into nerve impulses, which can be interpreted by the brain as sound. The cochlea also contains the body’s balance apparatus—the vestibular system.
The middle ear space is the part of the ear that is primarily affected by allergies. The middle ear has a drainage tube, or pressure release valve, called the eustachian tube that runs from the middle ear space to the back of the throat. In their normal state, the eustachian tubes open and close quickly, releasing middle ear pressure throughout the day when one swallows or yawns. If this tube is clogged with mucus or its opening is blocked by allergy swelling, pressure and fluid can build up in the middle ear. This creates the sensation of being plugged up and can result in diminished hearing. When the ears do finally “pop,” it can be painful and louder than usual. If the ears do not pop often enough and negative pressure is present long enough, fluid can build up in the middle ear space and hearing ability decreases further. This fluid creates a good environment for infection to occur.
When negative pressure or fluid is present in the middle ear space due to allergies or an upper respiratory infection, the type of temporary hearing loss present is called a conductive hearing loss. In this situation, the middle ear space is not allowing sound to be conducted to the inner ear. This pressured or clogged feeling can also cause discomfort.
Allergies and frequent colds are a well-recognized cause for negative pressure buildup and recurrent middle ear infections in children. Although this is usually a temporary, or reversible, hearing loss, it is imperative to keep the periods of decreased hearing at a minimum during the early language development years
This temporary hearing loss can also fluctuate, getting better and worse as allergy congestion symptoms change. This fluctuating hearing loss can make it difficult for parents to notice a hearing loss in a child affected by this condition. At times, the child may appear to hear well, and other times he or she may seem to ignore people, turn up the television volume, or not follow directions.
A complete hearing evaluation performed by an audiologist can identify the difference between temporary conductive hearing loss and permanent sensorineural (nerve) hearing loss. It will also identify the amount of hearing loss caused by the middle ear problem as well as the degree of negative pressure behind the eardrum or whether middle ear fluid is present. The hearing evaluation will also rule out other causes of hearing loss. Speak to your family doctor about your allergy concerns to see whether referral to an allergy specialist or ear, nose and throat specialist is needed. The good news about seasonal allergy symptoms is that they will likely subside as the seasons change and allergy triggers dissipate.
Feel free to call and speak to the audiologists at Northwest Ohio Hearing Clinic to schedule your hearing evaluation or ask questions about the hearing loss symptoms you or your child is experiencing.
Shelly Horvat, AuD, CCC-A, is a Doctor of Audiology with Northwest Ohio Hearing Clinic, located at 1125 Hospital Dr., Suite 50 in Toledo (419-383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327).