Can a loud blast cause muffled hearing and ear clogging?

Question

Hi doctor,

I have an acoustic shock disorder in the left ear after a very loud cracker blast 6 months ago. My ear got clogged, and I have muffled hearing. The audiometry test and impedance test were normal. I have been doing the Valsalva, and it pops the tympanum normally. Every morning after waking up, the left nostril gets blocked slightly since the blast incident. Then I perform Valsalva, and the nostril opens immediately. I do not understand. How was negative air pressure in the middle ear caused due to the blast? Or is this due to the TTTS problem involving the tensor tympani?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for sharing your concerns.

The loud blast you experienced likely caused a sudden pressure change in your middle ear, which can sometimes affect the muscles around the ear, such as the tensor tympani. Even though your hearing tests and tympanic membrane function appear normal, your symptoms—ear fullness, muffled hearing, and the daily blockage of your left nostril that clears with Valsalva—may be related to a condition called acoustic shock disorder. This can involve spasms or dysfunction of the middle ear muscles and issues with eustachian tube function, which regulates air pressure in the middle ear. The blast may have caused irritation or subtle injury to these structures, leading to your ongoing symptoms. I recommend following up with an ENT (ear, nose, and throat) specialist who can evaluate these muscles and the eustachian tube more closely and suggest treatments to relieve your discomfort.

I hope this answers your query.

Do not hesitate to reach out if your symptoms worsen or if you have any new concerns.

Thanks and regards.