Q. I feel discomfort with earplug with a history of ear perforation. Why do I feel so?

Answered by
Dr. B Vageesh Padiyar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 10, 2020 and last reviewed on: Sep 02, 2020

Hi doctor,

Could I have a little bit of advice about my ears? I have been swimming casually for years, head-above-water (attempting to keep ears dry but some water inevitably splashes in with no issues). I recently managed to get some earplugs to work though so I could start to swim underwater, but have a (different) concern about each ear and whether I am fine to continue doing that or if I ought to get them looked at. I have included a video and a picture below taken with a Bebird otoscope I bought.

Right ear was perforated at a young age, and it did not heal itself so I had a skin graft operation. I am pretty sure it is still intact (ear was clearer a few weeks ago so I got a better look at the eardrum and it looked fine to me). When I try to insert an earplug though it makes noises as I try with difficulty to get a good seal, then when it is sealed, there is a little bit of unpleasant pressure and a distracting rumbling sound and my breathing is really loud, etc. Half the time I get it to seal for a while and the other half of the time it is quite bothersome. There is sometimes quite a pop when I remove the plug, and it is quite a relief taking it out (but no pain or other issues afterward just feels normal again).

Here is what it looks like in there after today's swim. I am guessing the problem is just wax, and I have pushed some wax around in there with the earplug. If so would you recommend olive oil or sodium bicarbonate ear drops to get it out?

Left ear seals a lot more easily with my earplugs, no unpleasantness on that side at all. I have zero issues with it. However, I was told by my doctor that it was perforated around a decade ago. They did not seem too concerned and said it might heal itself. Looking at it here though I do not think it ever did heal as it looks like there is a hole in it to me.

If there is any hearing loss I have never noticed it. My question is, if this has never caused me any problems, is it fine to just leave it ruptured like that forever if it never heals, or is there some long-term reason I should consider having it fixed?



Welcome to icliniq.com.

I have seen the attachments (attachments removed to protect patient identity).

As far as your left ear is concerned, I do see a lot of chalky deposits over the eardrum what we call as myringosclerosis. This would have happened as part of healing post-surgery.

As you have rightly put it, the most probable reason for having unpleasantness while applying earplugs is most attributed to the ear wax. Usually, when we try to seal the ear canal, there is a column of air that gets pushed in. In the presence of anything such as wax can reduce the ear canal volume causing distortion of sound waves entering causing reverberations in the ear. It is not advised to use sodium bicarbonate or any oil as it can attract a fungal infection and worsen things. My advice to you would be to get any residual wax removal done under vision by an ENT specialist.

As far as your right ear is concerned, with the photo you have sent, I am not quite but able to distinctly make out if the perforation is still present. It looks as though the body would have healed the perforation forming a dimeric membrane. The only way to be sure about this is by doing a Valsalva manoeuvre and if you feel a hissing sound with air escaping through the right ear, there is a possibility that the perforation is still present and not otherwise.

If the eardrum is perforated and if you like to swim, it is always advised to get it closed to prevent recurrent middle ear infections. However, if it is closed, there is no surgery required at any cost.

I hope this helps.

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