Ear fullness is essentially ear pressure originating in the middle ear. It can appear as a feeling of clogged or blocked ears and occur simultaneously with other symptoms such as tinnitus, altered hearing perception, pain, excess mucus production and nasal congestion. There can be so many causes behind the clogged ears sensation, from self-limiting respiratory infections to chronic ear infections, nerve damage or allergies. Sometimes, clogged ears are just your auditory system’s attempt at regulating pressure in the middle ear when outside pressure changes drastically, such as when you travel by plane or go in an elevator, in which case it is, well, normal. Ear fullness can be transient and resolve itself in a matter of minutes or days or it can be chronic and last for months.
What is ear fullness? Ear fullness is essentially either a fluid buildup in the middle ear or a difference in pressure between the outer and middle ear. What does ear fullness feel like? Some people describe it as having a cotton ball in the their ears that obstructs sound or a feeling of ear full of fluid. Others experience ear pressure or a blocked ear sensation. Depending on the cause behind ear fullness, other symptoms may occur.
Ear fullness causes. What causes fullness in the ears? If you experience a feeling of fullness in ears, either alone or together with other symptoms, you need to consider the following causes:
1) Difference in air pressure. This can be a result of travelling by plane and often occurs when the plane is taking off or landing. Ear fullness is common when travelling by subway, scuba diving or swimming submerged or deep underwater, mountain climbing, anything that involves high altitudes. Some people experience this feeling when riding an elevator. It’s a temporary symptom and should resolved naturally. Some people report getting rid of ear pressure after blowing their nose, yawning or swallowing food. Especially loud noises causing strong vibrations on the eardrum can affect normal hearing and trigger or accentuate the feeling of ear fullness.
2) Allergies. Seasonal allergies can cause a persistent feeling of ear fullness or clogged ears. Sinus pressure, allergic rhinitis with red, watery, itchy eyes and a runny nose with a productive, runny or thick, clear mucus, sleepiness and lethargy are associated symptoms.
3) Ear infections. They can cause fluid buildup and inflammation that results in a feeling of pressure in the ears. Otitis is most common and includes otitis externa, otitis media and otitis interna, any of the three having the potential to cause ear pressure directly or indirectly. An external ear infection (otitis externa) occurs when water is left behind in the ear canal, resulting in a perfect medium for bacteria and fungus growth. Because excess water in the outer ear canal is the starting point of the infect, otitits externa is also known as swimmer’s ear. Middle ear infection can present as non-infectious fluid accumulation or bacterial infection and lead to clogged ears and ear pain. An acute otitis media will cause ear fullness and pain.
4) Respiratory infections: common cold, sinusitis etc. The Eustachian tubes connect the middle ear to the nasal passages. Normally they are closed but will open when swallowing food, water or in response to pressure, allowing for regulation of the pressure in the middle ear. Respiratory infections that cause excess mucus production can block the nose and the resulting nasal congestion does not allow the Eustachian tubes to regulate air pressure within the middle ear, resulting in a feeling of ear fullness.
For example, the common cold causes a productive cough and the excess mucus it generates can engender Eustachian tube dysfunction and a feeling of ear fullness (see Common Cold: Causes, Symptoms and Treatment). Sinusitis also causes mucus accumulation which leads to nasal congestion and a feeling of a heavy head or forehead and heavy or full ears. Respiratory infections are actually one of the main reasons of clogged ears when sick. In cases of respiratory infection with excess mucus production and nasal congestion, clogged ears and nose usually occur together.
Tonsillitis and ear pressure. Tonsillitis is commonly associated with ear ache, but can easily cause secondary infections of the middle ear or sinuses which are characterized by ear pressure. So if you have clogged ears when waking up and find it hard to swallow, it is possible you have a tonsillitis which has given rise to a secondary infection.
5) Side effects of respiratory infections. Ear fullness can occur as a side effect of a bad respiratory infection. And one such side effect is inflammation of the inner ear, also known as labyrinthitis. Symptoms of labyrinthitis include vertigo, tinnitus or ear ringing and even temporary or permanent hearing loss. A less common but possible symptom is ear fullness. Labyrinthitis is also one of the reasons why some people get clogged ears after running or experience ear fullness during exercise.
6) Eustachian tube dysfunction. The Eustachian tube is an ear canal connecting the middle ear to the back of the nose. The middle ear is normally filled with air, but isolated from the exterior, except for the Eustachian tube which opens and closes somewhere in the back of the nasal passages to allow it to regulate its pressure. Eustachian tube dysfunction can result in ear fullness, ringing ears, tenderness, even dizziness. Patulous Eustachian tube is an ear disorder which causes the Eustachian tubes to open sporadically. This affects normal hearing and is a cause for middle ear fullness. Dysfunction can also be a result of severe ear infections, sinus infections, labyrinthitis or middle ear inflammation, allergies and temporomandibular disorders (see article on Jaw and Ear Pain: Causes, Symptoms and Treatment).
7) Blocked ears. An ear full of wax can easily cause a feeling of fullness or ear pressure. Normally, wax serves a protective role, creating a barrier against infection, but it’s not supposed to remain in the ear indefinitely. Actually, all wax produced in the ear canal between the middle and outer ear will eventually be transported out as a result of natural jaw movements which encourage wax to migrate outside of the ear. Excess wax can obstruct the ear canal, cause ear fullness and ultimately affect hearing and predispose to infections which can further cause complications.
8) Perforated eardrum. Injury to the eardrum can result in a perforated eardrum. Using cotton swabs to clean earwax, syringe irrigation or inserting various objects in the ear canal are the most common causes. A perforated ear drum impacts normal air pressure in the middle ear, resulting in both hearing loss and ear pressure or a feeling of fullness.
9) Sensorineural hearing loss. It is one of the main reasons behind hearing loss and a result of nerve damage, autoimmune or genetic factors. The condition causes varying degrees of deafness and is usually permanent. There is no treatment for it, only various symptoms management strategies. According to statistics, more than half of sensorineural hearing loss sufferers experience ear pressure, fullness or clogged ears.
10) Other causes: polyps, cysts, large adenoid tonsils (a special kind of tonsils at the base of the nasal cavity), benign tumors (example: acoustic neuroma) could all exert pressure and affect hearing in one or sometimes both ears, resulting in a feeling of stuffed ears or ear fullness. Superior canal dehiscence syndrome is a condition that results in the partial or total absorption of a segment of temporal bone in relation to the inner ear and can result in ear pressure or fullness. Meniere’s disease causing fluid to build in the inner ear also results in symptoms of ear fullness, tinnitus, vertigo and hearing loss.
11) Clogged ears and high blood pressure. Many high blood pressure sufferers experience ear fullness during exercise, especially after running, sometimes a feeling of throbbing in the ears or pulsating tinnitus (see Tinnitus or Ringing Ears: Causes and Treatment).
Conclusion. If you experience ear fullness for months, it can be a sign of an unresolved ear infection, nerve damage or a symptom of hearing loss and should be investigated by a specialist. If you experience persistent ear fullness and other worrisome symptoms such as discharge, tinnitus, ringing or buzzing ears, headaches, vertigo, loss of balance, sinus pressure, loss of hearing or alterations in auditory acuity, it is important to see a doctor as soon as possible.
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