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  • Writer's pictureDr. Koralla Raja Meghanadh

Why Do We Experience Ear Pain and Blockage During Cold?


Introduction

In the final stages of a cold or during a bout of rhinitis, some people might notice ear pain or a sense of blockage in their ears. This is a sign of Otitis Media, also known as a Middle Ear Infection. This is quite common, and in this article, we'll break down why it happens and how to take care of it.


A girl with common cold

Cold

The cold is a widespread respiratory infection caused by a virus. It mainly affects the nose, leading to symptoms like a runny or stuffy nose, sneezing, coughing, and a sore throat. In simple terms, it targets the nasal region and is one of the most frequent infections people can catch. When left untreated, it can turn into a bacterial infection requiring antibiotics to fix it.


Untreated cold can also lead to chronic sinusitis and Otitis Media.

Basics of Ear Infection

A girl with common cold experiencing ear pain

Ear infections, medically known as Otitis, can happen in different sections of the ear. They are generally categorized into three types based on where the infection occurs:


  1. Otitis Externa - This is an infection of the outer ear canal.

  2. Otitis Media - This refers to an infection in the middle ear.

  3. Otitis Interna - This is an infection that affects the inner ear.

Each type has its own set of symptoms and treatment options.


The Connection Between Cold and Ear Infections

An untreated cold can cause Otitis Media,i.e., middle ear infections. 90% of ear infections occur due to cold. To understand the cause, we need to understand the anatomy.


Anatomy of Middle Ear

The middle ear is a small chamber shaped like a cuboid with six walls and a volume of one cubic centimetre. It contains the eardrum, consisting of three layers, and for proper hearing, the air pressure in the middle ear must match atmospheric pressure. This balance is maintained by the eustachian tube when we swallow, allowing air to flow in. The middle ear also has an air reservoir in the mastoid cellular system.

Middle ear connection to Nose

We have a eustachian or auditory tube that connects our middle ear to the back of our nose. This tube helps keep air flowing to the middle ear. The skin lining in the nose and the eustachian tube is the same continuous mucosa lining.


An infection in your nose that leads to extra mucus or swelling in this lining can also impact your middle ear. This is because the continuous mucosa layer links the two areas, so a problem in one can easily affect the other.


How Cold Causes Ear Pain and Blockage

Fluid seepage into the middle ear

During the cold, our nose secretes excess fluids. These fluids from the nasopharynx can enter the middle ear through the eustachian tube.


These fluids could be filled with bacteria and viruses, and the middle ear becomes a breeding ground for the bacteria causing infection in the middle ear.


Blowing nose forcefully

As mentioned earlier, fluids typically don't flow from the nasopharynx to the middle ear in adults because of the diagonal position of the eustachian tube.


However, when people with rhinitis or a stuffy nose, especially if one nostril is blocked, blow their nose to find relief, it can create high pressure in the nasopharynx. This high pressure can push the contents into the eustachian tube.


Thick fluids

If the fluids in the nasopharynx are thick in any scenario, they might not reach the middle ear. Instead, they cause a blockage in the auditory tube, cutting off the air supply to the middle ear.


This results in pressure building up in the middle ear, resulting in ear pain and fluid seepage from the blood that will, in turn, result in an ear infection.


Inflammation of Mucosa

As previously mentioned, the eustachian tube and the nose share the same skin lining. When you have a cold, it can lead to inflammation of this lining, known as the mucosa. This inflammation can also block the eustachian tube, resulting in increased pressure in the middle ear, which can cause Otitis Media. This elevated pressure is responsible for both ear pain and a sensation of blockage in the ear.


Prevention of Otitis Media during Cold

  1. Use nose drops when you get a cold

  2. Saltwater gargling

  3. Do not blow the nose as it creates high pressure in the nasopharynx, pushing the infection into the middle ear via the eustachian tube.


Key Takeaway

It's pretty common for a cold to cause pain in the ear and ear blockage, but the good news is that it's usually preventable. Specifically, ear infections like Otitis Media are more likely to occur when a cold isn't adequately treated. Using nasal drops and inhaling steam can effectively treat the cold and reduce the risk of developing a middle ear infection.

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