With the arrival of winter, various respiratory diseases are on the rise—flu, mycoplasma pneumonia, colds, the recent respiratory syncytial virus infection, and the silent influence of COVID-19. They all come with a vengeance, catching people off guard. Chronic conditions like annoying rhinitis can also worsen during the winter.

These illnesses not only exhibit respiratory symptoms but can also cause earaches, ear congestion, and even changes in hearing.

What causes changes in hearing?

The most common reasons are the obstruction of the eustachian tube and upper respiratory infections. The eustachian tube is a passage connecting the ear and the nasopharynx. Normally closed, it opens when we yawn, swallow, sigh, or sing to maintain equal pressure inside and outside the eardrum. However, during a cold or upper respiratory infection, bacteria and viruses can travel backward through the eustachian tube from the nasopharynx or oropharynx, leading to middle ear infections, commonly known as otitis media. This often presents as ear congestion and mild hearing loss.

According to relevant literature, approximately two-thirds of children under 3 years old have experienced acute otitis media at least once. This condition is closely related to upper respiratory infections, with reports stating that the incidence of otitis media in children with upper respiratory infections is around 10%. If left untreated, it can result in hearing loss.

Another study suggests that individuals who had an acute upper respiratory infection within the month before being diagnosed with otitis media had a significantly higher risk of developing middle ear infections compared to those who did not have an upper respiratory infection in the year before the diagnosis.

Patients with chronic rhinitis may notice inconsistent hearing between their left and right ears. Upon examination, the primary cause is often their allergic rhinitis. When inflammation is controlled, the eustachian tube clears, fluid in the middle ear is gradually absorbed or drained, and hearing is restored.

The most common cause of hearing loss after COVID-19 infection is secretory otitis media, typically appearing 1-3 weeks after the viral infection. Symptoms include ear congestion, ringing in the ears, and hearing loss, either in one or both ears.

COVID-19 also exhibits neurotropism, with the virus often causing loss of smell and taste due to its invasion of the nerves responsible for these senses. If the virus infects the cochlea or auditory nerve, sudden deafness may occur.

Excessive or improper blowing of the nose can also lead to retrograde infection of the eustachian tube, triggering acute otitis media. Excessive force may even cause eardrum perforation, mainly due to excessive pressure in the eustachian tube.

How to deal with sudden changes in hearing?

  1. Seek medical attention promptly, and actively cooperate with treatment—this is the most crucial response. The worsening of many problems often results from delaying the optimal intervention time or not following medical advice due to concerns about drug side effects.

  2. Do not self-medicate, especially with prescription drugs. Some medications may have ototoxic effects, and there are strict dosage requirements. Always follow medical advice when using medication.

  3. Some of the currently prevalent diseases are viral, and there are no specific drugs. Adequate rest is essential for the body's recovery.

  4. If incurable hearing loss occurs, promptly choose and fit hearing aids and assistive devices to slow down the continued decline in hearing.

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