Ear and hearing conditions affect the ear canal, eardrum, middle and inner ear, hearing nerve, or your balance system. Symptoms include pain, discharge, pressure, tinnitus, dizziness, hearing difficulties or hearing loss. Explore ear symptoms, conditions, hearing tests and treatments. Follow the links for each diagnosis or procedure.
Hearing loss can affect one ear or both ears and may develop gradually. Reduced hearing may be an early sign of hearing loss.
Fullness, popping and difficulty clearing the ears may occur with Eustachian tube dysfunction or middle-ear fluid. Conductive hearing loss occurs when sound is blocked in the external or middle ear.
Ear pain, itching or discharge may result from infection, inflammation, a perforated eardrum or another ear condition.
Delayed speech, inconsistent responses to sound or recurrent ear infections may indicate hearing loss and warrant a hearing test and a paediatric ENT assessment. Early intervention may support the child’s speech and language development.
Seek immediate medical assessment if hearing suddenly drops in one or both ears, even if the ear feels blocked. Don’t assume earwax is the cause. New facial weakness, severe persistent vertigo, or severe ear pain with fever or swelling also needs urgent assessment. Call 995 if dizziness occurs with facial drooping, arm weakness or difficulty speaking.
The pinna collects sound waves. The external ear canal directs them towards the eardrum.
Sound waves vibrate the eardrum. The middle ear bones, the malleus, incus and stapes, amplify these vibrations.
The cochlea converts fluid vibrations into electrical signals. The auditory nerve, also called the hearing nerve, carries these signals to the brain, which processes sound. The inner ear also contains structures that help control balance.
| Type of hearing loss | Description |
|---|---|
| Conductive hearing loss | Conductive hearing loss occurs when sound transmission is blocked or reduced in the outer or middle ear. Causes include impacted earwax, fluid in the middle ear space, a perforated eardrum and a reduced movement of the middle-ear bones. |
| Sensorineural Hearing Loss | Sensorineural hearing loss affects the cochlea or auditory nerve. Ageing, loud noises, infections, ototoxic drugs and other medical conditions can also contribute. Sensorineural hearing loss is often permanent. |
| Mixed Hearing Loss | Mixed hearing loss means that conductive and sensorineural factors occur together. |
Checks the ear canal and eardrum for wax, infection, fluid or structural changes.
Measures the quietest sounds you can hear at different pitches. Comparing air and bone conduction helps identify the type of hearing loss.
Assesses how clearly you understand speech.
Checks how the eardrum and middle ear respond to changes in air pressure.
Otoacoustic emissions, auditory brainstem response testing or balance assessments may be recommended, depending on your symptoms and initial findings.
Consider testing if you have communication difficulties, unequal hearing, persistent tinnitus, ongoing symptoms after ear infections or regular exposure to workplace noise. Your medical history identifies risk factors such as a family history of hearing loss, repeated loud-noise exposure or ototoxic drugs. One-sided hearing loss may require further assessment for uncommon causes such as acoustic neuroma. Visit an audiologist in Singapore for detailed information about testing, hearing aids, device programming and rehabilitation.
In Singapore, newborn hearing screening is generally performed before hospital discharge. HealthHub reports that about 4 in every 1,000 babies have significant hearing loss. Children born with hearing impairments and their family members may need early intervention to support language development. Early detection allows hearing and communication support to begin sooner.
Earwax impaction
A build-up of earwax in the external ear canal can cause fullness, tinnitus and temporary hearing loss. Cotton buds may push wax deeper in the ear or injure the canal.
Otitis externa
Also called swimmer’s ear, this is inflammation or infection of the external ear canal. Symptoms can include pain, itching, swelling and discharge.
Preauricular sinus
A small congenital opening near the ear may become infected or form an abscess.
Medial canal fibrosis
Scar tissue can narrow or close the deeper ear canal, reducing sound transmission.
Otitis media with effusion
Otitis media with effusion, also called glue ear, is fluid behind the eardrum without signs of an acute middle-ear infection. It can cause muffled hearing and may persist after an infection has cleared.
Perforated eardrum
A tear or hole may follow infection, injury or a sudden pressure change and can cause conductive hearing loss.
Otosclerosis
Abnormal bone remodelling can restrict stapes movement and cause progressive conductive hearing loss.
Cholesteatoma
Skin cells trapped behind the eardrum can damage nearby structures. Persistent unpleasant-smelling ear discharge and worsening hearing loss need assessment.
Tinnitus
Hearing sound without an external source. It may occur with hearing loss, noise exposure, earwax or an infection. Tinnitus with one-sided hearing loss or a pulsating sound needs medical review.
Vertigo and balance disorders
Inner-ear problems may cause spinning, unsteadiness or nausea. The timing, triggers and associated hearing loss help guide diagnosis.
Noise-induced hearing loss
One very loud sound or repeated noise exposure can permanently damage cochlear hair cells.
Tier 1
Options may include safe earwax removal, prescribed ear drops, treatment of infections or inflammations, pressure-management measures, medication reviews, and monitoring.
Tier 2
Digital hearing aids can be programmed for an individual’s hearing pattern. Hearing technology may include noise management, directional microphones, rechargeable batteries and Bluetooth connectivity. Wearing hearing aids requires proper fitting and follow-up, whether they sit in the ear or behind it.
Assistive devices include remote microphones, captioned communication, vibrating alarm clocks and flashing doorbell alerts. An audiologist can help select and adjust suitable devices.
Tier 3
Dr Barrie Tan is a Senior Consultant ENT Specialist with more than 20 years of experience. He previously served as Head of the Department of Otolaryngology at Singapore General Hospital and Director of the Centre for Hearing and Ear Implants at SGH.
At your appointment, Dr Barrie Tan will review your symptoms and medical history and examine your ears. Hearing or balance tests may be recommended when needed. The findings help determine whether monitoring, medical treatment, hearing rehabilitation or surgery is appropriate.
