Deviated Septum Causes Ear Problems? Evidence, Diagnosis & Treatment

Can a Deviated Septum Cause Ear Problems?

Patients with a deviated nasal septum may have middle ear disorders due to interference in the functioning of eustachian tube (ET). This is typically observed in the ear on the same side of the obstructed nasal passage.

The ET connects the middle ear cavity and the nasopharynx (throat). It ventilates and balances air pressure in the middle ear.

Chronic nasal obstruction due to the presence of a deviated septum may block the ET. This leads to poor ventilation of the middle ear, which may cause inflammatory disorders.¹Low WK, Willatt DJ. The relationship between middle ear pressure and deviated nasal septum. Clin Otolaryngol Allied Sci. 1993;18(4):308-310

source

Frequently Asked Questions – Deviated Septum Side Effects

In this section we cover every “can a deviated septum cause ear…?” question that we’ve come across:

Can Deviated Septum Cause Ear Pressure?

While the deviated septum does not directly cause ear pressure, its presence may cause nasal obstruction, which in turn weakens the function of the ET, causing imbalanced ear pressure.

The ET ventilates the middle ear, enables the eardrum to vibrate properly, and helps drain secretions from the middle ear. It is normally closed but opens when we swallow, yawn, or chew.²Seibert JW, Danner CJ. Eustachian tube function and the middle ear. Otolaryngol Clin North Am. 2006;39(6):1221-1235

In some patients, the presence of a chronic nasal obstruction due deviated septum can cause swelling of the mucosa (inner lining) of the ET. This may narrow or block the tube, impairing its ability to balance air pressure, and creating a feeling of pressure in the ear.³Low WK, Willatt DJ. The relationship between middle ear pressure and deviated nasal septum. Clin Otolaryngol Allied Sci. 1993;18(4):308-310

Can a deviated septum cause an inner ear infection?

Deviated septum does not cause inner ear infection. But it can contribute to middle ear infections.

Generally, mucus from nose and sinus bypasses the opening of the ET and drains into nasopharynx (throat). Chronic nasal obstruction can cause nasal and sinus inflammation which leads to excessive mucus accumulation and microbial growth. The excess mucus along with microbes may enter the opening of the ET, causing its obstruction. This damp, warm, and stagnant area becomes a breeding ground for microbes, triggering development of infections in the middle ear.

Persistent infection may cause perforation of the ear drum (tympanic membrane) which is present between middle and inner ear.⁴Stammberger H. An endoscopic study of tubal function and the diseased ethmoid sinus. Arch Otorhinolaryngol. 1986;243(4):254-259.

Can a deviated septum cause ringing in the ears?

Deviated septum is not directly involved in causing ringing in the ears, or tinnitus.

Nasal congestion from a severe cold, or sinus infection can create abnormal pressure in the middle ear, impacting normal hearing and causing tinnitus symptoms.

Tinnitus refers to the perception of noise arising without any external stimulus. Blocked ET can cause symptoms such as ringing or popping noises. The severity of tinnitus varies from an occasional noise in one or both ears, to an unbearable sound.

In many cases, the removal of the blockage will alleviate tinnitus symptoms. In some situations, the blockage may cause permanent damage.⁵Causes of tinnitus; American Tinnitus Association; Retrieved on July 5, 2020;

Does deviated septum cause clogged ears?

In some patients, presence of deviated septum is associated with ET dysfunction, which may cause clogged ears.

ET dysfunction occurs when the mucosal (inner) lining of the tube is swollen, and does not open or close properly. This interrupts the passage of air through the ET, resulting in ventilatory disturbance in middle ear. As a result, patients with ET dysfunction complain of clogged ears or ear fullness.⁶Salvinelli F, Casale M, Greco F, D'Ascanio L, Petitti T, Di Peco V. Nasal surgery and eustachian tube function: effects on middle ear ventilation. Clin Otolaryngol. 2005;30(5):409-413.

Can a deviated septum cause ear pain?

Deviated septum can cause ET dysfunction which leads to pressure imbalance in the middle ear, causing symptoms such as ‘discomfort or pain’ and ‘ear fullness.’ Ear pain is the most common symptom of middle ear infection.⁷Schilder, A., Chonmaitree, T., Cripps, A. et al. Otitis media. Nat Rev Dis Primers 2, 16063 (2016).

Presence of nasal obstruction also causes sinus infection which slows the flow of the mucus and causes its accumulation. As a result, mucus from the nose and sinus, which usually bypass the ET opening to drain into the nasopharynx (throat), now enter the ET.

This causes blockage of the ET and inflammation, resulting in ear pain. When the ET is completely blocked, mucus tends to collect behind the ear drum. Bacteria growing in the mucus can cause pain and middle ear infection.⁸Stoikes NF, Dutton JM. The effect of endoscopic sinus surgery on symptoms of eustachian tube dysfunction. Am J Rhinol. 2005;19(2):199-202.

Can deviated septum cause hearing loss?

Deviated septum rarely causes hearing loss.

About 85% of all deafness is due to middle ear involvement. Of middle ear infections (otitis media), 90% have their origin in inflammatory conditions of the nose, sinus, and pharynx.⁹Johnson, M. R. (1941). Nasal Obstruction And Impairment Of Hearing: Report Of Forty-Six Cases Of Submucous Resection With Audiometric Studies. Archives Of Otolaryngology - Head And Neck Surgery, 33(4), 536–549.

The presence of deviated septum can cause nasal and sinus inflammation, along with increased production of mucus. Due to the close association of ET with nasal and sinus cavities, the increased mucus production may block the ET. This leads to decreased ventilation of middle ear and creates negative ear pressure which can impact hearing. In severe cases it may cause hearing loss.¹⁰Lin X, Shan X, Lin S, Shu B, Wang Y, Xiao W. Is Sensorineural Hearing Loss Related to Chronic Rhinosinusitis Caused by Outer Hair Cell Injury?. Med Sci Monit. 2019;25:627-636. Published 2019 Jan 22. doi:10.12659/MSM.912382

In children with a nasal septum deviation, swelling of adenoids (tissues present in the higher part of throat, behind the nose) and sinus infection decrease hearing ability.¹¹Kopacheva Barsova, Gabriela & Marina, DAVCHEVA-CHAKAR & Irena, DUMA-VASOVSKA. (2007). Nasal Septum Deviation and Conductivity Hearing Loss In Children. Journal of Special Education and Rehabilitation. 8. 10.5281/zenodo.28823.

Can a deviated septum cause swimmer's ear?

No, deviated septum does not cause swimmer’s ear.

Swimmer’s ear is an external or outer ear canal infection (otitis externa). This infection is five times more common in swimmers than non-swimmers, hence called swimmer’s ear. Presence of any inflammation of the outer ear canal, such as infections, allergies, or skin conditions, can lead to swimmer’s ear.

It is higher in swimmers because of exposure to water with high microbial activity. This water may enter the ear canal and multiply if the skin of the ear canal is damaged.

Initial symptoms include itching and soreness inside the ear which may soon turn painful and swollen. Medical attention is required in cases of ear canal infection.¹²Michael B. Strauss, Wendy Groner-Strauss & Robert W. Cantrell (1979) Swimmer's Ear, The Physician and Sportsmedicine, 7:6, 101-105

source

Alternative Remedies for Deviated Septum & Ear Problems

If your ear infections, clogging, or other problems are caused by a deviated septum, we strongly recommend you look into septoplasty (also known as deviated septum surgery).

But if you’re unable to get septoplasty done soon, here are some things you can do at home to potentially reduce your ear problems:¹³Llewellyn A, Norman G, Harden M, et al. Interventions for adult Eustachian tube dysfunction: a systematic review. Southampton (UK): NIHR Journals Library; 2014 Jul. (Health Technology Assessment, No. 18.46.) Chapter 1, Background.

Medical therapy: Nasal congestion and inflammation of the ET can be treated with intake of decongestants, antihistamines (anti allergic), and topical or oral steroids. The doctor may prescribe antibiotics for the treatment of sinus infection
Saline (salt water) irrigation or flushing of nose helps in mucociliary clearance (draining of mucus and foreign particles), which eases congestion
Activities that cause the ET to open (e.g., yawning, swallowing, and chewing). These activities help maintain pressure in the middle ear
Pressure equalization methods which increase pressure in the nose. These reopen the ET and fill air into the middle ear. Some common methods include:

Valsalva manoeuvre: This is done by closing the mouth and nostrils and performing a forced exhalation

source

Medical balloon: Blowing up a medical balloon through each nostril, 2-3 times daily can clear the blockage

source

Use of simethicone: This is currently being investigated in adults to assess whether it can help break up bubbles that may block the opening of the ET
Performing yoga and breathing exercises (pranayama) are known to help ease ET obstruction¹⁴Yoga therapy for ear disorder; Asana International Yoga Journal; Retrieved on July 5, 2020;

Yoga poses

Sources:

1
Low WK, Willatt DJ. The relationship between middle ear pressure and deviated nasal septum. Clin Otolaryngol Allied Sci. 1993;18(4):308-310
2
Seibert JW, Danner CJ. Eustachian tube function and the middle ear. Otolaryngol Clin North Am. 2006;39(6):1221-1235
3
Stammberger H. An endoscopic study of tubal function and the diseased ethmoid sinus. Arch Otorhinolaryngol. 1986;243(4):254-259.
4
Causes of tinnitus; American Tinnitus Association; Retrieved on July 5, 2020;
5
Salvinelli F, Casale M, Greco F, D'Ascanio L, Petitti T, Di Peco V. Nasal surgery and eustachian tube function: effects on middle ear ventilation. Clin Otolaryngol. 2005;30(5):409-413.
6
Schilder, A., Chonmaitree, T., Cripps, A. et al. Otitis media. Nat Rev Dis Primers 2, 16063 (2016).
7
Schilder, A., Chonmaitree, T., Cripps, A. et al. Otitis media. Nat Rev Dis Primers 2, 16063 (2016).
8
Johnson, M. R. (1941). Nasal Obstruction And Impairment Of Hearing: Report Of Forty-Six Cases Of Submucous Resection With Audiometric Studies. Archives Of Otolaryngology - Head And Neck Surgery, 33(4), 536–549.
9
Lin X, Shan X, Lin S, Shu B, Wang Y, Xiao W. Is Sensorineural Hearing Loss Related to Chronic Rhinosinusitis Caused by Outer Hair Cell Injury?. Med Sci Monit. 2019;25:627-636. Published 2019 Jan 22. doi:10.12659/MSM.912382
10
Kopacheva Barsova, Gabriela & Marina, DAVCHEVA-CHAKAR & Irena, DUMA-VASOVSKA. (2007). Nasal Septum Deviation and Conductivity Hearing Loss In Children. Journal of Special Education and Rehabilitation. 8. 10.5281/zenodo.28823.
11
Michael B. Strauss, Wendy Groner-Strauss & Robert W. Cantrell (1979) Swimmer's Ear, The Physician and Sportsmedicine, 7:6, 101-105
12
Llewellyn A, Norman G, Harden M, et al. Interventions for adult Eustachian tube dysfunction: a systematic review. Southampton (UK): NIHR Journals Library; 2014 Jul. (Health Technology Assessment, No. 18.46.) Chapter 1, Background.
13
Yoga therapy for ear disorder; Asana International Yoga Journal; Retrieved on July 5, 2020;