ENT doctors debunk 11 ear and nose myths

• Otolaryngologists Erich Voigt and Jacqueline Jones debunk 11 myths about the ear and nose.
• They talk about how to properly stop a nosebleed and clean your ears without Q-tips.
• They also explain that earwax is good for your ears and how to protect yourself from hearing loss.

Following is a transcript of the video.

Erich Voigt: "To stop a nosebleed, pinch the bridge of your nose and tilt your head back."

That's the exact opposite of what you should do.

Jackie Jones: "It's OK to use Q-tips to clean your ears."

Voigt: Oh, boy, yeah.

Jones: Oh, boy.

"Taping your mouth shut will stop your snoring."

Voigt: OK, this, another one I'm ripping up. Never tape your mouth shut.

I'm Dr. Erich Voigt. I'm an otolaryngologist, head and neck surgeon. I'm an associate professor of otolaryngology at NYU Langone Health. I've been in practice for over 20 years.

And I am Dr. Jackie Jones. I'm an associate professor of otolaryngology at Weill Cornell Medicine, and I've been in practice for almost 31 years now. We are specialists in ear, nose, and throat.

Voigt: So, our field, actually the real title is otorhinolaryngology. Oto is ear, rhino is nose, larynx is laryngology.

Jones: So we sort of think of it as one continuous passage from your nose down into your lungs. So everything is interconnected.

Voigt: And today we will be debunking myths of the ear, nose, and throat.

Jones: "It's OK to hold in your sneeze."

Not a good idea.

Voigt: I think a small sneeze can be held in. But if you're generating one of those big sneezes, you don't want to hold it in. All of that pressure is going to back up into your ears, into your throat, into your lungs. Our nose is the filter of everything we're breathing in. So you're breathing in pollen, you're breathing in germs, you're breathing in particles and dust. That builds up in our mucus. And then a sneeze is the reflex to get that material out.

Jones: But sneezing is overall a good thing, 'cause you are clearing out your nose. But again ...

Voigt: Cover up.

Jones: Cover up. "It's OK to use Q-tips to clean your ears."

Voigt: Oh, boy, yeah.

Jones: Oh, boy.

So, this is a box of cotton-tip applicators. And there is a warning on here, but, whoa, Erich, I don't think I can see that.

Voigt: So, Jackie, I brought a magnifying glass just to demonstrate there is a warning label on there. And it says, and I quote, "Do not insert swab into ear canal."

Jones: But see how small that is? It really should be in big, bold letters here. But we're telling you, don't do it.

Voigt: So, this is a plastic model of an ear. This is called the pinna, and this is the outer ear. And you can use a cotton-tip applicator to clean the outside, the little grooves you can see. Some people do have, as their wax is coming out, they can clean that outer portion. That's OK. But you do not want to go putting this in here like this. 'Cause you're going to push your wax in, you're going to abrade the surfaces, and you're going to cause damage.

Jones: Some of the things that I recommend on cleaning the ear is drops of alcohol in the ear. And, again, as long as you don't have any ear problems or a hole in your ear, you can use hydrogen peroxide. That tends to bubble a bit but can be used. And a warm, wet washcloth that you ring out well and use to clean the outside of your ear. We really don't want you to overclean your ear.

"Bugs can't get inside your ears." Oh, gross. Get those mattresses off the floor, 'cause no matter how clean you are, those bugs could climb into your bed.

Voigt: First of all, bugs don't want to be in your ear. They are actually afraid of us. They're private. So cockroaches, spiders, they don't want. But every once in a while, they'll meander in. And the ear is a blind pouch. I've seen actually a spider who's made a web inside of someone's ear canal. The thing about the cockroaches, they go in, but they can't turn around. Once they're in there, there's not enough space for them to turn around and get out. So what they do is they keep clawing forward against the eardrum. And I don't know if you've ever seen cockroaches' legs under a microscope, but it's like hairs, and they're hooks. And so then they're scratching the eardrum. And as they're scratching the eardrum, the sound that's generated is horrendous, and the pain that's generated is horrendous. So the person starts scratching at their ear, and their ear starts bleeding. I've seen people come into that ER ripping their ear off, and so I immediately know, from across the room, cockroach in the ear. So what we do is we try to calm the person down. And then you can put rubbing alcohol in the ear or mineral oil in the ear or some liquid that will actually kill the bug, and then you can suction it out.

Jones: Cockroach is about the grossest thing that we see. But you can get flying insects in the ear too.

Voigt: Oh, sure, absolutely.

Jones: So same sort of thing. We want to drown them out. But, you know, you don't have to be phobic. It's pretty gross, but we don't see it that frequently.

Voigt: But if it happens to you at home, try not to panic, and just put rubbing alcohol or mineral oil in your ear, and then go to the doctor.

"To stop a nosebleed, pinch the bridge of your nose and tilt your head back."

Jones: Ugh. Uh-uh!

Voigt: I'm throwing this out. I'm throwing this one out.

Jones: Great, I'm so glad he did this.

And this is not an offense to the school nurse. They're classically told, "Pinch up here and hold your head back." And that's the exact opposite of what you should do. First off, the nose has a tremendous blood supply. The blood supply to the nose has five arteries that meet up here in the front. It's called Kiesselbach's plexus. And Kiesselbach's plexus have arteries and veins that meet together. So if you pinch the front of your nose, the sidewall against the septum, and hold it for five minutes and you stay upright and lean forward a little bit so that you can, if some of the blood's going down the back, you can spit it out. But if you pinch your nose for five minutes, you will stop 90% of nosebleeds.

Jones: Absolutely.

Voigt: Think of it as if you had a cut on your skin. You see the blood, what do you do? You put pressure on it. Pressure stops bleeding because it allows the flow to stop and then your own clotting mechanism to kick in.

Jones: "Taping your mouth shut will stop your snoring."

Voigt: OK.

Jones: Oh, my goodness.

Voigt: This, another one I'm ripping up. Never tape your mouth shut. I don't know how that's out there, because when you're asleep, you need to breathe. And let's just say your nose gets blocked and congested and you've got your mouth taped shut. How are you breathing? So, never.

Jones: Snoring comes from many different places. You're not just snoring from your mouth. Snoring comes from the turbulent flow of air through the respiratory system. And that turbulent flow can come from your nose, it can come from your mouth, it can come from lower down in your throat. So just taping your mouth closed is not going to fix that problem for a lot of people.

Voigt: It's very dangerous.

Jones: Yeah, and very dangerous. Not recommended.

Voigt: "Only loud music causes hearing loss." OK, only loud music? How about, "Anything loud can cause hearing loss." There's different ways your ear can get damaged. One is a sudden loud noise blast. So let's say a firearm or a firework near the ear. Then there's a cumulative effect where you might have noise at, say, 90 decibels or 100 decibels. Over time, that also will start harming those cells.

Jones: So, I'm speaking about 35 to 40 decibels right now. So 80 to 90 decibels is pretty loud. The more worrisome loss is that cumulative loss, because people don't even realize it's happening. You know, you go on the subways, you walk around in the city, it can be really loud.

Voigt: The construction sounds, factory noises, sirens. All of those things can cause hearing loss. So I think of loud noise as if you're looking up into the sun. You don't do it right, it hurts. Same thing. Loud noise blasting in your ear, it harms those little inner hair cells and causes permanent hearing loss.

Jones: And that's such a great point. Once it's gone, it's gone. We cannot do really anything to get your hearing back once it's gone. So thinking about your hearing early on in life is an important factor.

Voigt: "Swimming causes ear infections."

All right, well, many people swim. It's a very common human activity. Not everybody gets an ear infection. But there is an entity called swimmer's ear.

Jones: Swimmer's ear is when you get an overgrowth of either bacteria or fungus in the outside ear canal. And one of the main culprits from swimmer's ear is overcleaning of your ear.

Voigt: When you look at the ear canal, this is the outer ear, your ear canal's about an inch and a half long. It's lined with wax glands. These glands produce cerumen, or wax, that waterproof our ear. That's one of the jobs. That's why it's waxy. So when people clean out their ear too much, they're taking all the wax away. Now water's going in. And when water is sitting on the skin in a dark cave, the skin, if you've ever had, you know, taken a long bath and your skin kind of changes a little bit or you had your foot in water for a long time, it changes it. So that change occurs in the ear. And all of a sudden this ear canal is gonna start collapsing, and closing and closing and closing. And the germs inside start multiplying. And then you get swimmer's ear, which is an outer ear infection. These are some of the most painful infections that we've seen.

Jones: Oh my goodness. And what's another big culprit for swimmer's ear is these things that I absolutely love. But they're not great, especially in the summer.

Voigt: I think we have to make a new name, earbud ear.

Jones: You're putting this thing in your ear. And what's the thing that it's doing in the summer? It's making warm, dark environment even warmer and darker.

Voigt: So, some things you can do to treat it at home, or even preventative if you swim a lot, you can use rubbing alcohol. You just get an ear dropper and you can put three drops or so in your ear, wiggle it around, let it drain out. You can also use vinegar. Cut it in half with water. You can put that in your ear as well after swimming or if you feel water stuck in your ear.

"You should always get rid of earwax."

You should not get rid of earwax. [laughs] Earwax is protection to your ear. Now, there are circumstances where we, as ear, nose, and throat doctors, do take out the earwax. But that's when there's too much of it. So in a doctor's office, you might use an ear curette, as the doctor will go in and pull the wax out. But this is done under a microscopic guidance, and incredibly gently, because if you go too far in, you're going to burst the eardrum. Or you're going to scratch the ear and it's going to bleed.

Jones: Yeah, and one of the things that we use in the office to protect the outside ear canal is, we use a speculum. Which, we put it in the outside portion of the ear canal, and then we work through this little speculum, just to sort of protect the ear canal. So these are things you just can't do at home.

"Loss of smell is only temporary."

Well, that's a big one this year. You know, as we've gone through COVID, one of the big warning signs of COVID-19 was loss of sense of smell and taste associated with it. What happened is the virus goes into the nose and it hits those olfactory nerves, which are the nerves that supply the sense of smell to our brain. And the olfactory nerve sits way back here in the back of the nose, so it's a really interesting place. You only really smell from the back of nose.

Voigt: The sense of smell is probably the least appreciated of our senses. But when you lose it, it's devastating. So, some of those causes can be a head injury. So, our brain sits here. This is the bottom of the skull. And there are these little, teeny, tiny openings. Teeny, tiny openings where the hair cells of the olfactory nerve go through and enter into the nose. So if you get a whiplash injury, your head goes like this, those little hair cells can get sheared and you can have a permanent loss of sense of smell simply from a whiplash injury or a head injury. Some of these are permanent, some are temporary.

Jones: So one of the big things that we've been working on this year is olfactory training for people who've lost their sense of smell from COVID-19, where those nerves have been damaged. What we do is we have you get different types of smells. We use essential oils. Lavender, eucalyptus, cinnamon, lemon, are some of my favorites. And then what you do is you use those every day. And what it does, it helps to retrain your brain to recognize those smells.

Jones: "Headphones are just as bad as earbuds for your hearing."

Voigt: So, there are in-the-ear earbuds. I think we have an example.

I do, I brought mine.

Voigt: When this goes in your ear, for some people, if they're the type of person that makes a lot of earwax, they might be shoving their wax in. So if you pull your earbud out and you see a big glob of wax, you might have a big accumulation inside. And that's why you're not hearing so well. In addition, the earbuds sitting in there for long periods of time can start hurting your ear. The ear is a dark, moist environment. You can start getting ear infections from them. The pressure of the plastic could press on the TMJ, or your jaw joint, causing pain in your ear. So those are some of the drawbacks.

Jones: But they do provide a nice sound quality. But I try and limit myself to use them maybe an hour or two a day at the most, when I'm commuting back and forth to work. One of the things that, as ear, nose, and throat doctors, that we like better is over-the-ear earphones. So, these have some real advantages. They're much more comfortable. They dissipate the sound, so it's not that concentrated sound down into your ear canal. They're not going to push that wax down into your ears. So, a much better choice is these over-the-ear earphones. So, these are the noise-canceling ones. What are your thoughts about these?

Voigt: Yeah, so, noise canceling has a few advantages. It can block out the outside noise, so then you don't have to blast your music over the outside noise. Jones: We don't like any blasting of noise, whether it be over the ear or in the ear. Just don't do it. It's just unhealthy for your ears.

Jones: "If you have pain in your ear, you have an ear infection."

Voigt: As an ear, nose, and throat doctor, I probably see more non-ear-related ear pain or ear-caused ear pain than ear-infection ear pain. And the reason for that is the ear has five nerves that innervate it for sense. And those nerves can give what's called referred pain from other sites. Someone might come in and say they have an ear infection because they have ear pain, but I'll examine them and their ear is fine. But where the site of the infection is, is their jaw joint. They may have had a tooth extracted two weeks ago and the dentist was pulling their jaw. They might have muscle tension. People might grind their teeth. So all of those are very common causes of ear pain. And that's not from an ear infection.

Jones: Yeah, and that's a really good point, 'cause referred pain can be from anywhere. It can be from the throat, it can be from deeper down. Another big source of ear pain is eustachian tube problems. And that's that drainage passage that runs from the back of the ear into the nose. And all of us have experienced at some point, when you fly, that feeling of pressure and pain in your ear.

If your hearing's bad or you're having problems with your sense of smell, your voice is changing, don't just ignore it.

Voigt: So if you've got some issues with your ears, your nose, your throat, your head, and neck, if you feel a lump or bump, you've got pain that's not going away, it's probably worthwhile to get a checkup. Don't ignore symptoms that are lingering for more than two weeks, because there could be something serious going on.