Q: Why do my ears often get blocked by wax? What should I do? Are there any drops that can dissolve the wax?

A: Everyone’s ears produce wax. Wax has antibacterial properties and is useful in protecting the ear against infections. The outer ear canal has a self-cleaning mechanism that brings wax and dirt from the inner part of the outer ear outwards. The best is to leave the ears alone. If wax builds up and blocks the ear canal, a doctor can remove it. Eardrops such as Tropex, Waxsol only soften earwax. It does not dissolve wax.

Q: What are the best ear diggers to clear wax from my ears?

A: This is a trick question. Clearing earwax with ear diggers, cotton buds is not advised and so there is no ‘best’ ear digger.

Q: I get a smelly discharge from my right ear everytime I take a bath. There is no pain or hearing loss. Is that a problem?

A: A smelly discharge may indicate an ear infection. Water tends to aggravate the problem. If the discharge persists, please see your family doctor first who refer you for ear cleaning if necessary.

Q: What is Ear Candling? Does it work?

A: Ear candling is an ancient method of clearing wax from the ear. It supposedly works when hot air caused by the candle flame results in convention currents in the ear canal which then sucks wax out of the ear. However, numerous studies have shown that is does not work at all. The wax you see after the procedure is the wax from the candle!

Q: My two year old child is starting to talk but the words are not clear. He frequently misses the ‘Fs’, ‘Cs’ and ‘Ts’and says ‘or’ when it should be ‘four’, ‘ar’ when it’s ‘car’ and ‘oi’ when it’s ‘toy’. He had a hearing screening test at birth and it says his hearing is normal. What should I do?

A: The first thing that should be said is that it’s good the hearing screening test at birth is normal. There are many reasons why a two year old child has unclear speech. It may be just a normal phase in speech development. However, if it persists he should have his ears examined. Sometimes, hearing can be affected from wax or fluid build-up in the middle ear space. The child can still hear but will hear speech as muffled sounds and reproduce the same muffled sounds when talking. It is also prudent to check for tongue-tie, which means short tongue. You can check for this condition by asking the child to point the tongue upwards. If there is a web-like structure holding the tongue down, he may have tongue-tie affecting pronunciation.

Q: I suddenly lost my hearing in one ear when I woke up this morning. There has been a ringing sound in that ear ever since. What is the cause? Is there something I can do?

A: Whenever hearing is suddenly lost in one ear with or without ringing in that ear, an audiogram (hearing test) should be done immediately to confirm if there is a hearing loss and if so, how severely the hearing is affected. The cause of the hearing loss may be a viral infection of the inner ear leading to Sudden Onset Sensorineural Hearing Loss (SSNHL). The importance of making diagnosis is to commence treatment early. The window period for treatment is within one week from onset of symptoms, preferably within two days.

Q: Will the use of MP3 players cause hearing loss?

A: This is a question I get often from parents of young adults. The answer is dependent on a few factors which include a number of hours of use per day, the loudness of music and kind of music. A recent US poll in 2004 showed more than half of American teens experience some degree of hearing loss as a result of excessive use of MP3 players. However, this report was a poll and not a controlled study and the conclusions should be scrutinized before accepting them. Personally, the use of MP3 players in moderation should not have any significant impact on hearing.

If you like to pose a question to Dr Chee, please email gchee@gcheeent.com and he’ll get back to you within one to two days (unless it’s the weekend).


Q. I heard using steroids in the long term is bad for health. Is there a problem using nasal steroid spray for a long time?

A: Taking oral steroids in the long-term is associated with complications. However, there are no long-term complications associated with the use of nasal steroid sprays such as Nasonex, Flixonase as very little (less than 1%) of the active ingredient (steroid) actually gets into the blood system. Studies have also shown that it is safe to use nasal steroid sprays in children.

Q: I’m allergic to house dust mites. What are the ways I can get my room house dust mite free?

A: House dust mites are found just about everywhere. It is estimated that in one queen size bed, there are 10 million mites living with you. Hence, it is nearly impossible to have a room dust mite free. There is a mite killer called Acardust which comes in the form of a spray. This can be applied to the beddings, carpets, blankets etc and serves to kill the mites in them. It needs to be applied on a monthly basis. The use of air-purifiers, ionizers etc have little effect on the houst dust mite population as does sunning mattresses or washing lining in hot water or beating mattresses.

Q: I get persistent yellowish discharge from my nose. It improves with antibiotics but soon recurs after the medications finish. What should I do?

A: It sounds as if you have chronic or recurrent sinusitis, or infection of the sinuses. If the problem persists for more than 3 months, or has more than 3 episodes of sinusitis a year, a CT scan of the sinuses is indicated to determine the extent of infection. Depending on the CT scan report, endoscopic sinus surgery may be required to clear infection and restore function of the sinuses.

Q: My nose is always blocked. It makes me feel uncomfortable, affects my sleep and causes a headache. What can be done?

A: Nasal blockage can be due to enlarged turbinates, infection or growths in the nose. Enlarged turbinates can be treated with radiofrequency application (see Radiofrequency Turbinate Reduction under Commonly performed clinic procedures). Infections should be treated with an appropriate course and dose of antibiotics. Tumors are confirmed on biopsy and treatment depends on the type and extent of disease.

Q: My cheeks and forehead hurts every time I fly. Could it be due to my sinus problem?

A: Flying results in changes in atmospheric pressure. Sinuses are closed spaces within the skull and the openings of the sinuses are usually millimeters wide. If the openings are narrowed further by allergies or infection, then patients feel the changes in atmospheric pressures more acutely during flying or diving. Topical antidecongestants usually afford effective relief of symptoms.

Q: Is there a cure for my sensitive nose?

A: Nasal sensitivity as a result of allergy is a genetic condition and hence, strictly not curable. However, there is a form of treatment called Immunotherapy  which alters the immune system’s response to allergens so that the patient does not experience the symptoms of allergy when exposed to allergens.

Q: My child constantly rubs his nose and eyes and the nose sometimes bleeds. He says it’s itchy and is associated with runny nose. What can be done?

A: Many patients with nasal allergies rub the nose because histamine release as a result of allergen exposure, causes itchiness as a result of inflammation and swelling. Bleeding is common in poorly-controlled allergies because of the trauma associated with rubbing and sneezing. There are many medications that give good control of such symptoms. Antihistamines such as Clarityne, Aerius, Telfast, Xyzal, Zrytec etc are good and non-sedating. Eye drops such as Patanol target eye symptoms.

If you like to pose a question to Dr Chee, please email him at gchee@gcheeent.com and he’ll get back to you within one to two days (unless it’s the weekend).