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Warm or Fluid Sensation in The Ear Symptoms, Causes & Statistics

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Are you experiencing a warm or wet feeling inside one or both ears? There are a number of reasons it feels like there's water in your ear, and most are common and can be treated by your primary care doctor. Read below to learn what may be making your ears feel wet or warm and how it may be treated.

6 most common causes

Illustration of a doctor beside a bedridden patient.
Ménière's Disease
TMJ Dysfunction Disorder
Ear Infection
Illustration of a doctor beside a bedridden patient.
Cholesteatoma
Illustration of various health care options.
Ear plug made of skin cells
Illustration of various health care options.
Glue ear (otitis media with effusion)

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Warm or fluid sensation in the ear explained

We all know the ear as the body part responsible for hearing; however, the ear is a complex organ that also plays an important role in activities such as balance.

The ear is composed of three main parts and connecting structures:

  • Outer/external ear (pinna): This consists of the outside portion visible to the eye and a canal that runs from the eardrum to the outside of the head.
  • Middle ear: This consists of three small bones that connect and transmit sound waves from the outside world to the inner ear.
  • Inner ear: This consists of nerves and receptors necessary for hearing and balance.
  • Other structures: The ear is also composed of a tympanic membrane (eardrum) that divides the outer ear from the middle ear, and a Eustachian tube. The Eustachian tube is a structure that links the middle ear to the nose and helps equalize pressure in the middle ear.

See this image for a visual representation of the outer, middle and inner parts of the ear and its different components.

The hollowness of the ear makes it susceptible to foreign materials and the accumulation of fluid. A warm or fluid sensation in the ear is usually the sign of an underlying condition that necessitates follow-up with a healthcare professional.

Common characteristics of warm or fluid sensation in the ear

Characteristics associated with warm or fluid sensation in the ear may include:

  • Drainage: Depending on the severity of fluid accumulation in the ear, drainage may occur. In the initial stages, the drainage may be clear and odorless; however, if an infection occurs, the drainage can become excessive and look like pus.
  • Decreased or muffled hearing: When fluid obstructs the middle ear, sound waves from the outside world cannot be properly transmitted from the outside world to the inner ear. This results in difficult or muffled hearing.

Common accompanying symptoms

A warm or fluid sensation in the ear can be associated with many different conditions and symptoms can vary. Most often, patients are largely asymptomatic in the beginning; however, other symptoms associated with a warm or fluid sensation in the ear develop as the condition progresses and may include:

  • Pain
  • Swelling
  • Fever
  • Congestion or runny nose
  • Pain that radiates from the ear to the face or sinuses

If you notice any of these symptoms, make an appointment with your doctor promptly in order to follow-up on your symptoms, get a diagnosis and receive appropriate care.



Why does your ear feel wet or warm?

Fluid accumulation in the ear is caused by buildup that gets trapped within the tissues and tubes. Fluid can accumulate due to inflammatory causes that result in injury and compensatory swelling or environmental causes that result in buildup.

Infections

The majority of causes of fluid accumulation in the ear stem from inflammation and infection of its different components.

  • Bacterial: Because the ear is open to the outside environment, it is very susceptible to bacterial causes of infection. These organisms are often present on the skin and easily infect the tissues of the ear. This causes entrance of fluids into the tissues that result in inflammation, swelling and other symptoms.
  • Viral: Since the ear is also directly connected to the nose, viral illnesses such as the cold or flu can cause congestion and swelling of the nasal passages, throat, and Eustachian tubes that can also result in inflammation and swelling of the ear.

Blockage

Conditions that result in excess moisture inside the ear canal create an environment ideal for bacterial and fungal growth.

  • Environmental: External factors such as swimming and heavy perspiration put moisture directly into the ear canal. Repeated exposure can result in bacterial growth and future infection that leads to fluid accumulation within the ear. Earwax is a natural component of the ear that works to protect, clean and lubricate the ear; however, it can also accumulate and cause similar symptoms.
  • Structural: Some people have narrow ear canals that make drainage of moisture more difficult. This structural anomaly causes a blockage that traps water and promotes bacterial growth and infection that results in swelling.
  • Devices: Items that you put directly into your ears such as headphones or hearing aids can also cause a blockage that traps excess water.

4 warm or fluid sensation in the ear conditions

This list does not constitute medical advice and may not accurately represent what you have.

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Swimmer's ear (otitis externa)

Swimmer's ear, or otitis externa, is an infection of the canal which runs from the eardrum to the opening of the ear.

It is caused by anything that introduces bacteria, fungus, or a virus into the canal. Water that stays inside the ear after swimming is a common cause, as are cotton swabs used for cleaning or earpieces that create irritation.

Most susceptible are children, because they have narrower ear canals that do not drain well.

Early symptoms include redness, itching, and discomfort inside the ear canal, sometimes with drainage of clear fluid.

Even mild symptoms should be treated because they can quickly get worse. The infection can spread and intensify, becoming very painful with increased drainage, swelling, fever, and loss of hearing.

Diagnosis is made through patient history and physical examination of the ear canal. Lab tests may be done on a sample of the discharge from the ear.

Treatment includes having a medical provider clean the ear canal of debris and discharge, and a prescription for antibiotic and/or steroid eardrops.

Rarity: Common

Top Symptoms: fever, ear canal pain, ear fullness/pressure, jaw pain, ear pain that gets worse when moving

Urgency: Primary care doctor

Temporomandibular joint (TMJ) dysfunction disorder

Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.

The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.

TMJ disorder has three types:

  • Pain or discomfort in the muscles controlling the TMJ.
  • Dislocation or injury to the jawbone.
  • Arthritis of the TMJ.

Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.

Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.

Rarity: Common

Top Symptoms: dizziness, pain, restricted movement, and clicking sounds from jaw, history of headaches, jaw pain, pain in the back of the neck

Symptoms that always occur with temporomandibular joint (tmj) dysfunction disorder: pain, restricted movement, and clicking sounds from jaw

Urgency: Primary care doctor

Possible meniere's disease

Meniere's disease is a disorder of the inner ear that affects balance and hearing.

Meniere's disease is due to an abnormality in the inner ear that results in low levels of fluid, thus interfering with the sense of balance. The abnormality may be hereditary or it could be from allergies, autoimmune disease, or other illness.

Symptoms usually affect only one ear and include severe attacks of vertigo, or the sensation of spinning; tinnitus, or ringing in the ear; pressure inside the ear; and increasing deafness. These symptoms are unpredictable and can come and go without warning.

Meniere's disease is progressive and will not go away on its own. It can lead to a severe loss of hearing and balance, and so a medical provider should be seen at the earliest symptoms.

Diagnosis is made through patient history; physical examination; hearing tests; and balance tests.

There is no cure for Meniere's disease, but it can be treated with motion sickness and anti-nausea medicines, hearing aids, and occasionally surgery.

Middle ear infection

Middle ear infection, also called acute otitis media, is a bacterial or viral infection of the air-filled space behind the eardrum. An ear infection is usually secondary to a cold, allergy, or influenza.

Young children are most susceptible due to weaker immune systems and to the small size and shape of the Eustachian tubes in the ears. Children in group care settings are more exposed to colds and flu and therefore more prone to ear infections.

Symptoms include ear pain due to inflammation; drainage of fluid from the ear; and sometimes hearing difficulty. Children may cry, run a fever, and pull at the affected ear.

If symptoms last more than a day, a medical provider should be seen. Long-lasting or repeated ear infections can lead to hearing damage and to speech and learning problems.

Diagnosis is made through physical examination.

Middle ear infections often clear up on their own and antibiotics may only be needed for infants and severe cases. Warm compresses and over-the-counter pain relievers can be used. Do not give aspirin to children.

Glue ear (otitis media with effusion)

Glue ear is caused by fluid built up in the middle ear (under the eardrum). It happens more frequently in kids than adults because of having frequent colds and less developed tubes in the ear. In adults, it's caused by acute or chronic sinusitis in 66 percent of cases. It may also be caused by cigarette smoke, allergies, reflux, genetics, or bacteria, all of which stimulate the production of the fluid.

90 percent of cases resolve without treatment in 6 months. If you do go to the doctor, he/she would take a look in the ear to confirm the diagnosis. Adults can request vasoconstrictor nose sprays (Neo-Synephrine or Afrin), but that can't be used long term. Flonase can also be prescribed. Follow up with a doctor if things don't get better in 1 week!

Rarity: Common

Top Symptoms: ear fullness/pressure, constant hearing loss, hearing loss in one ear, trouble hearing that is better in noisy environments, ear canal pain

Symptoms that always occur with glue ear (otitis media with effusion): ear fullness/pressure, hearing loss in one ear, constant hearing loss

Symptoms that never occur with glue ear (otitis media with effusion): ear canal pain, fever

Urgency: Wait and watch

Ear plug made of skin cells

Keratosis obturans is a rare disease where materials that make up the skin create a plug in the ear, causing pain, discharge, and hearing changes.

You should go see your primary care doctor in the next few days, where he/she can diagnose this by looking at the ear. Removal is needed for you to go back to normal.

Cholesteatoma (a non-cancerous growth in the ear)

Cholesteatoma is a type of skin growth located in the ear, behind the eardrum. While it can be present from birth, it is usually caused by an ear infection. Symptoms include dizziness, hearing loss and pressure in the affected ear, and discharge from the affected ear.

You should consider visiting a medical professional in the next week or two to discuss your symptoms. Cholesteatoma can be evaluated with a review of your symptoms and an ear exam. Imaging such as a CT scan may be performed to rule out other conditions. Once diagnosed, it can be treated with ear cleaning, antibiotics, and eardrops. Surgery to remove the growth may be needed in some cases.

At-home treatments and when to see a doctor for wet or warm feeling in ear

When to see a doctor

If your symptoms are caused by infection, your doctor will treat the fluid accumulation by stopping the infection and allowing the ear to heal.

  • Drainage/Cleaning: Your doctor will use suction or a small device to drain water and clear away debris, earwax or extra skin. This is necessary to allow for the next step, the antibiotic eardrops, to move freely through all infected areas of the ear. Depending on the extent of blockage or swelling, your doctor may insert cotton or gauze in the ear to promote drainage instead.
  • Eardrops: Your doctor will prescribe eardrops with a combination of ingredients that fight bacteria and fungi as well as reduce inflammation and help restore your ear’s normal pH balance.

At-home treatments

At the onset of symptoms, it is important to seek prompt medical attention and get your doctor’s advice before trying things for yourself at home. Moreover, at-home treatment for most causes of fluid accumulation in the ear involve supportive measures such as rest and hydration.

Ear quiz

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Prevention

In order to prevent fluid accumulation in the ear from occurring, there are many things you can do at home and change in your normal routine.

  • Keep your ears dry: Thoroughly dry your ears after exposure to moisture from swimming or bathing. Practice techniques such as tipping the head to the side to help water drainage from the ear canal and wipe the outer ear slowly and gently with a towel.
  • Do not put foreign objects in your ear: Do not attempt to scratch or dig out earwax with objects such as cotton swabs or paper clips. These items may not only irritate or break the skin in your ear but can also pack the material deeper into your ear canal worsening blockage and moisture buildup.
  • Protect your ears from irritants: Be conscious of the type and quality of jewelry and piercings you use on your ears. Furthermore, protect your ear canal from hair sprays and dyes by using cotton balls or other protective measures.

When it is an emergency

Go to the emergency room if you notice severe symptoms such as the following, these may be signs of a perforated (also known as ruptured) eardrum:

  • Bloody discharge from the ear
  • Total unilateral hearing loss
  • Dizziness
  • Vomiting
  • Extreme pain

FAQs about warm or fluid sensation in the ear

Is a ruptured eardrum an emergency?

Although a ruptured eardrum will usually heal on its own, sometimes the associated symptoms are severe enough to warrant emergency assessment. If you are experiencing severe pain, bloody discharge, nausea or dizziness, in addition to fluid sensation in the ear, go the emergency room.

Will I regain my hearing after my ear infection?

Hearing loss in the setting of an ear infection can be a scary and concerning symptom. Fortunately, the hearing loss is not the result of damage or injury to the ear but rather a temporary obstruction of the middle ear that prevents sound waves from reaching the inner ear/brain. In most situations, once the fluid accumulation resolves, hearing is restored.

How can I tell if my child has an ear infection?

Ear infections occur most often in young children who usually do not have the capacity to properly communicate their symptoms. However, there are many signs you can look for that may indicate your child has an ear infection. These signs include pulling or tugging at the ears, increased irritability (difficulty sleeping, more crying and/or fussiness), fever, drainage from the ear, and problems with balance or clumsiness [5].

Is earwax bad?

Earwax is good in small amounts. It is the ear’s natural protectant and important for preventing bacterial and fungal infection. However, too much earwax can cause blockage and predispose the ear to infections and other problems. It is important to regularly clean the ears with either saline or hydrogen peroxide with cotton balls or a bulb syringe.

Why shouldn’t I use cotton swabs?

You may think that cotton swabs can help clean out the ears; however, they usually end up pushing wax and debris deeper into the ear canal [6]. Cotton swabs are also dangerous because they can irritate the skin and even perforate the eardrum if pushed too far.

Warm or fluid sensation in the ear statistics

People who have experienced warm or fluid sensation in the ear have also experienced:

  • 9% Ear Fullness/Pressure
  • 8% Ear Canal Pain
  • 6% Pain In One Ear Canal

People who have experienced warm or fluid sensation in the ear were most often matched with:

  • 66% Swimmer'S Ear (Otitis Externa)
  • 33% Chronic Glue Ear (Otitis Media With Effusion)

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

References

  1. Tucci DL. Ear discharge. Merck Manual Consumer Version. Reviewed June 2017. Merck Manuals Consumer Version Link
  2. Ear Infection. Centers for Disease Control and Prevention. Updated Dec. 7, 2017. CDC Link
  3. Swimmer’s Ear (Otitis Externa). American Academy of Otolaryngology-Head and Neck Surgery: ENT Health. Reviewed August 2018. ENT Health Link
  4. Ruptured eardrum. U.S. National Library of Medicine: MedlinePlus. Updated Jan. 7, 2019. MedlinePlus Link
  5. Ear infections in children. National Institute on Deafness and Other Communication Disorders (NIDCD). Updated May 12, 2017. NIDCD Link
  6. Otman H. Why You Really Shouldn’t Use a Q-Tip to Clean Your Ears. University of Michigan Health Blog. Published Jan. 10, 2017. U of M Health Blog Link