Muffled sound is a sensation that can feel like there’s something in your ears. It’s usually temporary and can have a number of simple causes.

Swallowing, yawning and chewing sugar-free gum can help open the Eustachian tube and clear the ear canal. A doctor should be consulted for more serious cases.

1. Earwax

Earwax does a great job of keeping our ears free from debris but sometimes it goes a bit haywire and can lead to muffled hearing. It can be a symptom of a conductive hearing loss that occurs when sound waves cannot make it from the middle and outer ear to the inner ear. It can occur instantly or over time and can affect one or both ears.

It is important not to try to remove excess earwax yourself using a cotton swab or similar object as this can push the earwax deeper into the ear canal and cause impaction which may lead to further symptoms such as itching, dryness and dizziness. It is always best to visit your hearing healthcare professional and have earwax removed safely with an otoscope.

Another common reason for a feeling of a clogged or muffled ear is that you have water in the ear which is also known as swimmer’s ear. This can happen after taking a shower or swim in the pool and is usually a temporary condition. Simply shaking the head or tilting it can help to release the water and you should be able to hear again fairly quickly.

Other reasons for a muffled sensation in the ears can include having too much noise exposure which can damage hearing on a temporary or permanent basis. It can also be caused by a perforated eardrum, a blockage in the middle ear due to a growth or fluid, or a tumour on the ear nerve (an acoustic neuroma). If you are experiencing these symptoms it is important to see a health care provider for a proper diagnosis as this will require further tests and treatment.

2. Nasal congestion

Muffled hearing can feel like you have cotton wool in your ears or that there is a sound-blocking layer over the top of your ear. The condition can be temporary, lasting a few hours to a few days depending on the cause, or permanent. In most cases, muffled hearing is a symptom of an underlying health issue such as compacted earwax, a sinus infection, a perforated eardrum, swimmer’s ear or a blockage in the middle ear (such as a build-up of fluid or a growth). Muffled hearing generally falls under the category of conductive hearing loss and will need medical treatment.

Muffled noise can also be a sign of a cholesteatoma, which is a cyst-like tumour that forms on the eardrum. This condition is not a serious one but may need to be treated with antibiotics. Muffled hearing can also be a symptom of a tumor that grows on the main nerve from the inner ear to the brain, known as an acoustic neuroma. The condition can also be caused by a head trauma, especially after a blow to the ear or a severe fall.

Another common cause of muffled hearing is a stuffy nose. Muffled hearing from nasal congestion occurs when the tissues and blood vessels inside the nose become swollen with too much fluid. This often happens due to a common cold or a sinus infection. Home remedies for a stuffy nose can be effective, but if the problem persists, then medical attention is needed. If left untreated, a chronically blocked nose can lead to a reduction in overall quality of life. In some instances, long-term nasal congestion can lead to a reduced sense of smell, a feeling of constant drooling or swallowing (known as post-nasal drip) and difficulty breathing through the nose.

3. Airplane ear

The air pressure inside your middle ear can cause muffled hearing. It happens when the air pressure in your middle ear doesn’t match the air pressure around you, which can prevent the eardrum (tympanic membrane) from vibrating normally. This condition, also known as airplane ear or barotrauma, often occurs during takeoff and landing. It can also happen when you’re riding an elevator or driving up a mountain. Airplane ear isn’t dangerous, but it can make it difficult to hear other people.

Muffled sound is often accompanied by pain, tinnitus (ringing, hissing or roaring noises), aural fullness or discomfort and drainage from the ear. It usually lasts a short amount of time and may go away on its own or with medication.

If your muffled sound doesn’t improve within a few days, you should see a doctor for diagnosis and treatment. The underlying causes of muffled hearing could include a blocked ear canal, tinnitus or damage to sensory hair cells in the inner ear.

Clogged ears, especially during an airplane flight or a trip up a mountain, are caused by an imbalance of the air pressure inside the middle ear and the air pressure surrounding you. This causes the ear to feel like it’s filled with cotton balls and doesn’t allow sound waves to pass through. This condition, called airplane ear or barotrauma, isn’t serious and usually resolves on its own once the pressure has stabilized. However, it’s important to follow the maneuvers recommended to alleviate ear pain and pressure.

4. Sinus infection

Muffled hearing can be the result of an infection or other condition that causes blockage in your ear canal. Symptoms will vary depending on the cause, and a medical professional will be able to determine if your case is minor or needs immediate treatment to prevent more serious damage to your eardrum or other components of the inner ear.

The ear canal naturally produces a waxy substance that helps to lubricate the ear canal, but sometimes this can build up and become impacted. This can cause a number of symptoms, including earaches, muffled hearing, and ringing in the ears. A doctor can recommend an at-home earwax removal kit or perform a procedure in the office to remove excess earwax and prevent future clogs.

A sinus infection can also affect your ability to hear, especially if it causes a blockage in the Eustachian tube. If your sinus infection is caused by a virus, symptoms may disappear on their own, but bacterial infections will typically last longer and require antibiotic treatment.

In many cases, your doctor will prescribe a decongestant to clear up the congestion and help you hear again. If you are suffering from a chronic sinus infection, you will likely need to see a specialist who can diagnose the problem and prescribe long-term management solutions.

A muffled sound can feel like there are cotton balls in your ear and is similar to the pressure experienced at high altitudes when flying. It isn’t a total loss of hearing, but it can make it difficult to understand other people and concentrate. Fortunately, most cases of muffled sounds are temporary and can be resolved quickly without needing to seek medical attention.

5. Foreign objects

Muffled sound is the result of an obstruction in the ear canal, such as earwax, an insect or any small object. This type of blockage needs immediate medical attention to prevent injury to the eardrum. It can cause pain, fullness of the ear and hearing loss. It’s more common in young children who often poke things into their ears for fun. It’s important for adults to teach kids to keep objects out of their ears.

If the foreign object is an insect, tilt your head upward and pour alcohol or warm oil into the ear. The insect should float out of the ear. Avoid using cotton swabs or other tools as this could push the object deeper into the ear canal and lead to more damage.

Blocked ears also occur from exposure to loud noises, which can cause noise-induced hearing loss (NIHL). This can be a one-time event or the result of repeated exposure. The best way to prevent this is to limit the amount of time you spend in noisy environments and to use earplugs or headphones.

For the most common foreign bodies found in the external auditory canal (EAC), such as beads, paper or tissue paper and popcorn kernels, non-emergent removal is possible in the ED. However, if there’s a possibility the patient is uncooperative or that the object is dangerous, such as a button battery, seek help immediately. For difficult-to-reach objects such as a bean or pebble, surgical loupes and an otologic endoscope are useful. For other types of objects, a rubber-bulb syringe with water and a Curette or right-angle hook are used. This procedure should be done with a Frazier tip under binocular microscopy.