[boomy3555]

Just use the simple universal precautions and clean your IEM's as you would anything you put in or on your body. I'm the first to admit that I don't clean my IEM's as often as I should but so far no "Otitis Externa" A little common sense goes a long way.

 

[GreatDane]

Great first post markotb. Welcome to Head-Fi...you had me at keratinized stratified squamous epithelium.

 

[markotb]

Quote:

Originally Posted by MegatronRx /img/forum/go_quote.gif markotb Thanks for your post. It was very informative. If anything your first post started off on the right foot. In terms of increased ear wax production, you are correct that hormonal changes are responsible for increases and decreases in ear wax production, however, inflammation and changes in the bacterial flora are know to cause changes in ear wax production. An IEM which sits outside the body contains bacteria that is not present in the ear canal. Pushing this bacteria in your ear can alter this flora if it persists for a long enough period. I haven't practiced for a while but I recall a few patients who developed otitis externa (outer ear infection) as a result of using ear-plugs. Also, if you read any med textbook(not everything is discussed on PubMed) on otitis externa, insertion of objects into the ear such as earplugs has been known to cause infection and lead to increase in wax production.

Haha medical textbooks and I have had a special love affair for some time now, which ironically is how I got into head-fi in the first place, because a lot of times I need music in the background when I read...
Your point is well taken. In fact if you look at studies of ear infections (btw, everything may not be on PubMed, but EVERYTHING that's published in a textbook has previously been published as a primary source in a journal somewhere), you will see that people with hearing aids have a higher incidence of ear infections. However, you have to be careful how you interpret those results. People that wear hearing aids are usually older, and older people have a higher incidence of comorbid conditions that predispose them to ear infections. So, is it that hearing aids really increase the risk for ear infection, or is it that you picked to study a population that will get more infections anyways? If anything, I would say that there is a SLIGHT increase in the risk of ear infection (or otitis externa) if you wear IEMs, hearing aids or other things that go in your ear canal. But that risk is negligibly small, and it basically stems from the fact that people may scratch their ear canal after wearing IEMs or hearing aids, which then creates brakes in the earwax and skin lining which then allows bacteria to break into the skin, etc. etc. By comparison, excessive cleaning of the ears or swimming poses a much greater and better documented risk for otitis externa (which, incidentally is why there is a higher incidence of ear infections during the summer months), but it's not like people debate whether it's worth getting in the pool because there is the oddball chance that they will get an ear infection...

Quote:

Originally Posted by GreatDane /img/forum/go_quote.gif Great first post markotb. Welcome to Head-Fi...you had me at keratinized stratified squamous epithelium.

Thank you. There's nothing quite like throwing big words around to make yourself sound like you know what you are talking about...

 

[music_4321]

Excellent post! -- nice debut on Head-fi

Quote:

Originally Posted by markotb /img/forum/go_quote.gif I don't wanna start off my first post on these forums on the wrong foot, but what you have said is not exactly correct. Let me first say that I did a search on PubMed and Google Scholar, and there doesn't seem to be anyone that has directly studied the issue of IEM use or foreign object placement and earwax production so there's no way to explicitly make a claim one way or the other. However, we can make some pretty reasonable conclusions based on other studies of ear wax production. 1) Your argument that putting an IEM in your ear constitutes a foreign object that triggers the innate immune system that then triggers an increased production of ear wax is flawed in 2 ways. First, an object in your ear is not recognized by your innate immune system as a foreign object. In order for your immune system (innate or adaptive) to recognize an object as foreign, that object must first penetrate the skin barrier before receptors on immune cells can bind to it and trigger an immune response. In the case of the ear, that would mean that the IEM would have to somehow scratch and damage the keratinized stratified squamous epithelium that lines the ear (you would basically have to have a break in the skin that lines the ear). While I am sure that this has happened to someone while using IEMs, this would be an exception rather than the rule. Second, even if hypothetically the IEM was somehow recognized by the innate immune system as foreign, there is no evidence that I have seen that shows that the immune system would increase the production of ear wax (see more on this under point 2). 2) OK, without getting into too much unnecessary detail, I am gonna try to explain the factors that control the amount of earwax production. Ear wax is produced by glands that are imbedded in the skin lining the outer ear that are called sebaceous gland. Most of the control on these glands is hormonal. Androgens (testosterone, DHT, etc.), thyroid hormones, insulin and the pituitary itself have been shown to promote sebaceous gland activity, while estrogens inhibit it. There's some debate about what exactly progestins do, but that's not important. The important point is that your earwax production is MOSTLY controlled by your hormones which are affected by a bazillion things including genes, stress, exhaustion, nutritional status, health, etc. etc. which explains why some people produce more earwax than others. Now to the important part as far as IEM use is concerned. In addition to hormonal control of sebaceous gland activity, there are also "non-endocrine" factors, most important of which for our discussion is temperature. It has been shown that sebum (in this case earwax) excretion rate increases about 10% per 1º C increase (1, 2). So, if we assume that the temperature inside the outer ear canal increases when you use IEMs (pretty reasonable) then there's probably an increase in earwax secretion due to this temperature effect. How much exactly the temperature increases is up to anybody's guess at this point, because I am fairly certain no one has studied that. So, what the hell does all this gibberish mean for IEM users?!? It means that you should keep using your IEMs as much as you please and you will be just fine. If your ears get clogged with earwax, chances are that they were gonna get clogged anyways because of your hormones and had very little if anything to do with how much you used your IEMs. And for those that do get clogged ears, no worries, because it is about as benign as medical conditions go (although it can be a big pain in the ass). 1) BURTON, J. L. The physical properties of sebum in acne vulgaris. Clin. Sci. Lond., 39: 757, 1970. 2) CUNLIFFE, W. J., J. L. BURTON, AND S. SHUSTER. The effect of local temperature variations on sebum excretion rate. Br. J. Dermatol. 83: 650-654,197O. Well, I can't exactly give you a proof with references because all my physics textbooks are at my parents' house and finding the primary sources would be a pain in the ass, BUT I can come close. What you hear is influenced by two things: the frequency of the sound wave and the amplitude of the the sound wave. The frequency controls the pitch, while the amplitude controls the loudness that you perceive. As sound travels through air the magnitude of the amplitude decreases because energy is lost while moving the air molecules back and forth to create the sound wave. This makes sense, because as you said, it's a hell of a lot more pleasant to be farther away from a firing gun than right next to it. So, according to this reasoning it makes sense that the closer you are to the source the worse off you are. However, you fail to take into account the initial amplitude (loudness) of the sound source. IEMs have a very low initial amplitude, because they are very close to the tympanic membrane. Regular speakers have a much higher amplitude because they are placed farther away from the ears. Using abstract numbers, let's just say that you need a sound wave amplitude of 5 to perceive an enjoyable volume level. Your IEMs are gonna have an initial sound wave amplitude of 25 that's gonna deteriorate to 5 by the time the sound wave reaches your tympanic membrane, while a regular speaker cabinet will have an initial sound wave amplitude of 2500 that will also deteriorate to 5 by the time it reaches your ear because the sound has to travel a lot farther. Basically, what this means is that loud is loud and soft is soft regardless of whether you use an IEM or a speaker. I hope that's enough of a proof for you. SO, on that note, happy IEM listening , and hopefully I'll stop lurking and start participating a little more in these forum discussions.