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Ask Dr. Sears: Ear Pulling a Problem?

Q. I've noticed my son often tugging on his ears. We've had the doctor check them several times, and he definitely doesn't have an infection. What could be the reason for his discomfort?

A. While your son's ear tugging could just be a harmless quirk, it's possible it could be a clue to another underlying medical problem. Ear-tugging as the only symptom is rarely a sign of an infection. Usually a child with an ear infection will have other signs, such as a cold, runny nose, and painful nightwaking. Your doctor has already excluded this possibility, but here are some other possible causes:

Fluid behind the eardrum.

The Eustachian tube, located behind the eardrum, connects the middle ear cavity with the throat. Its function is to equalize pressure between the throat and middle ear. If a child's Eustachian tube is clogged with fluid, either by an infection or an allergy, discomfort is caused by pain from the unequal pressure on each side of the eardrum. When an adult's eustachian tube is clogged, we often yawn, swallow or do a lot of jaw contortions in order to pop the Eustachian tube open and relieve the discomfort. Children, on the other hand, may tug at their ears in an attempt to pop open the Eustachian tube. You can suspect this as a possible cause if your child has other signs of allergies, such as a runny nose, watery eyes and/or cough. Sometimes when a doctor examines the eardrum of a child with allergies, they can look normal. It takes a special test (a tympanogram or examination with a pneumatic otiscope) to detect a clogged Eustachian tube. Spritzing saltwater into your child's nostrils and clearing them out or putting your child into a steamy shower can unclog stuffy nasal passages and a plugged Eustachian tube. One trick I've used on my patients to pop open a clogged Eustachian tube is to have them gently blow up balloons.

Dental pain.

While dental pain referred to the jaw bone and the middle ear is more common in adults than in children, a problem tooth can still often radiate discomfort up into the jaw, which lies just beneath the Eustachian tube. A child may tug at the ears, feeling like the problem is there, when in reality it's his teeth. If the problem persists and is accompanied by any other signs of a sore tooth, have your child's dentist check it out.

A harmless mannerism.

Preschool-age children show a lot of odd mannerisms, or harmless habits: hair twirling, eye blinking, facial twitches and ear tugging. This is the most likely scenario for your son. Keep a journal of what triggers the tugging. Is he tired, upset or worried? Has there been an upsetting event at school, a major family change (such as a move) or problems with friends? By identifying a possible trigger, you can help your child work through it and eliminate the habit.

If you've ruled out any medical cause and can't identify the trigger, try ignoring the ear-pulling for a while. If you focus less on the mannerism, so will your child.