You've heard the saying, 'Don't insert anything in your ear smaller than your elbow.' Well, that expression has a lot of merit. Injury to the external ear canal, perforation of the eardrum and hearing loss can result from carelessly poking objects too deeply into the ear canal. This can be intentional or accidental. For example, many people clean their ears with cotton swabs, hairpins and other pointed objects. But doctors warn that this can be very dangerous. Besides, it's not necessary. The ear is self-cleaning, and any discharge should be gently wiped from the visible portion of the outer ear with a clean, dry cloth. Other factors that can lead to injury of the ear or hearing loss include repeated blows to the pinna (PIHN-nuh), the pliable outer ridge of the ear, as may be the case in boxing or other contact sports. A sudden blow, especially a slap, to the ear or a very loud noise may perforate the eardrum. Also, atmospheric pressure changes associated with flying at high altitudes or scuba diving without earplugs can cause minor damage and pain collectively known as barotrauma. Treatment of injuries to the ear varies according the cause and severity.