Ear Infections
What is the Condition about:
Ear infections are a common condition that affects the middle ear, the area behind the eardrum. Ear infections can be caused by bacterial or viral infections and may result in pain, discomfort, and temporary hearing loss.
How I investigate the Condition:
To diagnose an ear infection, I perform a physical examination of the ear and review the individual's medical history. Additional tests, such as a tympanometry test, may be performed to determine the presence of fluid in the middle ear.
What treatment options are available:
The treatment options for ear infections depend on the severity of the condition. In most cases, ear infections can be treated with antibiotics. Pain relief medication may also be recommended to alleviate discomfort. In severe cases, surgical intervention may be necessary.
What is Ear Infection?
Acute otitis media is a viral or bacterial infection of the middle ear. It is more common in children than in adults. Common symptoms are pain, hearing loss and a sensation of ear blockage. Signs to look out for in young children are fever, irritability and tugging at the ear.
Acute otitis media can be extremely painful due to the eardrum bulging from a build-up of fluid behind it. The eardrum may occasionally burst due to the pressure, after which there may be pus or blood-stained discharge leaking from the ear canal. The child will suddenly feel much better after this as the pressure has gone. You may also notice symptoms of a cold such as runny nose or sore throat.
Otitis externa is bacterial or fungal infection of the skin of an otherwise normal ear canal. It causes ear discharge, blockage, itch and sometimes pain.
Acute otis media
Otitis externa
What causes Ear Infection
Children below the age of three are particularly susceptible to acute otitis media due to the size and configuration of the Eustachian tube that connects the middle ear to the back of the nose.
Acute otitis media often occurs after a cold. Viral infection causes swelling of the lining of the nose and Eustachian tube, preventing proper ventilation of the middle ear. At the same time viruses and bacteria can travel up the Eustachian tube to the middle ear, resulting in an infection. Some children who get frequent acute otitis media have glue ear and/or large adenoids.
Otitis externa may occur after swimming, which is why it is sometimes known as Swimmer’s Ear. In early ENT textbooks it was called ‘Singapore Ear’! – testament to the fact that it is common in humid, tropical environments. It can also occur due to cleaning the ear with cotton buds or other instruments as this can scratch the delicate ear canal skin.
Recurring ear infections, especially if they are painless, may also indicate an underlying problem with the eardrum or ear canal, which can lead to more serious consequences if it is not addressed in a timely fashion (see Eardrum perforation/retraction and Cholesteatoma).
How is Ea
How is Ear Infection treated?
Most acute otitis media is due to a virus and will resolve on its own (antibiotics do not work for viruses). Antibiotics may be prescribed to treat possible bacterial infection in very young children and children who are unwell or have prolonged symptoms.
Occasionally acute otitis media can spread to the bone behind the ear, causing pain, swelling and redness behind the ear (mastoiditis). The outer ear may protrude forwards. This requires URGENT assessment by an ENT specialist or your local Emergency Department.
Otitis externa is treated using antibiotic or antifungal drops or creams applied to the ear canal itself. Debris often needs to be cleared from the ear canal with a procedure known as microsuction. The ear should be kept completely dry until the infection has resolved.
Children who suffer from recurrent middle ear infections may need to have grommets (ventilation tubes, small tubes inserted in to the eardrum) and/or the adenoids removed (adenoidectomy).
If an underlying problem with the eardrum or ear canal is diagnosed, such as eardrum perforation or cholesteatoma, surgery is usually recommended (see tympanoplasty and tympanomastoid surgery).
