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Welcome to our health education library. The information shared below is provided to you as an educational and informational source only and is not intended to replace a medical examination or consultation, or medical advice given to you by a physician or medical professional.

Ear Infections

Infections of the ear generally occur in the outer ear (otitis externa) or the middle ear (otitis media). They may be classified as either “acute,” which means the infection lasts for only a short time, or “chronic,” when the infection persists or recurs.

Ear infections can be uncomfortable at the very least for patients. When left unattended, they can cause much pain and may lead to lasting or permanent damage to the hearing.

What causes ear infections?

Ear infections are caused by bacteria, fungi or viruses. These organisms/germs may be introduced into the ear through contact with another infected individual or source, sharing of hearing devices, buildup of mucus or fluid in the ear cavity or from a sore throat, allergy or foreign body in the ear.

When the eustachian tube, which runs from the middle ear to the back of the throat, becomes blocked and fails to drain fluid, bacteria, viruses or fungi can grow and may lead to infection. In acute cases, the infection clears up either by itself or with medical attention. In a chronic condition, the infection does not clear completely or repeatedly occurs and the fluid in the ear may become very thick, causing the eardrum to stick to the bones in the middle ear. This can lead to a condition called “suppurative chronic otitis,” where the eardrum repeatedly ruptures or drains or the middle ear persistently swells. Acute ear infections are more common than chronic infections.

Who is at risk of developing ear infections?

Both children and adults are at risk of developing ear infections; however, children have shorter and narrower eustachian tubes, thus they are more likely than adults to get an ear infection.

What are the symptoms of ear infections?

The most common symptoms of ear infections are earache, a sensation of fullness in the ear, a general feeling of being unwell, ear discharge and, in serious cases, high fever, nausea or vomiting, bleeding and impaired hearing. Young children may be fussy or irritable and may have trouble sleeping.

In chronic cases, the symptoms may be less pronounced and may be ignored by the patient for a period of time.

How are ear infections diagnosed?

Any sign of ear infection should be brought to the attention of a doctor. During evaluation, the doctor will take a complete medical history of the patient, particularly if he/she has had any ear infection in the past. The doctor will ask the patient to describe symptoms and will examine the ears with an otoscope as well as the throat, sinuses, neck, lungs and head.

During the examination of the ear, the doctor will look for signs of swelling or bulging, redness, fluid or discharge, scratches or perforation of the eardrum. The doctor may require a culture test for any discharge to determine the presence and type of bacteria or a skull X-ray or CT scan of the head or middle ear to check for the spread of infection.

In chronic cases, the doctor may require a hearing test to check for hearing damage.

How are ear infections treated?

Treatment of ear infections would depend on the cause, severity, location and duration of the infection. Many cases of acute infection clear up on their own within 72 hours, even without medical intervention. Warm compress, over-the-counter medication such as ibuprofen or acetaminophen or eardrops may be prescribed in case of pain or fever. Where the cause of the infection is bacteria or fungus, the doctor may prescribe antibiotics or antifungal cream or drops. Steroid cream may also be applied to help reduce swelling. A diluted acidic solution made of distilled vinegar and water may also be used to clean an infected ear, especially if the eardrum is perforated.

For children suffering from ear fluid or discharge, the doctor may insert small tubes into the ears to drain the discharge and open up the ear canal. This procedure is called tympanostomy and is done under general anesthesia. The tubes fall out by themselves over time; if they don’t, the doctor will remove them in an outpatient procedure.

Other surgical procedures employed for infected ears include mastoidectomy, where the mastoid bone is cleaned up; the repair or replacement of small bones in the middle ear; and the repair of a perforated eardrum.

Can ear infections be prevented?

Ear infections can be prevented by minimizing exposure to sources of bacteria, viruses and fungi and by generally keeping healthy. One should also avoid putting any foreign objects inside the ear, over-cleaning the ear with cotton swabs and getting water inside the ears when swimming or bathing.

What are the complications of ear infections?

Ear infections, when left untreated, may lead to chronic conditions that cause ruptured or perforated eardrums, infection of the bones around the skull (mastoiditis), infection of the brain (meningitis), cysts in the middle ear (cholesteatoma), hardening of middle ear tissues (tympanosclerosis), partial or full hearing loss, paralysis of the face and impaired balance and speech.

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