Ear Infections

The ear is divided into three regions: the outer, the middle and the inner ear. Each of these regions can be affected by infection. The outer ear is made up of the portion of the ear easily seen and the ear canal. Infections most commonly involve the ear canal and are often related to swimming. Bacteria from unclean water can infect the canal causing pain, swelling and discharge. The ear canal can also become infected from excessive removal of wax, such as with Q-tips. Trauma to the thin tissue inside the ear canal can allow bacteria and fungi normally present in the ear canal to set up an infection. Infections in patients with diabetes can be more serious and immediate medical attention is warranted.

The middle ear is a small air-filled space behind the eardrum. Infections of this space are the most common type of ear infection encountered and are referred to as otitis media. 90% of children will have had at least one episode of otitis media by the age of 3. Otitis media often occurs in adults and children following or during an upper respiratory infection. Swelling around the opening of the Eustachian tube, which connects the middle ear to the nose, leads to the accumulation of fluid in the middle ear. This fluid can become infected from bacteria present in the nose. This is manifest as extreme pain, fever and often hearing loss. Occasionally the ear drum will rupture from the pressure of the infection. This will usually heal without consequence.

Otitis media is usually treated with antibiotics. However, it may take up to 3 months for the fluid to completely resolve behind the ear drum. Occasionally, the fluid will not resolve and in these cases a myringotomy or incision into the eardrum, may be necessary to drain the fluid and restore hearing. Children who have more than 6 ear infections a year or fluid that persists longer than 3 months may benefit from placement of a small tube into the eardrum. This allows for drainage of fluid, a decrease in the number of infections and improvement in your child’s hearing.

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Infections of the inner ear are rare and are usually manifest as vertigo or whirling dizziness. Occasionally hearing loss may accompany the spinning sensation. Extreme nausea and/or vomiting may also be present. The vertigo usually improves slowly over time, but may be rather incapacitating initially. Immediate attention by an Ear, Nose and Throat Specialist is recommended.