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 of the
ear canal are usually treated with antibiotic drops and
will often resolve quickly. 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 sequelae. 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.
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. |
