Introduction
Ear infections are very common but are also very debilitating. They can be divided into outer ear infections (otitis externa, also known as “Swimmer’s ear”), middle ear infections (otitis media) or inner ear infections (which are rare, and are discussed under Vertigo and dizziness). Middle ear infections are very common in children, whereas outer ear infections mainly affect adults.
Causes
Most outer ear infections are caused by water exposure or trauma to the ear canals (e.g. cotton bud use). Middle ear infections generally follow an upper respiratory tract infection (cold or flu). Eustachian tube (the tube connecting the ear to the nose) dysfunction is a common cause of ear infections in children. Bacteria, viruses and fungi can all be causes of ear infections and are all treated differently. Proper assessment is required so that the appropriate treatment can be instituted.
Symptoms
Ear infections are painful and need to be addressed quickly and correctly. Apart from pain which can also refer to the jaw or scalp, patients may experience fever, hearing loss (and sometime speech delay with recurrent infections), discharge, a feeling of fullness in the affected ear, tinnitus (ringing in the ear) or imbalance. Young children may pull at their ears.
Diagnosis
The ear canal and ear drum (tympanic membrane) are examined under a microscope to determine the cause of the infection. Any discharge should be swabbed and sent for culture. A hearing test may be performed if there is a concern about hearing loss. In severe cases, CT scans or Nuclear Medicine tests may be needed to assist with management. If left untreated, some ear infections can lead to serious complications.
Treatment
Treatment targets the cause of the infection, so it is crucial to determine whether it is an outer ear or middle ear infection, and whether it is bacterial, fungal or viral. All require different treatments.
Pain relief is very important for both children and adults. Ear toileting (cleaning) under the microscope is very effective for otitis externa. These infections often need antibiotic ear drops also. Keeping your ears dry is essential as water will exacerbate the infection. Middle ear infections require oral antibiotics. Sometimes, decongesting the nose is helpful in treating or preventing middle ear infections.
Recurrent middle ear infections that require several causes of oral antibiotics may benefit from insertion of Grommets.
Ultimately, most ear infections respond very well to the correct treatment once the proper diagnosis has been made.
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