What are the common symptoms of middle ear infections. How are middle ear infections diagnosed and treated. Can middle ear infections be prevented. What complications may arise from untreated middle ear infections.

Understanding Middle Ear Infections (Otitis Media)

Middle ear infections, medically known as otitis media, are a common ailment affecting both children and adults. These infections occur in the space behind the eardrum, causing inflammation and fluid buildup. While anyone can develop a middle ear infection, infants between six and 15 months old are most susceptible. Statistics show that approximately one in four children experience at least one middle ear infection by the age of 10.

What causes middle ear infections?

Middle ear infections typically develop as a result of other respiratory infections, such as the common cold. These conditions can lead to:

• Mucus buildup in the middle ear
• Swelling or blockage of the Eustachian tube (a thin tube connecting the middle ear to the back of the nose)
• Impaired drainage of fluids from the middle ear

Additionally, enlarged adenoids (soft tissue at the back of the throat) can obstruct the Eustachian tube, increasing the risk of infection. Children are particularly vulnerable to middle ear infections due to their smaller Eustachian tubes and relatively larger adenoids compared to adults.

Recognizing the Symptoms of Middle Ear Infections

Identifying the symptoms of a middle ear infection is crucial for prompt treatment. In most cases, acute otitis media symptoms develop rapidly and resolve within a few days. The primary symptoms include:

• Earache
• High temperature (fever)
• Nausea or vomiting
• Fatigue or lack of energy
• Mild hearing loss due to fluid accumulation in the middle ear

In some instances, a perforated eardrum may occur, resulting in pus discharge from the ear. This rupture often leads to a reduction in earache as the pressure on the eardrum is relieved.

How do middle ear infections present in young children?

Detecting middle ear infections in infants and young children can be challenging as they cannot effectively communicate their discomfort. Parents and caregivers should be vigilant for the following signs:

• Elevated body temperature
• Pulling, tugging, or rubbing of the ear
• Irritability, poor feeding, or restlessness at night
• Coughing or a runny nose
• Unresponsiveness to quiet sounds or signs of hearing difficulty
• Loss of balance

Diagnosing Middle Ear Infections

While most cases of otitis media resolve on their own within a few days, certain situations warrant medical attention. Consult a healthcare provider if you or your child experience:

• Symptoms persisting or worsening after two to three days
• Severe pain
• Discharge of pus or fluid from the ear
• Chronic suppurative otitis media (persistent, painless ear discharge lasting for months)
• Underlying health conditions that may increase the risk of complications (e.g., cystic fibrosis or congenital heart disease)

During a medical consultation, the healthcare provider will examine the ear using an otoscope to assess the eardrum’s appearance and any signs of infection or fluid buildup.

Treatment Approaches for Middle Ear Infections

Most middle ear infections clear up within three to five days without specific treatment. However, managing symptoms and providing relief is essential. Here are some treatment approaches:

How can pain and fever be managed during a middle ear infection?

Over-the-counter pain relievers such as paracetamol or ibuprofen can help alleviate pain and reduce fever. It’s crucial to ensure that any medication given to children is age-appropriate and administered in the correct dosage.

Are antibiotics necessary for treating middle ear infections?

Antibiotics are not routinely prescribed for middle ear infections. However, they may be recommended in cases where:

• Symptoms persist or worsen after a few days
• The infection is particularly severe
• The patient has certain risk factors or underlying health conditions

Your healthcare provider will determine whether antibiotics are necessary based on the individual case and severity of the infection.

Preventing Middle Ear Infections

While it’s not always possible to prevent middle ear infections, certain measures can help reduce the risk:

• Practicing good hygiene, such as frequent handwashing, to minimize the spread of respiratory infections
• Avoiding exposure to secondhand smoke
• Breastfeeding infants, as breast milk contains antibodies that can help protect against infections
• Keeping children’s vaccinations up to date, particularly those that protect against respiratory infections

Can lifestyle changes help prevent recurrent middle ear infections?

For individuals prone to recurrent middle ear infections, the following lifestyle modifications may be beneficial:

• Avoiding known allergens that may contribute to nasal congestion
• Using a humidifier to maintain optimal indoor humidity levels
• Practicing proper bottle-feeding techniques for infants to prevent fluid from entering the Eustachian tubes
• Managing chronic nasal or sinus conditions under medical supervision

Complications of Untreated Middle Ear Infections

While most middle ear infections resolve without complications, untreated or severe cases can lead to various issues:

What are the potential complications of chronic or untreated middle ear infections?

Possible complications include:

• Chronic suppurative otitis media (long-term ear discharge)
• Mastoiditis (infection of the mastoid bone behind the ear)
• Cholesteatoma (abnormal skin growth in the middle ear)
• Tympanic membrane perforation (hole in the eardrum)
• Hearing loss (temporary or permanent)
• Rare but serious complications such as meningitis or brain abscess

Prompt medical attention and appropriate treatment can significantly reduce the risk of these complications.

Special Considerations for Middle Ear Infections

Certain groups of individuals may be at higher risk for developing middle ear infections or experiencing complications:

How do underlying health conditions affect middle ear infections?

Individuals with the following conditions may be more susceptible to middle ear infections or require special considerations in their management:

• Cleft palate
• Down’s syndrome
• Immune system disorders
• Chronic respiratory conditions

These individuals may require more frequent monitoring and tailored treatment approaches to manage middle ear infections effectively.

Advances in Middle Ear Infection Research and Treatment

Ongoing research in the field of otolaryngology continues to improve our understanding and management of middle ear infections. Some recent developments include:

What new approaches are being explored for middle ear infection treatment?

Emerging areas of research and treatment include:

• Development of new antimicrobial agents specifically targeting common ear pathogens
• Exploration of probiotics to promote a healthy balance of bacteria in the upper respiratory tract
• Advancements in vaccine development to prevent infections that commonly lead to otitis media
• Improved diagnostic tools for more accurate and rapid detection of middle ear infections
• Investigation of novel drug delivery methods for targeted treatment of middle ear infections

These advancements hold promise for more effective prevention and treatment strategies in the future, potentially reducing the incidence and impact of middle ear infections on individuals and healthcare systems.

Living with Recurrent Middle Ear Infections

For individuals who experience frequent middle ear infections, managing the condition can be challenging. Here are some strategies to cope with recurrent infections:

How can one manage the impact of recurrent middle ear infections on daily life?

Consider the following approaches:

• Maintaining open communication with healthcare providers to develop a comprehensive management plan
• Keeping a symptom diary to identify potential triggers or patterns
• Exploring preventive measures, such as regular ear cleaning under medical supervision
• Discussing the potential benefits of surgical interventions, such as ear tube insertion, for chronic cases
• Addressing any hearing concerns promptly to minimize the impact on communication and quality of life
• Seeking support from patient groups or counseling services to manage the emotional aspects of chronic ear issues

By adopting a proactive approach and working closely with healthcare professionals, individuals with recurrent middle ear infections can effectively manage their condition and minimize its impact on their daily lives.

The Role of Nutrition in Middle Ear Health

While nutrition alone cannot prevent middle ear infections, a balanced diet can support overall immune function and potentially reduce the risk of infections. Consider the following nutritional aspects:

Can dietary choices influence the likelihood of developing middle ear infections?

While more research is needed, some nutritional factors that may play a role in ear health include:

• Adequate vitamin D intake, which has been associated with a reduced risk of respiratory infections
• Zinc supplementation, which may help boost immune function
• Omega-3 fatty acids, found in fish oil, which have anti-inflammatory properties
• Probiotics, which may help maintain a healthy balance of bacteria in the upper respiratory tract
• Limiting sugar intake, as excessive sugar consumption may suppress immune function

It’s important to note that while these nutritional factors may offer some benefits, they should not replace medical treatment for middle ear infections. Always consult with a healthcare provider before making significant dietary changes or starting any supplement regimen.

The Impact of Environmental Factors on Middle Ear Infections

Environmental conditions can play a significant role in the development and progression of middle ear infections. Understanding these factors can help individuals take proactive measures to reduce their risk.

How do environmental factors contribute to the incidence of middle ear infections?

Several environmental elements can influence the likelihood of developing middle ear infections:

• Air pollution: Exposure to high levels of air pollutants may increase the risk of respiratory infections, which can lead to middle ear infections
• Secondhand smoke: Children exposed to secondhand smoke have a higher incidence of middle ear infections
• Seasonal changes: Some individuals may experience more frequent ear infections during certain seasons, particularly in cold weather
• Altitude changes: Rapid changes in altitude, such as during air travel, can affect ear pressure and potentially increase the risk of infection
• Swimming and water exposure: Frequent swimming or prolonged exposure to water can increase the risk of outer ear infections, which may sometimes progress to middle ear infections

By being aware of these environmental factors, individuals can take appropriate precautions to minimize their exposure and reduce the risk of developing middle ear infections.

The Future of Middle Ear Infection Management

As medical research continues to advance, the future of middle ear infection management looks promising. Several areas of study are paving the way for improved prevention, diagnosis, and treatment of otitis media.

What emerging technologies and approaches may revolutionize middle ear infection care?

Some exciting developments on the horizon include:

• Gene therapy: Researchers are exploring the potential of gene therapy to enhance the body’s natural defense mechanisms against ear infections
• Nanotechnology: Nanoparticles may offer new ways to deliver medications directly to the middle ear, improving treatment efficacy
• Artificial intelligence: AI-powered diagnostic tools could help healthcare providers more accurately diagnose and monitor middle ear infections
• Personalized medicine: Tailoring treatments based on an individual’s genetic profile and specific pathogens involved in the infection
• Novel antimicrobial agents: Development of new antibiotics and antiviral medications specifically targeting common ear pathogens
• Immunomodulatory therapies: Exploring ways to enhance the immune response to prevent recurrent infections

While many of these approaches are still in the research phase, they offer hope for more effective and targeted treatments for middle ear infections in the future. As our understanding of the condition continues to grow, we can expect to see significant improvements in the management and prevention of otitis media, ultimately leading to better outcomes for patients of all ages.

Middle ear infection (otitis media)

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About middle ear infections

Otitis media is an infection of the middle ear that causes inflammation (redness and swelling) and a build-up of fluid behind the eardrum.

Anyone can develop a middle ear infection but infants between six and 15 months old are most commonly affected.

It’s estimated that around one in every four children experience at least one middle ear infection by the time they’re 10 years old.

Symptoms of a middle ear infection

In most cases, the symptoms of a middle ear infection (otitis media) develop quickly and resolve in a few days. This is known as acute otitis media. The main symptoms include:

• earache
• a high temperature (fever)
• being sick
• a lack of energy
• slight hearing loss – if the middle ear becomes filled with fluid

In some cases, a hole may develop in the eardrum (perforated eardrum) and pus may run out of the ear. The earache, which is caused by the build-up of fluid stretching the eardrum, then resolves.

Signs in young children

As babies are unable to communicate the source of their discomfort, it can be difficult to tell what’s wrong with them. Signs that a young child might have an ear infection include:

• raised temperature
• pulling, tugging or rubbing their ear
• irritability, poor feeding or restlessness at night
• coughing or a runny nose
• unresponsiveness to quiet sounds or other signs of difficulty hearing, such as inattentiveness
• loss of balance

When to seek medical advice

Most cases of otitis media pass within a few days, so there’s usually no need to see your GP.

However, see your GP if you or your child have:

• symptoms showing no sign of improvement after two or three days
• a lot of pain
• a discharge of pus or fluid from the ear – some people develop a persistent and painless ear discharge that lasts for many months, known as chronic suppurative otitis media
• an underlying health condition, such as cystic fibrosis or congenital heart disease, which could make complications more likely

Read more about diagnosing middle ear infections

How middle ear infections are treated

Most ear infections clear up within three to five days and don’t need any specific treatment. If necessary, paracetamol or ibuprofen should be used to relieve pain and a high temperature.

Make sure any painkillers you give to your child are appropriate for their age. Read more about giving your child painkillers.

Antibiotics aren’t routinely used to treat middle ear infections, although they may occasionally be prescribed if symptoms persist or are particularly severe.

Read more about treating middle ear infections

What causes middle ear infections?

Most middle ear infections occur when an infection such as a cold, leads to a build-up of mucus in the middle ear and causes the Eustachian tube (a thin tube that runs from the middle ear to the back of the nose) to become swollen or blocked.

This mean mucus can’t drain away properly, making it easier for an infection to spread into the middle ear.

An enlarged adenoid (soft tissue at the back of the throat) can also block the Eustachian tube. The adenoid can be removed if it causes persistent or frequent ear infections. Read more about removing adenoids.

Younger children are particularly vulnerable to middle ear infections as:

• the Eustachian tube is smaller in children than in adults
• a child’s adenoids are relatively much larger than an adults

Certain conditions can also increase the risk of middle ear infections, including:

• having a cleft palate – a type of birth defect where a child has a split in the roof of their mouth
• having Down’s syndrome – a genetic condition that typically causes some level of learning disability and a characteristic range of physical features

Can middle ear infections be prevented?

It’s not possible to prevent middle ear infections, but there are some things you can do that may reduce your child’s risk of developing the condition. These include:

• make sure your child is up-to-date with their routine vaccinations – particularly the pneumococcal vaccine and the DTaP/IPV/Hib/HepB (6-in-1) vaccine
• avoid exposing your child to smoky environments (passive smoking)
• don’t give your child a dummy once they’re older than six to 12 months old
• don’t feed your child while they’re lying flat on their back
• if possible, feed your baby with breast milk rather than formula milk

Avoiding contact with other children who are unwell may also help reduce your child’s chances of catching an infection that could lead to a middle ear infection.

Further problems

Complications of middle ear infections are fairly rare, but can be serious if they do occur.

Most complications are the result of the infection spreading to another part of the ear or head, including:

• the bones behind the ear (mastoiditis)
• the inner ear (labyrinthitis)
• the protective membranes surrounding the brain and spinal cord (meningitis)

Rarely, infections can leave a perforation or hole in the eardrum.

If complications do develop, they often need to be treated immediately with antibiotics in hospital.

Read more about the complications of middle ear infections

Diagnosing middle ear infections

A middle ear infection (otitis media) can usually be diagnosed using an instrument called an otoscope.

An otoscope is a small handheld device with a magnifying glass and a light source at the end. Using an otoscope, a doctor can examine the ear to look for signs of fluid in the middle ear, which may indicate an infection.

Signs of fluid in the middle ear can include the ear drum:

• bulging
• being an unusual colour (usually red or yellow)
• having a cloudy appearance

In some cases, a hole may have developed in the eardrum (perforated ear drum) and there may be fluid in the ear canal (the tube between the outer ear and eardrum).

Some otoscopes can also be used to blow a small puff of air into the ear to check for any blockages in the middle ear, which could be a sign of an infection. If the Eustachian tube (the tube that connects the throat and middle ear) is clear, the eardrum will move slightly. If it’s blocked, the eardrum will remain still.

Further tests

Further tests are normally only required if treatment isn’t working or complications develop. These tests will usually be carried out at your local ear, nose and throat (ENT) department.

Some of the tests that may be carried out are described below.

Tympanometry

Tympanometry is a test that measures how the ear drum reacts to changes in air pressure.

During a tympanometry test, a probe is placed into your child’s ear. The probe changes the air pressure at regular intervals while transmitting a sound into the ear. A measuring device is attached to the probe to record how the drum moves and how changes in air pressure affect this movement.

A healthy ear drum should move easily if there’s a change in air pressure. If your child’s ear drum moves slowly or not at all, it usually suggests there’s fluid behind it.

Audiometry

Audiometry is a hearing test that uses a machine called an audiometer to produce sounds of different volume and frequency. This can help determine if your child has any hearing loss as a result of their condition.

During the test, your child listens through headphones and is asked if they can hear the sounds.

Scans

On the very rare occasions where there’s a possibility the infection has spread out of the middle ear and into the surrounding area, a scan of the ear may be carried out. This may be either a:

• computerised tomography (CT) scan
• magnetic resonance imaging (MRI) scan

A CT scan takes a series of X-rays and uses a computer to assemble the scans into a more detailed image, whereas an MRI scan uses strong magnetic fields and radio waves to produce images of the inside of the body.

Treating middle ear infections

Most middle ear infections (otitis media) clear up within three to five days and don’t need any specific treatment.

You can relieve any pain and a high temperature using over the counter painkillers such as paracetamol and ibuprofen.

Make sure any painkillers you give to your child are appropriate for their age.

Placing a warm flannel or washcloth over the affected ear may also help relieve pain until the condition passes.

Antibiotics

Antibiotics aren’t routinely used to treat middle ear infections as there’s no evidence that they speed up the healing process. Many cases are caused by viruses, which antibiotics aren’t effective against.

Using antibiotics to treat minor bacterial infections also increases the likelihood of bacteria becoming resistant to them over time. This means more serious infections could become untreatable in the future. Read about antibiotic resistance for more information.

If antibiotics are needed, a five-day course of an antibiotic called amoxicillin is usually prescribed. This is often given as a liquid. Common side effects of amoxicillin include: 

• a rash
• feeling sick
• diarrhoea

An alternative antibiotic such as erythromycin or clarithromycin may be used for people allergic to amoxicillin.

In some cases, your GP may give you a prescription that you can choose to pick up a few days later if the condition hasn’t improved by then.

Adults and children who develop a long-term middle ear infection (chronic suppurative otitis media) may benefit from short courses of antibiotic ear drops.

Children

Antibiotics are usually only considered if your child:

• has a serious health condition that makes them more vulnerable to complications, such as cystic fibrosis or congenital heart disease
• is less than three months old
• is less than two years old with an infection in both ears
• has discharge coming from their ear

Adults 

Adults may be prescribed antibiotics if:

• they have a serious health condition that makes them more vulnerable to complications, such as cystic fibrosis or congenital heart disease
• symptoms are showing no signs of improvement after four days

Grommets

For children with recurrent severe middle ear infections, tiny tubes may be inserted into the eardrum to help drain fluid. These tubes are called grommets.

Grommets are inserted under general anaesthetic, which means your child will be asleep and won’t feel any pain. The procedure usually only takes about 15 minutes and your child should be able to go home the same day.

A grommet helps keep the eardrum open for several months. As the eardrum starts to heal, the grommet will slowly be pushed out of the eardrum and eventually falls out. This process happens naturally and shouldn’t be painful. Most grommets fall out within six to 12 months of being inserted.

Some children need another procedure to replace the grommets if they’re still experiencing problems.

Treatment with grommets isn’t routinely funded in all areas or for adults with recurrent otitis media.

Complications of middle ear infections

Serious complications of middle ear infections (otitis media) are very rare but very young children are still at risk because their immune systems are still developing.

Some of the main complications associated with middle ear infections are detailed below.

Mastoiditis

Mastoiditis can develop if an infection spreads out of the middle ear and into the area of bone underneath the ear (the mastoids).

Symptoms of mastoiditis can include:

• a high temperature (fever)
• swelling behind the ear, which pushes it forward 
• redness and tenderness or pain behind the ear
• a creamy discharge from the ear 
• headache
• hearing loss

Mastoiditis is usually treated in hospital with antibiotics given through a drip directly into a vein (intravenously). In some cases, surgery may be required to drain the ear and remove the infected mastoid bone.

Cholesteatoma

A cholesteatoma is an abnormal collection of skin cells inside the ear that can sometimes develop as a result of recurring or persistent middle ear infections.

If it’s not treated, a cholesteatoma can eventually damage the delicate structures deep inside your ear, such as the tiny bones that are essential for hearing.

Symptoms of a cholesteatoma can include:

• hearing loss
• weakness in half your face
• dizziness
• tinnitus – hearing sounds from inside their body rather than from an outside source

In most cases, surgery is required to remove a cholesteatoma.

Labyrinthitis

In some cases, an infection in the middle ear can spread into the inner ear and affect the delicate structure deep inside the ear called the labyrinth. This is known as labyrinthitis.

Symptoms of labyrinthitis can include:

• dizziness
• vertigo (the feeling that you, or the environment around you, is moving or spinning)
• loss of balance
• hearing loss

The symptoms of labyrinthitis usually pass within a few weeks, although medication to relieve the symptoms and treat the underlying infection may sometimes be prescribed. Read more about treating labyrinthitis.

Problems with speech and language development

If your child has frequent ear infections that affect their hearing while they’re very young, there’s a risk their speech and language development may be affected.

Contact your GP for advice if you’re concerned about your child’s development at any point.

Facial paralysis

In very rare cases, the swelling associated with otitis media can cause the facial nerve to become compressed. The facial nerve is a section of nerve that runs through the skull and is used by the brain to control facial expressions.

Compression of the nerve can lead to a person being unable to move some or all of their face. This is known as facial paralysis.

This can be frightening when it first occurs, as many parents are concerned their child may have experienced a stroke. However, the condition usually resolves once the underlying infection has passed and rarely causes any long-term problems.

Meningitis

A very rare and serious complication of a middle ear infection is meningitis. This can occur if the infection spreads to the protective outer layer of the brain and spinal cord (the meninges).

Symptoms of meningitis can include:

• severe headache
• being sick
• a high temperature (fever)
• stiff neck
• sensitivity to light
• rapid breathing
• a blotchy red rash that does not fade or change colour when you place a glass against it (although this is not always present)

If you think your child may have meningitis, call 999 and ask for an ambulance.

Meningitis caused by a bacterial infection is usually treated in hospital with antibiotics given through a drip directly into a vein (intravenously). Read more about treating meningitis.

Brain abscess

Another very rare and serious complication of a middle ear infection is a brain abscess. This is a pus-filled swelling that develops inside the brain.

Symptoms of a brain abscess can include:

• a severe headache
• changes in mental state, such as confusion
• weakness or paralysis on one side of the body
• a high temperature (fever)
• seizures (fits) 

If you suspect that you or someone you know may have a brain abscess, call 999 for an ambulance.

A brain abscess is usually treated using a combination of antibiotics and surgery. The surgeon will usually open the skull and drain the pus from the abscess or remove the abscess entirely.

Ear infections – NHS

Ear infections are very common, particularly in children. You do not always need to see a GP for an ear infection as they often get better on their own within 3 days.

Check if it’s an ear infection

The symptoms of an ear infection usually start quickly and include:

• pain inside the ear
• a high temperature
• being sick
• a lack of energy
• difficulty hearing
• discharge running out of the ear
• a feeling of pressure or fullness inside the ear
• itching and irritation in and around the ear
• scaly skin in and around the ear

Young children and babies with an ear infection may also:

• rub or pull their ear
• not react to some sounds
• be irritable or restless
• be off their food
• keep losing their balance

Most ear infections clear up within 3 days, although sometimes symptoms can last up to a week.

If you, or your child, have a high temperature or you do not feel well enough to do your normal activities, try to stay at home and avoid contact with other people until you feel better.

Differences between inner, middle and outer ear infections

How to treat an ear infection yourself

To help relieve any pain and discomfort from an ear infection:

Do

• use painkillers such as paracetamol or ibuprofen (children under 16 should not take aspirin)

• place a warm or cold flannel on the ear

• remove any discharge by wiping the ear with cotton wool

Don’t

• do not put anything inside your ear to remove earwax, such as cotton buds or your finger

• do not let water or shampoo get in your ear

• do not use decongestants or antihistamines – there’s no evidence they help with ear infections

A pharmacist can help with an ear infection

Speak to a pharmacist if you think you have an outer ear infection.

They can recommend acidic eardrops to help stop bacteria or fungus spreading.

Non-urgent advice: See a GP if you or your child have:

• earache that does not start to get better after 3 days
• regular ear infections

Urgent advice: Get advice from 111 now if you have:

• become generally unwell
• a very high temperature or feel hot and shivery
• swelling around the ear
• fluid coming from the ear
• hearing loss or a change in hearing
• other symptoms, like being sick, a severe sore throat or dizziness
• a child under 2 with earache in both ears
• a long-term medical condition (such as diabetes or a heart, lung, kidney or neurological disease) and symptoms of an ear infection
• a weakened immune system (for example, because of chemotherapy) and symptoms of an ear infection

What happens at your appointment

The GP will often use a small light (an otoscope) to look in the ear.

Some otoscopes blow a small puff of air into the ear. This checks for blockages, which could be a sign of an infection.

Treatment from a GP

The GP may prescribe medicine for your ear infection, depending on what’s caused it.

Infections inside the ear

Antibiotics are not usually offered because infections inside the ear often clear up on their own and antibiotics make little difference to symptoms, including pain.

Antibiotics might be prescribed if:

• an ear infection does not start to get better after 3 days
• you or your child has any fluid coming out of the ear
• there are other factors that increase your or your child’s risk of complications, such as having a weakened immune system

They may also be prescribed if your child is less than 2 years old and has an infection in both ears.

If antibiotics are not prescribed, eardrops containing a painkiller and an anaesthetic might be prescribed.

Outer ear infections

The GP might prescribe:

• antibiotic eardrops – to treat a bacterial infection
• steroid eardrops – to bring down swelling
• antifungal eardrops – to treat a fungal infection
• antibiotic tablets – if your bacterial infection is severe

If you have a spot or boil in your ear, the GP may pierce it with a needle to drain the pus.

Eardrops may not work if they’re not used correctly.

How to use eardrops

1. Remove any visible discharge or earwax using cotton wool.
2. Hold the bottle in your hand to warm it. Cold eardrops can make you feel dizzy.
3. Lie on your side with the affected ear facing up to put the drops in.
4. Gently pull and push your ear to work the drops in.
5. Stay lying down for 5 minutes so the drops do not come out.

Preventing ear infections

You cannot always prevent ear infections, particularly inner ear infections caused by colds and flu.

To help avoid inner ear infections:

• make sure your child is up to date with vaccinations
• keep your child away from smoky environments
• try not to give your child a dummy after they’re 6 months old

To help avoid outer ear infections:

• do not stick cotton wool buds or your fingers in your ears
• use earplugs or a swimming hat over your ears when you swim
• try to avoid water or shampoo getting into your ears when you have a shower or bath
• treat conditions that affect your ears, such as eczema or an allergy to hearing aids

Page last reviewed: 16 June 2021
Next review due: 16 June 2024

Types and symptoms of ear diseases, what hearing diseases are

Contents:

• How ear diseases are diagnosed
• Treatment of diseases of the ear

Types and symptoms of ear diseases

Almost all ear diseases, inflammatory, non-inflammatory, fungal, caused by trauma, have a similar clinical picture.

Eustachitis

This is an inflammatory disease of the auditory canal (it is called the Eustachian tube), which has an infectious nature. Due to inflammation, air exchange in the ear cavity is disturbed, which leads to otitis media.

The disease manifests itself as:

• pain and discomfort;
• sensation of the presence of fluid in the auditory canal;
• hearing loss;

90,007 indistinct noises and crackles in the inflamed ear.

If the process continues to develop and passes into the purulent stage, the temperature rises. All symptoms are worse when the person is in motion.

Mastoiditis

It is also an inflammatory disease and has an infectious nature. Inflammation of the inner ear often develops as a complication of the pathological process in the ear canal.

Symptoms are more intense:

• temperature rises sharply and reaches 39.0 – 39.5 degrees;
• general health worsens: weakness occurs, signs of intoxication increase;
• there is a throbbing pain, accompanied by hearing loss;
• appears purulent discharge;
• The outer part of the ear is swollen.

One of the obvious and early signs of mastoiditis is dizziness that appears without warning, suddenly.

Meniere’s disease

Disease, the main manifestation of which is increased pressure in the ear labyrinth. Because of it, the normal functioning of blood vessels is disrupted, so fluid gradually accumulates in the labyrinth. Why there is increased pressure in this area has not yet been fully elucidated. The disease can be stopped, but it is not yet possible to achieve a complete cure.

Main symptoms:

• paroxysmal sudden hearing loss;
• dizziness;
• imbalance, nausea;
• tinnitus is regular;
• Loud noise increases discomfort.

Neuritis of the auditory nerve (cochlear neuritis)

It occurs frequently and almost always acquires a chronic course. The inflammatory process affects the nerve plexuses of the inner ear. Symptoms are hearing impairment and the appearance of “extra” noise in the form of rustling. It is usually diagnosed in people over 50 years of age. A serious complication of the disease is necrosis, leading to progressive deafness that cannot be cured.

Otitis and tympanitis

Otitis is a group of infectious and inflammatory pathological processes affecting various parts of the ear. Tympanitis is a type of otitis media that affects the eardrum. Otitis media is often diagnosed in children and the elderly. Otitis is divided according to the place of occurrence into external, middle and internal. The latter sometimes has its own name – labyrinthite.

Symptoms of otitis media:

• sharp pain and throbbing, aggravated by moving the jaw;
• fever, feeling unwell, lethargy;
• stuffiness in the ear;
• may cause short-term hearing loss;
• enlarged lymph nodes.

If there are complications, the process becomes purulent (mesotympanitis), sometimes it also affects the bone tissue (epithympanitis).

Otomycosis

Disease caused by fungi (mold, yeast-like). Fungal infection is characteristic of the outer or middle sections. The first stage is asymptomatic, then the clinical picture becomes more pronounced.

• Worried about persistent itching;
• painful sores appear, sometimes with suppuration;
• there is a headache on the side of the affected ear;
• discharge appears, there is a feeling of congestion;
• pinna painful and sensitive.

Diagnosis of otomycosis is often made with metabolic problems such as diabetes, after chemotherapy sessions, with HIV status that causes a decline in immunity.

Otosclerosis

Refers to hereditary family pathologies. When the disease affects the bone tissue in the inner ear. It is diagnosed more often in premenopausal women, but the initial manifestations can be observed at a younger age. If not treated, it will lead to irreversible bilateral hearing loss.

Signs indicating possible atherosclerosis:

• gradual hearing loss without clear cause;
• appearance of tinnitus, or only in one ear;
• occasional dizziness;
• in a noisier environment, the patient begins to hear better;
• imbalances appear.

If you experience several of the above symptoms, you need to see an otolaryngologist.

Otogenic sepsis

A complication that occurs if purulent inflammation in the middle ear area becomes further widespread. The infection enters the general blood flow through the lymphatic vessels.

The complication is more common in young people. Symptoms increase sharply:

• temperature jumps;
• chilliness alternating with excessive sweating;
• worried about tachycardia, shortness of breath;
• there is a lack of appetite;
• health deteriorates sharply.

This condition is a medical emergency. For urgent surgical intervention, the patient is urgently hospitalized in the clinic.

Ear plug

This is the name of a thick clot of earwax. It can clog the ear canal, which will lead to the following unpleasant manifestations:

• a foreign body is felt in the ear, congestion worries;
• hearing loss;
• cough and yawning may occur;
• sometimes there is discomfort similar to motion sickness while driving.

It is not uncommon for these symptoms to appear after bathing, as the clot of earwax swells with water and can block the passage.

Ear injuries

The eardrum can be damaged if the pressure drops too quickly. This can happen in the air, or in water at a sufficient depth. Sometimes the eardrum is damaged by strong acoustic vibrations – very loud sounds and strong noises. Damage causes bleeding and pain. If the eardrum is damaged mechanically, for example, with a sharp object, or when struck, dizziness and ringing in the ear occur.

An ear injury is characterized by a short-term severe hearing loss.

Development of neoplasms of various nature is possible. The tumor appears in the region of the auricle, or near it, the occurrence of a tumor in another department is a very rare phenomenon. Neoplasms grow slowly and are usually painless.

How are ear diseases diagnosed? The otolaryngologist examines the outer part of the ear, and if this is not enough for diagnosis, he prescribes instrumental and hardware studies.

• Otoscopy is a painless method of examining the outer ear using an otoscope. This is an instrument that looks like a tube with a light. It helps to reveal hidden infections, injuries, and also to detect a foreign body.
• Tympanometry is an acoustic method for studying the functionality of the auditory tube and the mobility of the ossicles in the middle ear.
• Audiometry – a test for the study of hearing acuity. It is carried out by an audiologist on a computer.
• X-ray of the ear and temporal bone – recommended for inflammatory pathologies. Helps to identify pathological changes in the inner ear.
• ultrasound.
• Computed tomography.
• Bacterial culture is performed for discharge and suspected bacterial infection. It detects the sensitivity of bacteria to antibiotics, which allows you to choose the best therapy. In chronic ear infections, a complete blood count is prescribed.

Treatment of ear diseases

In the Bibirevo Central Clinic, the treatment regimen is selected by an otolaryngologist after a thorough diagnosis. Self-medication is not applicable. The main goal of complex treatment is to eliminate inflammation, remove pain. If the disease is chronic, it is important to extend the period of remission.

The following groups of drugs are prescribed for the treatment of ear diseases:

• Antibiotics in the form of tablets or drops (if a bacterial infection is detected).
• Analgesics.
• Antiseptic solutions for washing the affected ear.
• Anti-inflammatory ointments that are placed in the ear canal with the help of turundas.
• Nasopharyngeal vasoconstrictor drops.
• Hormonal preparations (for medical reasons).

Physiotherapeutic procedures are effective, but they are used only after the acute period of the disease has been removed. Physiotherapy is prescribed only by a doctor. If a fungal disease is diagnosed, thermal procedures and physiotherapy are prohibited. If ear problems are caused by a sulfur plug, manipulations are applied to make it softer.

If a purulent process is detected, surgery is most often prescribed.

To eliminate hearing loss, tympanoplasty is prescribed: a microsurgical manipulation that restores sound conductivity.

Prosthetics are offered for complex and advanced cases with significant hearing loss.

An otolaryngologist should be visited once a year, especially when there is a tendency to otitis and other inflammatory phenomena.

If you have a history of hearing loss in your family, you should see your doctor regularly after age 40.

Panova Natalia Alekseevna

Otolaryngologist (ENT)
Work experience — 40 years

Ear diseases (Ear diseases): types, symptoms, diagnosis

The article was checked by a doctor: Kogan Elena Lvovna

Structure and general classification of ear diseases

The organ of hearing consists of 3 parts:

1. Outer ear – auricle and external auditory canal.
2. The middle ear is located behind the eardrum and is an air chamber containing the auditory ossicles.
3. Internal – located in the temporal bone. It has many channels, which is why it is called a labyrinth. Here is the main organ responsible for the perception of sound – the cochlea.

Ear diseases can affect any of the indicated departments or several at once. Consider the general qualification of ear pathologies depending on the cause.

4. Infectious inflammatory diseases

They occupy a leading position. They mainly occur in childhood, since in children the ear canal is not yet fully developed, and therefore shorter than in adults. This contributes to the fact that the infection spreads faster in depth, affecting all parts of the hearing aid. This group includes all otitis media.

5. Injuries

Mechanical damage, shocks, bruises, a sharp change in atmospheric pressure (barotrauma), acoustic injuries can cause serious damage to the hearing organ. This also includes the presence of foreign objects in the auricle. Most often occur in athletes, scuba divers and children.

6. Fungal infections or otomycosis

The causative agent is yeast-like fungal microorganisms. It affects the outer and middle ear. The provoking factor is a decrease in immunity or trauma.

7. Non-inflammatory pathologies

Chronic diseases, which in most cases are hereditary. These are sensorineural hearing loss, otosclerosis, neuritis.

Otohematoma can be distinguished separately. This is a deformity of the outer ear, which is accompanied by hemorrhage and occurs as a result of injury.

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Main types and symptoms of diseases of the ear

Almost all ear diseases have similar symptoms. Consider the most common diseases and their clinical manifestations.

Eustachitis

Has an infectious nature. The inflammatory process affects the auditory canal (Eustachian tube), which leads to impaired ventilation in the ear cavity. The result is otitis media. The symptoms are:

• discomfort and pain;
• sensation of liquid;
• hearing impairment;
• crackling or strange noise in the ear;
• temperature increase in the event of a purulent process.

All manifestations are aggravated by movement.

Mastoiditis

Included in the group of inflammatory pathologies of an infectious nature. Affects the inner ear. Often occurs as a complication of the inflammatory process in the middle ear. Characteristic manifestations:

• sudden rise in temperature;
• general weakness, intoxication;
• throbbing pain;
• discharge with pus;
• outer ear edema;
• hearing loss.

One of the main first symptoms is dizziness. It comes on suddenly, for no reason.

Meniere’s disease

It is characterized by an increase in pressure in the labyrinth of the middle ear. As a result, blood vessels are affected, and fluid begins to accumulate in the ear cavity. The exact reasons have not been clarified. Not amenable to complete cure. Symptoms:

• attacks of deafness;
• nausea;
• balance problems, dizziness;
• constant noise in the diseased ear.

Discomfort is aggravated by loud noises.

Acoustic neuritis (cochlear neuritis)

Frequent disease with a chronic course. Inflammation affects the nerve structures of the inner ear. Patients complain mainly of hearing loss and the appearance of additional sounds. It can be whistling, crackling, rustling. It usually occurs in people over 50 years of age. Dangerous complication – necrosis, which leads to complete irreversible deafness.

Otitis and tympanitis

These are inflammatory diseases that affect various parts of the organ of hearing. This diagnosis is mainly made in children and the elderly. Allocate external, average and internal otitis (labyrinthitis). The manifestations of the disease include:

• severe throbbing pain which is aggravated by movements of the jaw;
• temperature increase;
• fatigue, lethargy;
• feeling of fullness in the ear.

There may be short-term hearing loss. Often there is an increase in lymph nodes. With a complication, mesotympanitis (purulent otitis media) and epitympanitis develop (a purulent process affects the bone).

Otomycosis

The main reason is yeast-like or mold fungi. Pathology can occur in the outer or middle ear. At the initial stage of infection proceeds without symptoms. The clinical picture is represented by the following manifestations:

• severe itching;
• suppuration;
• presence of ulcers;
• headache from affected ear;
• ear discharge;
• stuffy feeling;
• pinna sensitivity.

Often such a diagnosis is made in people with chronic metabolic diseases (diabetes mellitus), with a persistent decrease in immunity (HIV status) or after chemotherapy.

Otosclerosis

This is a hereditary pathology in which the bony labyrinth of the inner ear is affected. It occurs more often in women after 45 years of age. But the first manifestations can appear at a young age. Without appropriate treatment, it often leads to the development of bilateral hearing loss. You can suspect the disease by the following symptoms:

• progressive hearing loss without cause;
• incomprehensible sound or noise in one or both ears;
• dizziness;
• improve hearing in noisy environments;
• balance disorders.

With such manifestations, you need to contact an otolaryngologist.

Otogenic sepsis

A severe complication that occurs as a result of the spread of purulent inflammation from the middle ear. Infection through the lymphatic tract or through the vessels of the meninges enters the general circulation. The diagnosis is typical for young and middle age. Symptoms come on suddenly and include:

• temperature fluctuations;
• chills;
• increased sweating;
• tachycardia;
• refusal to eat;
• deterioration of health;
• shortness of breath.

Surgery is mandatory, so this condition requires immediate hospitalization.

Earplug

The accumulation of earwax, which partially or completely clogs the ear canal. A common condition that is accompanied by the following manifestations:

• sensation of a foreign object;
• ear congestion and hearing loss;
• coughing may occur;
• yawns;
• slight dizziness, as from motion sickness in transport.

Often, symptoms appear after water procedures. A clot of sulfur swells due to water ingress, and completely blocks the passage in the ear.

Ear injuries

With sudden pressure drops (at great depths in water or in air), an injury to the eardrum occurs. Also, damage is possible when exposed to loud sound vibrations. This condition is characterized by pain and bleeding. With mechanical damage to various objects, with bruises or blows, dizziness, severe ringing in the ears are noted. Temporary deafness is characteristic.

It is also possible the formation of various neoplasms in the ear. Usually, the tumor forms inside the auricle or near it. It rarely affects the middle section. They are characterized by slow growth and the absence of painful symptoms.

Causes of diseases of the ear

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• ENT (otolaryngologist)
• ENT for children (otolaryngologist)

Diseases can occur for various reasons. The main ones include:

1. Improper hygiene or the use of unsuitable items.
2. Reduced immunity.
3. The presence of other chronic foci of inflammation in the body. Infectious diseases of the nasopharynx are especially dangerous.
4. Injuries.
5. Endocrine diseases.
6. Metabolic disorders.
7. Heredity.
8. Excessive production of ear secretion.
9. Professional activity associated with constant noise.

In children, ear diseases are diagnosed more often due to the peculiarities of the physiological structure of the child’s ear. Also, they have not yet fully formed local and general immunity. In adults, the causes are usually associated with other chronic pathologies or injuries.

Diagnosis of ear diseases and medical appointments

If there is pain in the ear, or for no apparent reason, hearing begins to decline, then you should definitely contact an otolaryngologist. Depending on the symptoms, you may need to consult an audiologist – a doctor who deals with hearing disorders.

Diagnostic methods

The patient’s complaints, as well as the study of family history, play an important role in making a diagnosis. The doctor performs an external examination of the auricle. If this is not enough to determine the disease, then resort to hardware methods.

1. Otoscopy is a painless method of examining the outer ear using an otoscope. This is an instrument that looks like a tube with a light. It helps to reveal hidden infections, injuries, and also to detect a foreign body.
2. Tympanometry is an acoustic method for studying the functionality of the auditory tube and the mobility of the ossicles in the middle ear.
3. Audiometry – a test for the study of hearing acuity. It is carried out by an audiologist on a computer.
4. X-ray of the ear and temporal bone – recommended for inflammatory pathologies. Helps to identify pathological changes in the inner ear.
5. ultrasound.
6. Computed tomography.

In case of discharge and suspicion of a bacterial infection, bacteriological culture is performed. It detects the sensitivity of bacteria to antibiotics, which allows you to choose the best therapy. In chronic ear infections, a complete blood count is prescribed.

Possible complications in diseases of the ear

If you do not stop the spread of the infection in time, then it can get into the lymph, as well as into the brain tissue. In these cases, death is possible. Thus, complications of ear diseases can be:

• meningitis;
• abscess development;
• bacterial sepsis;
• facial paralysis;
• neoplasms, including oncological ones.

Running inflammation can destroy the integrity of the eardrum. This threatens with hearing loss or deafness. It can be partial or complete, affecting one ear or both at once. But most importantly, in some cases, deafness becomes irreversible.

Treatment of diseases of the ear

The treatment regimen is selected only by a doctor after carrying out the necessary research methods. Self-medication is not worth it. Treatment in most cases is complex. The main goal is to eliminate the inflammatory process and reduce pain. In chronic pathologies, therapy is aimed at prolonging the period of remission. For ear diseases, the following groups of medicines are used:

1. Antibiotic tablets or drops (if bacterial infection is detected).
2. Analgesics.
3. Antiseptic solutions for washing the affected ear.
4. Anti-inflammatory ointments that are placed in the ear canal with the help of turundas.
5. Nasopharyngeal vasoconstrictor drops.
6. Hormonal preparations (for medical reasons).

Physiotherapy methods give good results. But they are prescribed after the removal of the acute period and only by a doctor. With mycoses and other fungal infections, physiotherapy and heating are prohibited. With sulfur plugs, special means are used to soften it.

With purulent pathologies and the occurrence of an abscess, surgical intervention is performed. If hearing loss or partial deafness occurs, the doctor may recommend tympanoplasty. This is a microsurgical operation that aims to improve sound conduction. In severe cases of hearing loss, prosthetics are performed.

Prevention of diseases of the ear

Ear pain brings no less torment than toothache.