Ear Infections


An ear infection occurs when fluid becomes trapped in the middle ear following a viral or bacterial infection. This painful affliction is most common in children, but can affect people of all ages. Ear infections can be either acute (of short duration) or chronic (persisting or reoccurring frequently).

Causes

The majority of ear infections are viral or bacterial in nature, usually occurring after a cold or upper respiratory infection. These conditions cause swelling of the Eustachian tube, a small canal that connects the middle ear to the nostrils and provides an outlet for fluid drainage, trapping germs and fluid in the middle ear and leading to infection.

Because children are still growing physically, some of their internal organs may also be temporarily underdeveloped. This is true of the Eustachian tube, the canal that connects the middle ear to the nostrils, providing an outlet for fluid drainage. Because the Eustachian tube is smaller in children, it is more prone to swelling; when this occurs, fluid is trapped in the middle ear. This fluid presses against the eardrum, causing pain, and can harbor germs that lead to infection. The result is an earache and, in some cases, loss of hearing. When the infection does not completely go away or returns often, it is referred to as chronic.

Symptoms

The hallmark signs of ear infection are pain and pressure in the ear and fluid drainage. These may be accompanied by a low-grade fever and hearing loss. Infants are often fussier than usual, and may cry inconsolably, refuse to eat and have trouble sleeping. They may also pull or tug on the ear. Symptoms may be milder in chronic ear infections. Should your child display any of these symptoms, bring them to the doctor; the sooner an acute ear infection is treated, the lower the chances of it developing into a chronic condition.

Treatment

Treating an ear infection begins at home. To help soothe symptoms, gently press a warm washcloth against the affected ear. You may give your child eardrops and over-the-counter medications such as acetaminophen or ibuprofen to help relieve pain. Avoid aspirin, which can be dangerous to young children.

Your child’s doctor will likely prescribe antibiotics to treat a chronic ear infection. These should be taken until used up, even if your child’s symptoms appear to be improving; otherwise, the infection could worsen.

When medication is not effective, a surgical solution involving ear tubes may be considered. These are inserted in the middle ear and provide ventilation and fluids, keeping the ear clear and preventing infection. Most ear tubes remain in place anywhere from six to 18 months and eventually fall out on their own. If not, surgery to remove them is performed.

Complications

If left untreated, chronic ear infections can lead to a variety of complications including hearing loss, damage to the bones in the middle ear, balance problems, a middle ear cyst called a cholesteatoma, facial paralysis and inflammation of the brain. For these reasons, early detection and treatment are crucial. Better still is prevention.

You can’t always stave off an ear infection, but there are steps you can take to reduce the chances of your child developing one. These include breast-feeding your baby, making sure he or she is up-to-date on vaccinations, practicing good hygiene (e.g., regular hand-washing), keeping your child away from tobacco smoke, and enrolling them in as small a day care or preschool facility as possible. Simply put, fewer children mean fewer germs.

Call ENT Associates of Santa Barbara at (805) 964-6926 for more information or to schedule an appointment.

Swimmer’s Ear

When water becomes trapped in the ear, bacteria can cause inflammation and infection of the ear canal. This painful affliction is known as swimmer’s ear and can occur following exposure to any moist environment. Itchiness and pain are usually the first symptoms to appear. There may be a feeling of fullness in the ear, followed by swelling, redness and drainage of fluids. Fever, temporary hearing loss, and swollen lymph nodes may occur. If left untreated, swimmer’s ear can lead to permanent hearing loss, chronic ear infections and damage to the cartilage and bone.

Surfer’s Ear

Those with frequent exposure to cold water – most commonly surfers and swimmers – often suffer from reactive exostosis, an inflammation of the bone in the ear canal that leads to the formation of new bone growth. Known medically as exostosis but referred to informally as surfer’s ear, this condition causes bone to thicken, leading to a narrowing (and occasionally, a complete blockage or “occlusion”) of the ear canal. It can result in significant conductive hearing loss over time.

Cholesteatoma

Cholesteatoma is an abnormal skin growth in the middle ear behind the eardrum that may also affect the mastoid (skull bone). It begins as a cyst that gradually increases in size, destroying the bones of the middle ear and causing hearing loss. Symptoms of this condition include drainage from the ear, a feeling of fullness, hearing loss, earache and dizziness. Since these are also present in other conditions, tests such as CT scans and electronystagmography can be used to rule out other conditions and confirm the diagnosis. An otolaryngologist will determine the size and growth rate of the cholesteatoma and recommend treatment based on these findings. Controlling the infection with antibiotics or eardrops is a crucial first step. If you have a large cholesteatoma it may be treated surgically.