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Middle Ear Inflammation (Otitis Media)
A middle ear infection or inflammation of the middle ear happens when a virus or bacteria inflames the area behind the eardrum. This is also known as otitis media and is most common in children.
According to the National Library of Medicine, middle ear inflammations occur in 80 percent of children by the time they reach age 3.
Most middle ear inflammations occur during the winter and early spring. Middle ear inflammations usually go away without any medication. However, you should seek medical treatment if pain persists or you have a fever.
There are two types of middle ear inflammations: acute otitis media (AOM) and otitis media with effusion (OME).
Acute otitis mediaThis type of ear infection comes on quickly and is accompanied by swelling and redness in the ear behind and around the eardrum. Fever, ear pain, and hearing impairment often occur as a result of trapped purulent fluid or mucous behind the eardrum.
Otitis media with effusion (OME)After an infection goes away, mucous and fluid will sometimes continue to build up in the middle ear. This may also occur as a result of a cold or other conditions, like cleft palate. This can cause the feeling of the ear being full and affect your ability to hear clearly.
There are several reasons children get middle ear inflammations. They often stem from a prior infection of the respiratory tract that spreads to the ears.
When the tube that connects the middle ear to the pharynx (eustachian tube) is blocked, fluid will collect behind the eardrum. Bacteria will often grow in the fluid, causing pain and inflammation.
There are a variety of symptoms associated with middle ear inflammations. Some of the most common include:
A doctor will make sure they have your child's medical history and perform a physical examination. During the exam, the doctor will look at the outer ear and eardrum using an instrument called an otoscope to check for redness, swelling, pus, and fluid.
Adults are usually much better at describing their symptoms in words than kids. Complications are the same for both adults and children, as is treatment.
The doctor might also conduct a test called tympanometry to determine whether the middle ear is working properly and if OME is present.
For this test, a device is put inside your ear canal, changing the pressure and making the eardrum vibrate. The test measures changes in vibration and records them on a graph. This will show the presence of fluid but not whether the fluid is infected. A doctor will interpret the results.
There are a number of ways to treat otitis media. Acute otitis media may be treated with antibiotics, but OME is not typically accompanied by infection, so antibiotics are not helpful or necessary.
A doctor will base treatment on your child's age, health, and medical history. Doctors will also consider the following:
Depending on the severity of the infection, a doctor may tell you that the best option is to treat the pain and wait to see if symptoms go away. Ibuprofen or another fever and pain reducer is a common treatment.
Symptoms lasting more than 3 days usually mean a doctor will recommend antibiotics. However, antibiotics will not cure an infection if it's caused by a virus.
Complications resulting from otitis media are rare but can occur. These complications include:
There are ways to lower your child's risk of getting ear inflammations:
The American Osteopathic Association also recommends nursing your baby, if possible, since it can help reduce the incidence of middle ear inflammations.
Can An Ear Infection Go Away On Its Own?
© Simol1407/Shutterstock young girl with ear pain Ear infections are a pain in the, well, ear for many Americans. Children are especially susceptible to ear infections, so you may have experienced one firsthand growing up. Roughly five out of six children aged 3 years old or under will have one, according to the National Institute on Deafness and Other Communication Disorders (NIDCD).
As it turns out, ear infections have impacted humans for thousands of years. Recent research out of Tel Aviv University uncovered an ear infection in the remains of a human skull determined to be some 15,000 years old. As time passed, morbidity due to ear infections declined and rose again 6,000 years ago largely due to humans living more communally in highly populated home environments where hygiene was poor. As late as the 20th century, ear infections developed into chronic conditions that could even lead to hearing loss, until antibiotics were developed to treat them.
Even though ear infections can potentially lead to serious outcomes, the National Health Service (NHS) states that ear infections tend to go away on their own in roughly three days, although symptoms could persist for about a week. Ear infection symptoms often emerge suddenly. Besides experiencing ear pain, you may be developing an ear infection if you have a high temperature, are feeling low-energy, have issues hearing, your ear emits a discharge, or if you notice a sense of fullness or pressure within your ear and itching or scaliness around your ear.
The Different Types Of Ear Infections
© ivan_kislitsin/Shutterstock child in pool with swimmer's cap Though there are numerous types of ear infections, experts at NY Allergy & Science Centers (NYASC) explain that ear infections fall into three main categories: acute otitis media, otitis media with effusion, and otitis externa. Though these infections differ in the areas they infect, they share many symptoms, such as ear pain, ear drainage, fever, headaches, a feeling of fullness in the ear, and hearing loss, among others.
Acute otitis media (AOM) impacts the middle ear, which is located behind the eardrum. AOM occurs due to the eustachian tube becoming blocked, preventing normal drainage. This type of ear infection is often due to a cold and becomes exacerbated as the fluid builds up and possibly becomes infected. Those with allergies are at higher risk because allergens can lead to congestion and swelling of the eustachian tube. Most common in young children, otitis media with effusion (OME) is when non-infected fluid backs up in the middle ear, most likely due to a cold or upper respiratory infection. Children's Hospital of Philadelphia explains that children between three months and six years are more predisposed to OME due to their eustachian tubes being immature. Lastly, otitis externa is an infection of the outer part of the ear canal. Known colloquially as "swimmer's ear," typically only one ear will experience this type of ear infection. You can protect yourself from swimmer's ear by wearing a swimmer's cap and ear plugs and generally being mindful to always keep the ears dry, per NYASC.
Ear Infections: Diagnosis And Treatment
© Elnur/Shutterstock doctor examines girl's ear Though ear infections often go away on their own, the doctors at Florida Otolaryngology Group state that there are certain situations when you should see a doctor for an ear infection. For instance, if symptoms linger beyond three days, that's a sign that it might be time to see a healthcare specialist. Additionally, you should contact a medical professional if you are experiencing a fever of 100.4 or more, you have bloody fluid or pus discharge coming from your ear, or you're feeling dizzy, off-balance, or nauseated.
Your doctor can usually determine an ear infection based on your collection of symptoms. Even so, to confirm, they may conduct an exam followed by tests, according to the experts at the Mayo Clinic. For the exam, your doctor will use a specialized instrument called a pneumatic otoscope. This tool emits a small puff of air, allowing the doctor to determine if there is fluid build-up based on whether or not the eardrum exhibits movement. If the eardrum remains stationary, that means there is fluid buildup in the middle ear behind the eardrum. If the results are inconclusive, a doctor may administer a test that measures the movement of the eardrum (tympanometry) or one that measures how well sound resonates from the eardrum (acoustic reflectometry).
Once diagnosed, your doctor may decide to wait a few days to see if the infection subsides before recommending other therapies or procedures. To manage ear pain your doctor may suggest over-the-counter medications or anesthetic drops.
Read this next: 7 Things To Do And 7 Things To Avoid When You Start Showing Flu-Like Symptoms
Swimmer's Ear (Otitis Externa): Causes, Symptoms And Treatment
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When you duck your head underwater and end up with excess water retention in your ears, it may trigger an inflammatory response that could turn into an infection known as swimmer's ear, or otitis externa. Here's what you need to know about swimmer's ear, including its common causes, symptoms to watch for and treatments that can provide some relief.
What Is Swimmer's Ear?Otitis externa (OE) is an inflammation of the external ear canal that may sometimes spread to the outer ear. Symptoms usually appear a few days after swimming and may include swelling, redness and itchiness in and around the ear. Roughly 10% of people deal with OE at some point, according to research in the journal Deutsches Ärzteblatt International .
Swimmer's ear shouldn't be confused with a middle ear infection. With a middle ear infection, you can typically still wiggle your outer ear without discomfort or pain, which is not the case with swimmer's ear.
Otitis externa can either be infectious or non-infectious—depending on whether it's caused by bacteria or trauma, for instance—and it isn't contagious. (Contagious diseases are infectious, but not all infectious diseases are contagious.) The severity of OE ranges from mild to malignant (or necrotizing), the latter of which can be life-threatening.
Common Causes for Swimmer's Ear"Swimmer's ear is often caused by water exposure, which can come from swimming or flushing the ears," says Nicole Aaronson, M.D., a board-certified pediatric otolaryngologist at Nemours Children's Health in Wilmington, Delaware. Exposure to water can facilitate the growth of bacteria and fungus around the skin surrounding the ear canal, according to Dr. Aaronson. Bacteria causes more than 90% of otitis externa cases, according to research conducted in Germany . Germs from swimming pools or other bodies of water may also cause OE.
Potential causes of swimmer's ear include using another person's earbuds or wearing hearing aids without adhering to proper cleaning maintenance. Other causes include objects in the ear like cotton swabs or underlying skin conditions like eczema or psoriasis that may irritate the skin surrounding the ear canal, she suggests. "Prolonged use of antibiotic ear drops can also disrupt the normal bacterial flora of the ear canal and allow opportunistic bacteria and fungi to take hold," she adds.
Anyone with water retention in the ears is at risk for swimmer's ear, regardless of age. The occurrence of otitis externa tends to be higher among swimmers, explaining how the condition earned its nickname.
Swimmer's Ear Signs and SymptomsOtitis externa can result in the following symptoms, according to Dr. Aaronson:
OE is classified as either acute (lasting less than six weeks), chronic (lasting more than three months) or necrotizing. Symptoms differ slightly between acute and chronic OE. For instance, acute OE may present with symptoms like drainage, redness and severe pain while common symptoms of chronic OE include itchy, dry and scaly skin. Symptoms of necrotizing otitis externa, meanwhile, include ongoing drainage from the ear, trouble swallowing and fever.
A physical examination and review of your medical history with your health care provider can help provide a proper diagnosis and serve as a starting point for determining the most appropriate treatment plan.
Swimmer's Ear TreatmentsTreatments available for swimmer's ear include combination therapies like topical medications and the medical removal of debris and drainage, says Dr. Aaronson.
Depending on the type of OE and symptoms you're experiencing, your doctor may recommend one (or more) of the following treatments, according to Dr. Aaronson:
Following topical agent use, 65% to 90% of patients typically see improvements in their condition within seven to 10 days, according to German research .
"If the ear canal is very swollen, a wick may be placed in the ear canal to help the drops travel further down past the swollen area," says Dr. Aaronson. "The wick will later be removed or fall out on its own when the swelling of the ear canal goes down."
When to See a Doctor"You should see a doctor if you develop pain and/or drainage from the ear," advises Tiffany Chao, M.D., an assistant professor of otorhinolaryngology at the Perelman School of Medicine at the University of Pennsylvania. Multiple courses of ear drops won't always cure the infection, she says, adding that you should see an otolaryngologist if the infection persists.
There are several precautionary measures that can reduce the risk of swimmer's ear, according to the Centers for Disease Control and Prevention (CDC). Keeping your ears dry (while swimming or showering) with swim molds or ear plugs—and thoroughly drying your ears with a towel or hair dryer if water seeps in—is a great place to start.
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