An ear infection can be a painful experience. There are infections specific to the outer and middle ear that can occur independently or in some unlucky people they may occur together.
Outer ear infections are sometimes referred to as “Swimmers ear” but are certainly not restricted to swimmers. As the name suggests, this infection can occur after exposing the ear to water, but this is not necessarily always the case. Typically the ear becomes very painful to touch. There may be a discharge from the ear and occasionally blood. Hearing can be reduced as the ear canal swells and blocks while referred pain to the teeth, jaw and scalp may occur.
Middle ear infections are more common among children than adults but occur in all ages. Again, they can be quite painful with reduced hearing and in cases where the eardrum ruptures there can be discharge from the ear canal. Typically there is pus present behind the eardrum, which causes pain as the pressure builds. There may also be a sense of “autophony” which refers to hearing your own bodily sounds (like chewing or your pulse) louder than it should be. Children experience all of the same symptoms as adults but may not be able to express them when young. In this case the child may be feverish, more irritable, seem to have poor attention or hearing and can have disrupted sleep.
Like all infections, the cause can be a virus, bacteria or fungus. The exact cause can sometimes be determined with a swab or culture of fluid from the region.
Some people and groups are predisposed to ear infections. People with narrowed ear canals, those using hearing aids and those with some medical conditions are at greater risk of an outer ear infection.
Children tend to experience more middle ear infections due to the shape and size of their middle ear structures as well as their exposure to others with illness through childcare and school.
A detailed discussion with Dr Morrissey about the symptoms you are experiencing and a thorough examination will usually identify the type of ear infection. Laboratory tests such as swabs and cultures can help determine the specific cause in some cases, while further examinations like hearing tests and scans can help assess the magnitude of the problem and the presence of any complications from infection.
The solution, in this case, depends upon the problem.
Outer ear infections are usually managed by keeping the ear dry, careful cleaning of the ear under the microscope and through the use of antibiotics or anti-fungal medications. In some cases, underlying risk factors will need to be addressed. Where the infection is severe, tablet antibiotics and occasionally hospital admission are necessary.
Middle ear infections can be addressed with antibiotics in most cases. When they become a recurrent problem there may be surgical options such as “grommets” or ventilation tubes to consider. “Grommets” are small, plastic tubes, which help ventilate the middle ear. This reduces fluid in the middle ear and has been demonstrated to be beneficial in certain circumstances. Dr Morrissey can help you decide whether this is an appropriate option for you to consider.