Ear Infections

An ear infection occurs when there is a bacterial or viral infection or chronic inflammatory process, causing inflammation and fluid buildup in the middle of the ear. This is the air-filled section of your ear that is just behind the eardrum. There are two types of ear infections, acute and chronic. Acute ear infections are painful but short in duration. Chronic ear infections reoccur and don’t clear up on their own. Both types of infections have the potential to cause permanent damage to the middle and inner ear. Since ear infections often clear up on their own, treatment may start with monitoring the infection.

What causes an ear infection?

Ear infections occur when one of your eustachian tubes becomes swollen or blocked. This causes fluid to build up in your middle ear. Eustachian tubes are small tubes that run from each ear directly to the area where the nose and throat meet. This infection often comes from another illness such as a cold or allergies. The congestion and swelling of nasal passages, throat and eustachian tube ultimately lead to the ear infection.

Causes of eustachian tube blockage include:

• Allergies
• Colds or other upper respiratory infections
• Sinus infections
• Smoking
• Infected or swollen adenoids (tissue near your tonsils that traps harmful bacteria)
• Changes in air pressure
• Congenital malformations

What are the symptoms of an ear infection?

There are a few common symptoms of ear infections. Symptoms include:

• Mild to severe pain or discomfort inside the ear, often worse when lying down
• A feeling of pressure inside the ear that persists
• Fussiness in young infants (sometime pulling at the ears)
• Drainage of fluid from the ear
• Hearing loss

These symptoms may persist or may come and go. Symptoms can occur in one or both ears. Pain is usually more severe with a double ear infection, which is an infection in both ears. Chronic ear infection symptoms may be less noticeable than those with acute ear infections.

Children younger than 6 months who have a fever or ear infection symptoms should see a doctor. Always seek medical attention if your child has a fever higher than 102 degrees Fahrenheit or severe ear pain.

What is the treatment plan for an ear infection?

Your physician will examine your ears with an instrument called an otoscope. An otoscope has a light with a magnifying glass that helps physicians see inside your ear. The examination may reveal:

• Redness, air bubbles or pus (infected fluid) inside the middle ear
• Fluid draining from the middle ear
• A perforation in the eardrum
• A bulging or collapsed eardrum

If your infection is advanced, your doctor may take a simple of the fluid inside of your ear and test it to decide whether certain types of antibiotic-resistant bacteria are present. In very severe or certain chronic cases, they may also order a computed tomography (CT) scan of your head to determine if the infection has spread beyond the middle ear. If you’re suffering from chronic ear infections, you may need a hearing test.

Most mild ear infections clear up without any intervention. There are several methods that are effective in relieving symptoms of a mild ear infection. Methods include:

• Apply a warm cloth to the affected ear.
• Take over-the-counter pain medication such as ibuprofen or acetaminophen.
• Use over-the-counter or prescription ear drops to relieve the pain.
• Take over-the-counter decongestants such as pseudoephedrine or phenylephrine.

If your symptoms get worse, schedule an appointment with your doctor. If you’re prescribed antibiotics, it’s important to finish your entire course of antibiotics and follow up with your physician to ensure resolution of the infection. Surgery may be an option if your ear infection isn’t eliminated after all measures have been taken or if the infections become recurrent or chronic. Most often, tubes are placed in the ears to allow fluid to drain out. In cases that involve enlarged adenoids, surgical removal of the adenoids may be necessary. In cases where chronic sinus issues or allergies are involved, adequate and consistent treatment of these issues is important as well.