Ear Infections in Neptune, Holmdel & Manahawkin NJ
How Does The Ear Work?
The outer ear collects sounds. The middle ear is a pea-sized, air-filled cavity separated from the outer ear by the paper-thin eardrum. Attached to the eardrum are three tiny ear bones. When sound waves strike the eardrum, it vibrates and sets the bones in motion that transmit to the inner ear. The inner ear converts vibrations to electrical signals and sends these signals to the brain. It also helps maintain balance.
A healthy middle ear contains air at the same atmospheric pressure as outside of the ear, allowing free vibration. Air enters the middle ear through the narrow eustachian tube that connects the back of the nose to the ear. When you yawn and hear a pop, your eustachian tube has just sent a tiny air bubble to your middle ear to equalize the air pressure.
What Is Otitis Media?
Otitis media means inflammation of the middle ear. The inflammation occurs as a result of a middle ear infection. It can occur in one or both ears. Otitis media is the most frequent diagnosis recorded for children who visit physicians for illness. It is also the most common cause of hearing loss in children.
Although otitis media is most common in young children, it also affects adults occasionally. It occurs most commonly in the winter and early spring months.
What Are The Symptoms Of Otitis Media?
In infants and toddlers, be on the lookout for any of the following symptoms:
- Pulling or scratching at the ear, especially if accompanied by the following...
- Hearing problems or crying, irritability or fever
- Ear drainage
In young children, adolescents, and adults look for:
- Feeling of fullness or pressure
- Hearing problems
- Dizziness or loss of balance
- Nausea and/or vomiting
- Ear drainage
What does otitis media look like?
The middle ear is the space behind the eardrum. This is connected to the back of the throat by a passageway called the Eustachian tube. If that tube becomes blocked due to congestion from a cold or allergy, fluid builds in the middle ear. If bacteria or viruses have traveled up the Eustachian tube into the middle ear, they will multiply in the trapped fluid creating an infection, otitis media. This creates pressure as the eardrum pushes outward, and this leads to pain and decreased hearing.
What Causes Otitis Media?
Blockage of the eustachian tube during a cold, allergy, or upper respiratory infection and the presence of bacteria or viruses lead to the accumulation of fluid (a build-up of pus and mucus) behind the eardrum. This is the infection called acute otitis media. The build up of pressurized pus in the middle ear causes earache, swelling, and redness. Since the eardrum cannot vibrate properly, you or your child may have hearing problems.
Sometimes the eardrum ruptures, and pus drains out of the ear. But more commonly, the pus and mucus remain in the middle ear due to the swollen and inflamed eustachian tube. This is called middle ear effusion or serous otitis media. Often after the acute infection has passed, the effusion remains and becomes chronic, lasting for weeks, months, or even years. This condition makes one subject to frequent recurrences of the acute infection and may cause difficulty hearing.
What Are the Risk Factors for Developing Otitis Media?
Certain groups, especially children, are prone to developing otitis media. Here are various risk factors:
- Age — Children between the age of 6 months and 2 years are more susceptible to ear infections because of the size and shape of their Eustachian tubes and because their immune systems are still developing.
- Group Childcare — Just as with colds and flu, children in group childcare settings are more likely to get ear infections.
- Infant Feeding — Bottle-fed babies, particularly if they drink the bottle while lying down in their crib, are more prone to develop otitis media than breast-fed babies. This is a result of the feeding position.
- Seasons — Otitis media is more common in the fall and winter. In people with allergies, they may occur when pollen counts rise.
- Poor Air Quality — High levels of air pollution or cigarette smoke increase risk.
- Cleft Palate — If a child has a cleft palate, it is more difficult for his or her Eustachian tubes to drain.
Can Otitis Media Go Away On Its Own?
Around 80 percent of middle ear infections resolve on their own without antibiotics. The days of instantly prescribing a course of antibiotics are over, as more and more bacteria are becoming resistant thanks to over-prescription in the past. Generally, it’s wise to wait for 48 to 72 hours before considering antibiotics to see if the body overcomes the infection on its own. Over those first two or three days, over-the-counter pain medication should be used for any discomfort.
Can You Go Swimming with Otitis Media?
It’s a myth that children or adults can’t go swimming with an ear infection. The only case where that would be precluded would be if the eardrum has ruptured. Otherwise, the space where the ear infection is located is walled off from water. Swimming is OK with a middle ear infection, but the child or person should keep his or her head above water. Dunking the head underwater can force water up the nose and into the Eustachian tubes. Diving into a pool is a bad idea, as this increases the pressure on the inner ear.
What Happens if Otitis Media is Left Untreated?
These middle ear infections will often clear up on their own, but if they occur repeatedly and the parent opts to not treat a lingering infection, it can lead to serious complications, including:
- Impaired Hearing — Mild hearing loss is a part of most ear infections, as the accumulated fluid blocks sound. But the hearing improves as the infection clears. If ear infections recur over and over there be more significant hearing loss. In these recurring events, the eardrum or other structures in the middle ear can become permanently damaged, which would lead to permanent hearing loss.
- Speech or Developmental Delays — It’s important to think beyond the ear infection and consider that your child is not hearing clearly. This impairment, whether temporary or semi-permanent, can lead to delays in speech, social, and developmental skills.
- Spreading Infection — Untreated ear infections can spread to the mastoid, the bony protrusion behind the ear. This is called mastoiditis and can result in damage to the bone and the formation of pus-filled cysts.
- Eardrum Tearing — If fluid or pus is allowed to accumulate behind the eardrum, the pressure can cause the eardrum to tear.
How Is Otitis Media Diagnosed?
During an examination, the doctor will use an instrument called an otoscope to assess the ear’s condition. With it, the doctor will perform an examination to check for redness in the ear and/or fluid behind the eardrum. With the gentle use of air pressure, the doctor can also see if the eardrum moves. If the eardrum doesn’t move and/or is red, an ear infection is probably present.
Two other tests may be performed for more information.
- An audiogram tests if hearing loss has occurred by presenting tones at various pitches.
- A tympanogram measures the air pressure in the middle ear to see how well the eustachian tube is working and how well the eardrum can move.
Once a proper diagnosis has been reached, the doctor may prescribe one or more medications. It is important that all the medication(s) be taken as directed and that any follow-up visits be kept. Often, antibiotics to fight the infection will make the earache go away rapidly, but the infection may need more time to clear up. So, be sure that the medication is taken for the full time your doctor has indicated. Other medications that your doctor may prescribe include an antihistamine (for allergies), a decongestant (especially with a cold), or both. Sometimes the doctor may recommend a medication to reduce fever and/or pain. Analgesic ear drops can ease the pain of an earache. Call your doctor if you have any questions about you or your child’s medication or if symptoms do not clear.
What Other Treatment May Be Necessary?
Most of the time, otitis media clears up with proper medication and home treatment. In many cases, however, further treatment may be recommended by your physician. An operation called a myringotomy may be recommended. This involves a small surgical incision (opening) into the eardrum to promote drainage of fluid and to relieve pain. The incision heals within a few days with practically no scarring or injury to the eardrum. In fact, the surgical opening can heal so fast that it often closes before the infection and the fluid are gone. A ventilation tube can be placed in the incision, preventing fluid accumulation and thus improving hearing.
The surgeon selects a ventilation tube for your child that will remain in place for as long as required for the middle ear infection to improve and for the eustachian tube to return to normal. This may require several weeks or months. During this time, you must keep water out of the ears because it could start an infection. Otherwise, the tube causes no trouble, and you will probably notice a remarkable improvement in hearing and a decrease in the frequency of ear infections.
Otitis media may recur as a result of chronically infected adenoids and tonsils. If this becomes a problem, your doctor may recommend removal of one or both. This can be done at the same time as ventilation tubes are inserted.
Allergies may also require treatment.
Schedule A Consultation
Remember, Otitis media is generally not serious as long as it is treated both promptly and properly. If you believe that you could be developing a middle ear infection, contact us right away at one of our 3 convenient locations across New Jersey.
Copyright © 2015 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission.