Another Ear Infection?

Another Ear Infection?

Woman's Hospital

By Haley Caruso, Audiologist

National health statistics reveal that pediatric ear, nose, and throat disorders remain among the primary reasons children visit a physician, with ear infections ranking as the number one reason for an appointment. 

Ear infections can happen at any age; however, they are most common in young children. The location determines the type of ear infection:

  • Outer Ear Infection occurs when there is an infection on the visible part of the ear and the ear canal. This is also called otitis externa or more commonly “swimmer’s ear.”
  • Middle Ear Infection occurs when there is an infection in the air-filled space between the eardrum and the inner ear. The middle ear contains the ear bones and the Eustachian tube. This is also called otitis media and is the most common ear infection.
  • Inner Ear Infection occurs when there is an infection of the hearing organ (the cochlea) and/or the balance organ (semicircular canals) and is located within the skull. An inner ear infection is uncommon and is called labyrinthitis or vestibular neuritis.

Middle ear infections are the most common and occur when a virus or bacteria enters the ear and builds up behind the eardrum. Ear infections typically occur with a cold or a sinus infection; however, they can occur on their own. Bacteria enters through the tube that connects the ear to the back of the throat  called the Eustachian tube. If the Eustachian tube is swollen or becomes blocked, it can no longer regulate pressure properly and negative pressure develops behind the eardrum.  Eustachian tubes in children are smaller, shorter, narrower, and more horizontal making it easier for fluid to get trapped in the middle ear and the reason children are more likely to get ear infections.

Symptoms of a middle ear infection:

  • Pain
  • High fever
  • Difficulty hearing or muffled speech
  • Lessened appetite
  • In an infant: pulling or rubbing ears, increasingly fussy, sleeping poorly

Risk factors for ear infections include:

  • Daycare attendance
  • Cold or sinus infection
  • Allergies
  • Exposure to cigarette smoke
  • Use of a pacifier
  • GERD (gastroesophageal reflux disease)
  • Family history of frequent ear infections.

Treatment of middle ear infections may include:

  • Antibiotics- make sure to give ALL doses as prescribed.
  • Ibuprofen or acetaminophen (Be sure to talk to your pediatrician before giving).
  • Possible 72 hours wait and see approach when:
    • Patient is otherwise healthy
    • Mild symptoms
    • Unclear diagnosis
    • Pressure-Equalizing Tubes, or PE Tubes, may  be recommended if your child experiences recurring ear infections or fluid in place for months without resolve.

Prevention of a middle ear infection:

  • Holding child in an upright position during bottle feeding
  • Breastfeeding at least 6 months
  • Avoid use of pacifier (especially after 1st birthday)
  • NOT exposing your child to secondhand smoke
  • Frequent hand washing
  • Keep immunizations up to date and get flu shots yearly

Outer ear infections are caused by inflammation, infection, or irritation of the ear canal. A dry ear is unlikely to get infected. Outer ear infections are often caused by trapped water in the ear from baths, showers, swimming and sweat. Other causes include excessive wax, eczema and Q-tip trauma.

Symptoms of an outer ear infection:

  • Itching
  • Pain
  • Drainage
  • Decreased hearing
  • Redness or swelling of the skin around the ear

Treatment of outer ear infections many include:

  • Careful cleaning by ENT
  • Ear drops
  • Oral or topical antibiotics

Prevention of an outer ear infection:

  • Using ear plugs when swimming
  • Using a dry towel or hair dryer (from a distance) to dry your ears
  • Having your ears cleaned by an ENT (Ear, Nose, and Throat) specialist if you have itchy or flaky ears.
  • Avoiding Q-TIPS. This can pack dirt and ear wax further into the ear canal, remove the layer of wax that is needed to protect your ear, and can irritate the skin. Q-tips can make your ear a perfect environment for an outer ear infection.

Inner ear infections are typically caused by a viral or bacterial infection. A middle ear infection that is left untreated can lead to an inner ear infection. 

Symptoms of an inner ear infection:

  • Sudden onset of hearing loss.  If there is a sudden onset of hearing loss, contact your physician right away. The earlier treatment begins the better chance you have of recovering hearing.
  • Dizziness and/or imbalance (vertigo)
  • Ringing in the ear (tinnitus)
  • Nausea

Treatments of an inner ear infection treatments may include:

  • Steroids
  • Bed rest
  • Hydration
  • Anti-nausea medicine
  • Antihistamines
  • Antibiotics
  • Ear tubes
  • Surgery

Almost every child will experience an ear infection (or many)! Ear infections are the most common cause of hearing loss in children, but it is almost always restorable if treated effectively and quickly. If your child shows any of the ear infection symptoms listed above, it is best to contact your healthcare provider immediately. To learn more about Woman’s Audiology services visit our website or call 225-924-8450.