Ear infections are classified as externa (external) and media (middle) based on the location. Otitis externa involves the outer ear canal. This is the area from the opening of the ear to the eardrum, which is covered with skin. These infections are painful and can cause swelling in the ear, drainage and/or temporary hearing loss. They are often a result of water or moisture in the ear canal and therefore can be known as “swimmer’s ear”, even though swimming may not be involved. These infections are treated with antibiotic eardrops and additionally, sometimes with oral antibiotics.
Inner Ear Infection
“Inner ear infection”, often a misused term, is associated with dizziness but is actually inflammation of the balance nerve itself. Most of the time the inflammation is due to a virus and therefore, antibiotics do not help. The disorder usually has to run its course, which can be several days. On rare occasions, dizziness can be associated with a more serious condition; it may also be due to some other (non-ear-related) problem.
Otitis media involves the “middle ear” or the space behind the eardrum.
The middle ear is connected to the back of the nose by the Eustachian tube. Nasal congestion from colds or allergies can cause pressure and an accumulation of fluid in the middle ear, causing the Eustachian tube to become blocked. This fluid can then become infected. Otitis media is very common in childhood, and is treated with antibiotics and sometimes requires the placement of PE tubes.
Treatment for Otitis Media
For many young patients otitis media can become a chronic condition when fluid accumulation in the middle ear and the subsequent infections cannot be resolved with prescription medications. This sometimes leads to other problems, such as hearing loss or behavior or speech problems. In these cases, an outpatient surgical procedure called amyringotomy may be recommended. The surgery involves a small surgical incision through the eardrum to promote drainage and relieve pressure.
A PE (pressure equalization) tube, sometimes referred to as a tympanostomy tube, myringotomy tube, or a ventilation tube is inserted in the hole. Based on the type of PE tube the surgeon uses, the tube will remain in place for a short time, typically for six-months to one year, or for a longer period. Patients usually experience little or no postoperative pain, but grogginess, irritability, and/or nausea from the anesthesia can occur temporarily. Hearing loss caused by the presence of middle ear fluid is immediately resolved by surgery. Patients must take precautions to keep water out of their ears while PE tubes are in place to avoid the possibility of bacteria entering the middle ear through the PE tube. Our physicians recommend keeping ears dry by using custom earplugs or other watertight devices during bathing, swimming, and other water activities.