Ear infections

Ear Exam

Ear infections are very common, and for some patients can become a frequent problem.  Early diagnosis and prompt treatment of an ear infection can help to ensure full recovery.  It can also help to see a specialist if you are prone to frequent infections.

What are the types of ear infection?

In adults, the most common type of ear infection is otitis externa: an infection of the ear canal (external ear).  The main symptoms are blockage, itching and discomfort in the affected ear.  Sometimes, both ears can be affected.  Occasionally there may be some discharge from the ear.  The patient is usually not unwell in themselves.

In children, the most common type of ear infection is otitis media: an infection of the middle ear (behind the ear drum).  This presents differently to external ear infection, usually with severe pain in the affected ear and a fever.  Young children may be grizzly and off their food.  Often once the pain and fever improves, the ear can start to discharge yellow liquid.

Of course, adults and children can develop both kinds of ear infection. It is very important to determine which type of ear infection you have, so that suitable treatment can be started.

How are ear infections treated?

Otitis externa (external ear infection) is treated mainly with ear drops and sprays.  Oral antibiotics are not very effective in otitis externa.  Sometimes, ear canal swelling and discharge can block the access for the drops and reduce their effectiveness.

For this reason, in otitis externa it can also be helpful to have the ear examined and cleared of debris by a specialist using a technique called microsuction.  This procedure takes just a few minutes, and can enable the drops to access the ear canal more effectively.

Otitis media (middle ear infection) should be treated with pain relief for the first 48 hours unless you are very unwell.  Oral antibiotics are helpful if you are still in pain or feverish after the first 48 hours.

Can I decrease the number of infections?

If you experience frequent episodes of otitis externa, it can help to address the risk factors that cause it.  These include water entry due to showering, bathing and swimming, skin problems like eczema, diabetes, or abnormalities of the ear canal.  If you use cotton buds these should be completely avoided.  It can help to see a specialist for their help and advice.

It is normal for young children to get otitis media occasionally.  Most of the time, infections will lessen as your child grows. However if the infections are exceptionally frequent and causing a lot of time off school, options include grommet (ventilation tube) insertion or a trial of preventative antibiotics.