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Inner Ear Infection - Causes, Symptoms, Diagnosis, and Treatment

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Ears are very sensitive and are prone to bacterial, viral, or fungal infections. Long-standing ear infections can lead to hearing impairment gradually.

Written by

Dr. Ruchika Raj

Medically reviewed by

Dr. Oliyath Ali

Published At January 18, 2023
Reviewed AtJune 19, 2023

Introduction:

Inner ear infections have become very common among the general population. Our inner ear is prone to bacterial, viral, and fungal infections, which seek immediate attention. Normally, our inner ear has hair cells (present in the cochlea), which bend on receiving sound waves from the middle ear. This will generate electrical impulses that are transferred by the acoustic nerve (nerve supply to the ear) to the brain, which detects these signals as a sound. Any infections to the inner ear can disrupt the hearing pathway resulting in gradual progression into sensorineural (damage to the nerve transmitting electrical signals to the brain to perceive sound) hearing loss if left untreated. In severe cases, the infection can also spread from the inner ear to the temporal bone (lateral part of the skull bone) and the brain. Inner ear infections also lead to loss of balance due to damage to the vestibular nerve (the eighth cranial nerve).

What Are the Causes of Inner Ear Infections?

Inner ear infections are caused by:

  • Bacterial Infections: Bacteria like Streptococcus and Neisseria can result in damage to the inner ear. Labyrinthitis (swelling of the labyrinth - part of the inner ear that helps to control balance) can occur due to bacterial infections.

  • Viral Infections: Viruses like cytomegalovirus (CMV) and the rubella virus affect the inner ear and can cause damage or swelling of the vestibulocochlear nerve (the eighth cranial nerve).

  • Fungal Infections: Fungus like Aspergillus niger and Candida can result in inner ear infections.

What Are the Signs and Symptoms of an Inner Ear Infection?

Signs and symptoms associated with inner ear infections are:

  • Hearing impairment.

  • Dizziness.

  • Vertigo (spinning sensation in the head).

  • Deafness.

  • Loss of balance.

  • Tinnitus (ringing sensation in the ears).

  • Pressure changes in the ears.

  • Drainage from the ears.

  • Fever.

  • Nausea and vomiting.

  • Disorientation.

  • Pain in the ears.

  • Disbalance while walking.

  • Nystagmus (involuntary eye movements).

  • Blurred vision.

  • Meningitis (swelling of the brain tissue if the infection spreads to the brain).

How to Diagnose Inner Ear Infections?

Inner ear infections can be diagnosed by :

  • History and Clinical Examination: A detailed history of the patient for the symptoms present are recorded. The ear is examined clinically by an ENT (ear, nose, and throat specialist) by using an otoscope (an instrument with attached light used to check the inner part of the ears) to rule out the presence of any infections, ear discharge, and swelling in the ears.

  • Computed Tomography (CT) Scan: CT scan is done to rule out the presence of any inner ear infections, swelling, or growth.

  • An Otoacoustic Emission Test: It is done using a tiny speaker to produce sounds in the ear, and the response of the cochlear hair cells to the sound is recorded.

  • Auditory Brain Response (ABR) Test: It is done to detect the response of the nervous system (brain) to the sound produced in the ear by a mini earphone. It helps to identify the swelling or damage to the vestibulocochlear nerve (the eighth cranial nerve) causing a defect in the hearing pathway.

  • Vestibular Test Battery: It is done to assess the functions of the labyrinth (part of the inner ear) and vestibulocochlear nerve (the eighth cranial nerve) to rule out loss of balance due to infection.

  • Electrocochleography (ECOG): It is done to assess the inner ear functions in response to the sound. It can detect abnormal fluid pressure build-up in the ear.

What Is the Treatment for Inner Ear Infections?

Inner ear infections can be managed by:

1. Medicinal Therapy:

  • Antibiotics and Anti-Inflammatory Drugs: These drugs are started for the patient to reduce or stop the infections. Oral, intravenous (through a vein), and intramuscular (through muscles) routes for drug take time to reach the target site (ear) and can cause systemic adverse effects on the other organs of the body, so local drug delivery by intratympanic (within the tympanic membrane of the ear) injections is preferred to avoid these complications. Intratympanic drug administration increases the efficacy of the drug in the target area. Delivery of drugs directly into the inner ear by passing the needle through the oval window and depositing it in the inner ear is another technique that is followed, but it is quite invasive (risky).

  • Antifungal Drugs: Antifungal drugs like Gentamicin injections are given through the tympanic membrane to reduce the frequency and intensity of vertigo by destroying the vestibular (sensory receptors in the inner ear) hair cells.

2. Nanoparticles-Mediated Treatment: It is one of the current trending techniques to treat inner ear infections. Nanoparticles of small size (less than 1 micrometer) are used as targeted drug therapy to treat inner ear infections. These methods allow the drug to act effectively and specifically in the target areas by slow diffusion of the drug through the oval window in the inner ear. Nanoparticles like titanium dioxide (acts against fungal infections), zinc oxide (acts against bacterial infections), and copper oxide (acts against viral infections) are used to treat inner ear infections effectively. Chitosan (linear polysaccharide composed of randomly distributed β- (1→4)-linked D-glucosamine (deacetylated unit) and N-acetyl-D-glucosamine (acetylated unit)) is another polymeric nanoparticle that has been tested to treat inner ear disease effectively. Research for various nanoparticle-based drug delivery systems is still ongoing.

3. Cochlear Implants: Hearing loss induced by inner ear infections is managed by the use of cochlear implants (a small electronic device that stimulates the nerve for hearing) that helps in hearing sounds.

What Research Is Ongoing for the Treatment of Inner Ear Infections?

Further studies are ongoing for the development of biocompatible (ear-friendly) and multifunctional nanoparticles that can release or deliver the drug in a controlled manner without causing harm or toxicity to the ears due to uncontrolled drug delivery (drug overdose).

Conclusion:

Inner ear infections most likely occur from bacterial or viral infections and are rarely caused by fungus. Inner ear infections can cause hearing loss and loss of balance and can also spread to the brain if left untreated. Any signs and symptoms of ear infections noticed should be reported to the doctor for early diagnosis and management of the infection. Early management of ear infections can prevent permanent hearing loss and further complications associated with the infection.

Frequently Asked Questions

1.

Is an Inner Ear Infection Painful?

Yes, an inner ear infection can be painful. Inner ear infections, also known as otitis media, occur when the part of the middle ear becomes infected or inflamed. Other conditions, such as external ear infections (otitis externa) or dental problems, can also cause ear pain.

2.

Do Inner Ear Infections Cause Dizziness?

Yes, inner ear infections can cause dizziness. The inner ear plays an important role in the spatial orientation and maintaining balance. When an infection affects the inner ear, it can disrupt the normal functioning of the balance organs, leading to dizziness and a sensation of spinning or unsteadiness. This dizziness is known as vertigo.

3.

How Does Prednisone Treat an Inner Ear Infection?

Prednisone is a medication that belongs to a class of drugs known as corticosteroids. It is commonly used to treat various inflammatory conditions, including inner ear infections. Prednisone reduces inflammation and suppresses the immune system's response. The dosage and duration depend on the severity of the symptoms.

4.

Can an Individual Wear a Headset Over the Ear While Having an Inner Ear Infection?

Generally, it is not recommended to wear a headset over the ear while having an inner ear infection, especially if a person is experiencing symptoms such as ear pain, drainage, or dizziness. Wearing a headset over the ear can potentially aggravate the inner ear, increasing discomfort and worsening the symptoms. The pressure caused by the headset can also cause further inflammation or fluid buildup in the middle ear, prolonging the healing process.

5.

How Is an Inner Ear Infection Diagnosed?

An inner ear infection, also known as otitis media, is typically diagnosed through a combination of medical history, physical examination, and possibly additional tests. The additional tests include tests like, imaging tests like computed tomography and magnetic resonance imaging, audiometry, and tympanometry tests.

6.

How Does an Inner Ear Infection Look Like?

A healthy eardrum looks pinkish-grey while an infected middle ear or inner ear with otitis media looks bulging red, sometimes clear, yellow, or even greenish-hued drainage is present. An otoscope helps the provider to look at the surface of the eardrum.

7.

What Helps in Reducing Inner Ear Pressure From a Sinus Infection?

Several methods help in reducing the inner ear pressure that includes, the counter decongestants, warm compress, staying hydrated, steam inhalation, nasal irrigation, and rest by elevating the head. If still the symptoms persist consult a provider to get medical help.

8.

What Antibiotics Are Used for a Staph Infection of the Inner Ear?

A specific choice of antibiotics may depend on factors such as the severity of the infection, the suspected or confirmed strain of Staphylococcus, and the individual's overall health. Flucloxacillin, Cephalexin, Clindamycin, and Trimethoprim-Sulfamethoxazole are some antibiotics used in staph infections of the inner ear.

9.

What Is the Difference Between an Inner Ear Infection and Vertigo?

Inner ear infection is an inflammation of the inner ear while vertigo is a symptom characterized by a spinning or dizzy sensation. Inner ear infections typically cause vertigo as a symptom rather than being the same as vertigo. Vertigo can be caused by various conditions such as inner ear problems, migraines, head injuries, and certain medications.

10.

How Are Eyes Affected by an Inner Ear Infection?

Inner ear infections can affect the eyes causing infections like nystagmus, blurred vision, and eye pain. As the inner ear is responsible for balance, they can affect the eye as they are closely connected to the optic nerve. This nerve is responsible for transmission of visual information to the brain.

11.

How Longer Does an Inner Ear Infection Stay?

The duration of an inner ear infection, also known as otitis media, can vary depending on various factors, including the specific cause of the infection, the individual's overall health, and the effectiveness of treatment. Most ear infections clear within three days, some times, they can last up to a week.

12.

What Is the Treatment for an Inner Ear Infection?

Treatment can vary depending on severity, and individual factors. Some common treatments are pain-relieving drugs like NSAIDs, antibiotics, eardrops that contain antifungal, antibiotic, or steroid composition, and decongestants oral or nasal. Applying a warm compress and supportive care can also help in treating the infection.

13.

How Long It Takes for an Inner Ear Infection to Cure?

Inner infections can get severe if they affect the eyes or lead to symptoms like dizziness, vertigo, and balance issues. Most inner ear infections get cured within two weeks of time with proper treatment and management.

14.

What Is the Treatment for Inner Ear Infection Vertigo?

The vertigo symptoms caused by the inner ear are treated by some medications like antihistamines, antiemetics, benzodiazepines, a technique called Epley maneuver, vestibular rehabilitation therapy, symptom management by over-the-counter drugs, and treating the underlying ear infection.

15.

How Do Essential Oils Help in Treating Inner Ear Infections?

Essential oils are natural plant extracts that contain concentrated aromatic compounds. Many oils have antiviral and antibacterial properties that kill bacteria and prevent viruses from reproducing. Basil oil, garlic oil, tea tree oil, and oregano oil help in reducing pain and treating inner ear pain.
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Dr. Oliyath Ali
Dr. Oliyath Ali

Otolaryngology (E.N.T)

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