Middle ear infection or otitis media not only affects children but can affect adults too. It can cause severe ear pain and fever, and sometimes require treatment. Read the article to know about its symptoms, causes, types, diagnosis, and treatment options.
Did you know your ear has three different sections? These sections work together to collect sounds and help us hear by sending these sound signals to the brain. The sections of the ear are:
Outer ear - It consists of the pinna or auricle (the outer part of the ear that you see) and the ear canal (the part that connects the pinna to the middle ear). It works by collecting sounds and transporting them to the middle ear.
Middle ear - The eardrum or the tympanic membrane separates the outer ear from the middle ear. When sound enters the middle ear, it hits this membrane and produces vibrations. These vibrations move the three small bones (malleus, incus, stapes) present in the middle ear called ossicles.
Inner ear - It consists of the cochlea and semicircular canals. This part of the ear converts the vibrations into nerve signals.
image source : hearinglink
Ear infections more common in children than adults. But ear infections in adults can be more severe. With proper treatment, most complications can be avoided. Some factors increase the risk of ear infections, but these factors can be avoided.
Middle ear infection, otherwise called otitis media, is an infection behind the eardrum or the tympanic membrane. It occurs in conditions that prevent fluid from draining from the middle ear like allergies, cold, sore throat, or upper respiratory tract infection. They are more common in children but can occur in adults also. As it can be a serious problem in adults, additional tests might be required. If you keep getting ear pain and infection, it is best you consult an ENT otolaryngologist online.
The types of middle ear infections include:
Acute otitis media - Here, the infection causes sudden redness and swelling of the inner ear. It results from fluid and pus getting trapped under the eardrum. It causes severe ear pain and fever.
Chronic otitis media - This results in repeated ear infection over months or years and is usually not painful. The infection does not go away in some. It causes liquid to drain from the ear canal and is often accompanied by tympanic membrane perforation and hearing loss.
Otitis media with effusion - It is otherwise called serous otitis media, as it results in fluid and mucus buildup in the middle ear after the infection resolves. It makes the middle ear feel heavy and full.
Chronic otitis media with effusion - Sometimes, fluid and mucus buildup remains in the middle ear for a long time or keeps building up repeatedly. There is no active infection, but this can affect your hearing.
The common symptoms of a middle ear infection in adults are:
Nausea and vomiting.
Ringing in the ear (tinnitus).
Fluid or pus discharge from the ear.
Feeling of fullness in the ear.
Loss of balance.
Any irritation in the eustachian tube, which is the tube that connects the middle ear to the throat, causes the area around it to swell. The eustachian tube regulates the pressure between the outer and inner ear. When a cold or allergy irritates this tube, fluids start draining from the middle ear. This fluid collects behind the eardrum, which facilitates the growth of bacteria and viruses.
Viruses are the most common cause of a middle ear infection, and the common viruses include influenza, herpes viruses, Epstein-Barr virus, and poliovirus.
Your doctor will take a medical history and do a physical examination. Using an instrument called an otoscope, the doctor will look at the outer ear and eardrum for redness, swelling, and collection of pus or fluid. To check how well your eardrum moves, a pneumatic otoscope is used to blow a puff of air into the ear. If the tympanic membrane does not move well, it indicates fluid behind it.
To check if your middle ear is working properly, you might have to get a test called tympanometry. Here, a device is used to change the ear pressure and make the eardrum vibrate.
An audiogram or a tuning fork can also be used to test your hearing.
Mild infections clear on their own sometimes. The treatment will depend on the cause and severity of the infection. The treatment options include:
Antibiotics - Antibiotic eardrops are used for bacterial ear infections, but it is not effective against viral infections. Oral antibiotics to treat ear infections are generally not recommended for middle and outer ear infections.
Analgesic ear drops - Your doctor might also prescribe eardrops containing painkillers like Acetaminophen Ibuprofen.
Decongestants or antihistamines - Pseudoephedrine or Diphenhydramine may help relieve caused mucus buildup in the eustachian tubes.
Applying warm compress on the ear may ease the pain.
To drain the ear, stand or keep your head upright while sitting.
For sore throat and to clear the eustachian tubes, try gargling with salt water.
Avoid smoking and alcohol intake.
Manage stress, as it can worsen symptoms of ear infection.
Garlic oil, tea tree oil, apple cider vinegar, basil oil, olive oil, and hydrogen peroxide are also used as eardrops to treat ear infections. There is no scientific proof if this helps, so always consult your doctor before using any oil.
An untreated ear infection can lead to:
Infection of the bones in the middle ear.
Infection of the CSF (cerebrospinal fluid) that surrounds the brain and spinal cord.
Permanent hearing loss.
Perforations or ruptured eardrums.
Some of the ways to prevent middle ear infections are:
Wash your hands frequently to prevent viral and bacterial infections.
Avoid going out in a dusty environment.
Avoid using q-tips, as it pushes the wax inside the middle ear.
If you are suffering from ear pain for a long time, it is best you consult an ENT otolaryngologist online now!
In chronic cases of middle ear infection that are left untreated, the infection can spread, which can cause infection in the mastoid bone known as mastoiditis or even meningitis. It involves inflammation of the membranes that cover the brain and spinal cord.
Middle ear infections commonly resolve on their own within two or three days. Some cases resolve without any treatment. In some instances, an infection lasts longer than usual. Where there is an accumulation of fluid in the middle ear for a period of six weeks, or longer antibiotic treatment might be required.
Inner ear infections can last for a more extended period than middle ear infections. The most common type of ear infections are infections of the middle ear known as otitis media. Symptoms presented by middle ear infection are also different from that of an inner ear infection.
Vertigo caused by middle ear infections usually resolves once the infection is treated. However, this vertigo should also be treated with middle ear infection. The use of antihistamines like Desloratadine, antiemetics like Meclizine to reduce nausea and dizziness. Sedatives like Diazepam and immune-suppressing corticosteroids with a proper doctor's prescription can be used.
Middle ear infections commonly resolve on their own within two or three days, without any treatment procedure. Treatment shortens the period of recovery by three days than usual time taken for recovery.
There are specific home remedies you can try when you get affected by fluid behind the ear. When you feel wiggling in your earlobe it is necessary to create an air vacuum. You can try using a blow dryer, try alcohol and vinegar containing ear drops, etc.
Once antibiotics are administered to treat middle ear infection, the infection usually resolves in two to three days. The fever also subsides within 48 hours.
Many doctors suggest apple cider vinegar to treat an ear infection. But, when there are stronger concentrations of apple cider vinegar, it might damage the ear's fragile, sensitive skin. Even after diluting to lower levels, irritation is still possible in certain sensitive skin nature individuals. The proper method of treating an ear infection is to consult a doctor and follow their advice.
The popularly used home remedies to treat an ear infection are the usage of over-the-counter pain relievers, application of cold or warm compresses, usage of olive oil, sleeping consciously without applying pressure on the ear, mild neck exercises that do not aggravate the condition and the usage of ginger.
The usage of olive oil for earaches and ear infection is a commonly used folk remedy. There's no specific scientific evidence to prove that olive oil drops in the person's ear canal during infection can improve the ear pain. But many patients report that dropping a few warm drops of olive oil in the ear canal is moderately effective and soothes earache.
The first best thing you should do is seek proper consultation from a doctor of ENT Speciality. The doctor will prescribe you antibiotics and painkillers to treat the pain. Timely intake of medicines as prescribed and the application of a warm cloth or warm water bottle to the affected ear can increase the speed of recovery from an ear infection.
An ear infection usually resolves on its own even without proper treatment. However, due to the complications, if left untreated, people would always need medical attention. With appropriate antibiotic treatment, ear infection resolves in two to three days if not complicated. If the infection has already been complicated, consult the recovery time would prolong up to 6 weeks or more.
When patients affected by ear infection do not become normal with antibiotic treatment, those patients might have been affected by antibiotic resistance in them. In these patients, it is essential to treat with stronger antibiotics for which bacterias are not resistant to.
Certain symptoms produced during an ear infection indicate the need of serious medical attention. Those symptoms include fever even with the administration of antibiotics and antipyretics, and the other sign is visible drainage from the ear that indicates severe infection. When you encounter these two symptoms in adults, it is essential to avoid home remedies and immediately rush to a doctor.
Sometimes, even after proper antibiotic treatment, the infection resolves, but some amount of fluid is leftover in the middle ear. This condition has been termed as the middle ear effusion. The doctor would have to insert a tube known as a tympanostomy tube to drain the fluid clogged to treat this condition.
The etiology of an ear infection can be differentiated as bacterial or viral with the help of the color of drainage or fluid clogged in the middle or inner ear. A viral infection's drainage is usually watery in nature and white in color. While a bacterial infection's drainage is greenish-yellow in color, and it is quite thick.
The middle ear infections in adults are very commonly treated by using Antibiotics that can be taken either by oral route or topically as ear drops. Other treatments involved are prescribing pain relievers and nasal decongestants in middle ear infection, antihistamines, and nasal steroids as sprays.
Several techniques can be used to unclog ear after an episode of ear infection. It includes swallowing that leads to the eustachian tube's opening, yawning, Valsalva maneuver, Toynbee maneuver, warm compress, properly prescribed nasal decongestants, and nasal corticosteroids.
In most people, the fluid behind the eardrum resolves on its own. But in some people, it remains clogged there. So, those patients need immediate medical attention to drain the liquid with the help of a minor procedure by the otolaryngologist.
Antibiotic drops that usually contain Amoxicillin is generally good for an ear infection caused by non-drug resistant bacteria. However, a proper medical examination by an otolaryngologist and prescription is mandatory since they can cause side effects.
Initially, oral or topical antibiotics, painkillers, sedatives like Diazepam, and decongestants can be given. If the inner ear fluid does not resolve with medical treatment, surgical drainage of the fluid is warranted. You might require medical help.
If the affected person's ear wax is too hard, the topical ear drops applied may not be able to clear and enter the ear canal adequately. This leads to symptoms such as temporary loss of hearing, discomfort while sleeping and during routine work, irritation or pain inside the ear canal and the external ear, dizziness, and tinnitus.
If an ear infection is left untreated even when noticing warning signs such as ear drainage and fever, there are chances for the infection to get prolonged. It might start invading the bones of the skull, and in a worst-case scenario, it can lead to the meningitis of the brain.
Last reviewed at:
04 Nov 2019 - 5 min read
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