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Earache


 Earache is very common medical problem for both children and adults. The 2 most common conditions that cause earache are infection of the outer ear (otitis externa) and infection of the middle ear (otitis media).

 Otitis externa
 Skin infection of the outer ear or ear canal
 Often occurs after swimming (commonly called swimmer's ear)
 Otitis media
 Infection of the middle ear and eardrum
 Very common in infants and children aged 6 months to 2 years
 Can also affect older children and adults

Earache - Causes


 The 2 common causes of otitis externa are trapped moisture and minor injury to the ear canal. Otitis media is caused by bacteria growing in the middle ear behind the eardrum. It often follows a cold or upper respiratory tract infection. There are other risk factors identified with increased frequency of otitis media.

 Risk factors of otitis externa
 Moisture trapped in the ear canal
 The condition commonly called swimmer's ear can occur after swimming or bathing or sometimes just from hot humid weather.
 Bacteria that cause the infection are able to grow and multiply easily in the warm moist environment.
Minor injury or scrape to the ear canal skin
 This usually happens during attempts to clean the ear with objects, such as a cotton-tipped swab or paper clip.
 The break in the skin allows bacteria to penetrate and start an infection.
Risk factors of otitis media
 Cold or upper respiratory tract infection
 These conditions cause swelling at the back of the nose where the ear normally drains. The ear is connected to the nose by the eustachian tube.
 If the eustachian tube does not function properly, fluid can become trapped behind the eardrum (serous otitis media). If bacteria grow in that fluid, then infection occurs (otitis media). Allergies

 Daycare

 Secondhand smoke exposure

 Bottle (rather than breast) feeding

 Family history of ear infections

 Malformations of the head and neck area

Earache - Symptoms


 Otitis externa

Typically, there is an earache, which can be severe.

Mild cases may have more of an itch than pain.

Touching or pulling on the ear worsens the pain.

Hearing loss

Ringing or buzzing sounds in the ear

Blocked or full sensation in the ear

Swelling of the ear

Thick drainage from the ear

Otitis media

Pain in the ear (most common symptom)

Hearing loss

Ringing or buzzing sounds in the ear

Full or plugged sensation in the ear

Fever

Occasionally, discharge from the ear (eardrum ruptures and the infected fluid drains out)

Other symptoms in infants

Vomiting or diarrhea

Irritability

Poor feeding

Poor sleeping

Earache - Treatment


 Self-Care at Home

 Any severe earache requires medical attention. Only a doctor can make the proper diagnosis of otitis externa, otitis media, or other less common causes of earache including problems that are not infectious. These diseases have similar symptoms making self-diagnosis unwise and potentially dangerous.

 Medical Treatment

 Otitis externa
 Most cases are treated with eardrops for 7-10 days.

 These drops contain antibiotic to fight the infection and, sometimes, a steroid to reduce swelling.

 The drops are placed in the ear while the person is lying on his or her side, with the affected ear up.

 The outer ear is gently pulled backwards, and the drops are placed over the opening to the ear canal.

 The ear is gently wiggled for a minute to help the drops penetrate.

 The person should remain in this position at least 5 minutes. Then a cotton ball can be placed over the ear to catch any spill.

 Sometimes a wick is placed in the canal if swelling is severe.
 Some severe cases will require an oral antibiotic as well as the eardrops.
 The person may require strong pain medication for the first few days.
During treatment and for 1-2 weeks after treatment, water should be kept out of the ear.

 Either an earplug or small cotton ball coated with Vaseline can be used during bathing.
In some cases the drainage in the ear builds up, and the infection won't clear until it is removed. An otolaryngologist (an ear, nose, and throat specialist), using special equipment, usually will remove this build-up. Otitis media
 Most cases are treated with an oral antibiotic for 10-14 days.

 In some cases a decongestant medication is helpful.

 Pain medication may be needed for the first few days.

Earache - Prevention


 Preventive measures can be very useful to decrease the frequency of otitis externa. On the other hand, otitis media is difficult to prevent. Avoid the risk factors outlined under Causes, if possible.

 Otitis externa prevention—preventing moisture in the ear
 Careful drying of the ear after swimming or bathing

 Shaking out excess water

 Holding a hair drier on low heat setting at least 12 inches from the ear

 Wearing earplugs while swimming
Homemade solution of 1/2 rubbing alcohol, 1/4 white vinegar, and 1/4 distilled water may be used for tougher cases.

 Place 3-4 drops in each ear after swimming or bathing.

 Do not use drops if there is a hole (perforation) in the eardrum or if there is a ventilation tube in the ear.

 Immediately discontinue drops if any pain occurs.
 Otitis externa prevention—preventing scrapes to ear canal
 Careful cleaning of ears to avoid scraping the ear canal.

 Do not use objects (for example, paper clips, bobby pins, or fingernails) that may tear the skin. Most people have ears that are self-cleansing, and cleaning with a cotton-tipped swab is unnecessary and potentially harmful.
 Otitis media prevention
 Avoid risk factors (for example, secondhand smoke, daycare), if possible.
Treat severe allergies.

 Avoid contact with others who have a cold or respiratory infection.
 In severe cases, a prolonged course of an antibiotic can be used as a preventive measure.



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