Tag Archives: ear infection

Help For Chronic Ear Infections In Infants

ear infection infantEar infections, a fairly common occurrence in infants, are caused when there is an inflammation of the middle ear which is the cavity behind the ear drum.  When an ear infection does not heal in time or if the infection continues to reoccur (recurring), it is said to have become chronic. Chronic ear infections are called chronic otitis media.

What causes Chronic Ear Infections

The middle ear produces secretions which usually drain out through the eustachian tube to the throat. The eustachian tube is also critical for maintaining airflow through the ear and equalizing air pressure, which is essential for balance. When the fluids don’t drain properly, the bacteria present in the fluid gives rise to an infection.

Children are more likely to suffer from ear infections because the tubes are smaller and at a similar horizontal level hampering drainage, most often when the tubes are swollen or blocked with mucus from other illnesses like the flu. The ear infections typically occur with regularity in children under the age of 3 years.

Treatment of Chronic Ear Infections In Children

Doctors today usually have a wait-and-watch approach towards ear infections in infants with symptomatic relief since the infection often clears up on its own. When this condition continues, specific treatment for the infection needs to be undertaken.

For treating chronic infections, the doctor may prescribe a course of antibiotics.  When the infection fails to responds to the antibiotics, fluid builds up in the middle ear remains for longer time or hearing loss begins , a minor surgical procedure  (Myringotomy)is advised.

Myringotomy the surgery is especially recommended for infants since having persistent fluid in the ear might impact their hearing and speech development.

Under this surgery, a small ventilation tube or grommet, made of metal, plastic or Teflon, is placed in the eardrum to help drain the fluid. The tube releases pressure and acts as a vent until the eustachian tube returns to normal functioning.

Myringotomy is simple, low risk and takes less than half an hour. The surgeon makes a small incision in the eardrum, drains the liquid and then places tiny tube connecting the middle ear and the outer ear. The surgery is usually done in both ears and is called bilateral myringotomy.

The surgery significantly reduces the pain, the severity of symptoms experienced, and over time reduces the infection and its reoccurrence. Any loss in hearing is often restored. The tubes, which are invisible, stay for six to nine months and usually fall out by themselves.  At times, the infection reappears in which case the procedure would need to be repeated.

If left untreated for long, chronic ear infection may, in addition to causing hearing loss, also affect other areas of the ear such as the small bones in the middle ear or the eardrum itself. Surgical procedures are also needed in these cases to repair them.

Advertisements

What causes Ear Pain – How to get relief?

Edited my old blog post  ear pain

Earache (or Ear pain) in adult and children is one of the most common reasons for visiting ENT specialist and common reason my clinic gets calls on the helpline during Sundays, nights and other emergencies.  

The most common cause of ear pain is swelling or infection within the ear itself and diagnosis is simple. However, sometimes the cause is not in the ear, but in remote areas, known as referred earache. Therefore, finding out the cause of referred ear ache is real challenge and requires thorough examination by ENT doctor.

ear-pain treatment by ENT

 Causes of Ear Pain-

Common causes of earache are Outer ear infection (otitis externa), Middle ear Infection (acute otitis media), eustachian tube blockage and impacted wax.  

  1. Causes of ear pain within the ear
  •  Outer Ear and Ear-canal– Outer ear canal infection (Otitis externa), impacted wax, boil, Herpes Zoster
  • Middle ear– Infection (Acute otitis media), Eustachian tube blockage, Glue ear, travel by flight
2. Causes of ear pain outside the ear (Referred Earache)– 
  • Carious tooth, impacted wisdom tooth
  • TMJ (Jaw joint) disorder
  • Oral cavity and tongue-ulcers
  • Mumps/ Parotitis
  • Base of tongue- ulcer, tumor
  • Sore throat (Pharyngitis), tonsillitis, after tonsillectomy surgery
  • Elongated styloid process stretching nerve

  Common reasons and treatment of Ear Pain:

External ear infection (Otitis Externa)– Moisture may be trapped inside the canal while bathing or injury may occur in the skin of the ear canal while using ear buds to clean the ear. Consequently outer ear and ear canal infection develops.  Further, it may lead to fungal infection of the skin of outer ear.

Ear pain of otitis externa worsens on touching the ear and there may be swelling of the ear and blocked ear feeling.

Treatment Outer ear infection is treated with combination antibiotic and steroid ear drops for 7-10 days.

If ear swelling is severe a wick/ear dressing soaked with ear drops or ointment is placed in the canal. Oral antibiotics and analgesics are prescribed.

Furthermore if pus accumulates, incision and drainage may be required.

Impacted wax and foreign bodies–  Ear wax is not a disease rather it makes a protective layer in the ear canal. It may be a reason of ear pain; also attempts to clean the wax at home may hurt the skin, as a result ear infection develops.

Removal of Impacted ear wax causing obstruction and ear foreign bodies is done by an ENT Specialist by instruments or syringing.

If wax is hard then wax-softening ear drops may be prescribed for 5-7 days and ear cleaning is done after wax becomes soft.

Eustachian-tube block and glue ear Eustachian tube connects the middle ear with the nasopharynx. It helps with ventilation of the middle ear and drainage of fluid from the middle ear.

Cold, allergy, sinusitis, adenoids or sore throat may cause blockage of the tube therefore resulting in ear pain.

Tube blockage creates negative pressure in the middle ear, which in turn leads to fluid accumulation in the middle ear (Glue ear). Subsequently, increasing pressure in the middle ear may cause pain in the ear.

Treatment of Eustachian tube blockage is oral decongestants and nasal drops. Antibiotics may be given for glue ear.

If the fluid persists for more than 3 months, then a tiny tube (Grommet) may be placed into ear drum.

Otitis media– Otitis media is infection of middle ear which often spreads from cold, flu, sore throat or allergy.  

Treatment -Visit to an ENT clinic is required for proper diagnosis and suitable antibiotics prescription by an ENT doctor. Additionally pain killer, oral or nasal decongestants and antibiotic ear drops may be advised.

  Home remedies for ear pain-

  •  You can apply a cold pack or warm compresses to the ear to reduce pain.
  • Some safe over the counter pain-relievers can be used to ease the ear pain.
  • Do not use ear buds/q tips to clean the ear.
  •  Avoid putting oil, water or any other thing in the ear

Earache may be because of a myriad of reasons. Most common causes are impacted, wax, minor injury while ear cleaning, Eustachian tube blockage and ear infection due to cold.

If Ear pain is severe, continuous or associated with hearing problem, dizziness, headache, fever or is simply unexplainable you should visit your ENT specialist for timely treatment.

What to do if you have piercing /shooting ear Pain?  —Contact ENT clinic, Vashi, Navi Mumbai

 

Proper Way Of Using Ear Drops

Sometimes in our opd we keep patients aside and talk about ear drops (we means ENT specialist and Patients relatives ) and this talk is very frequent next only to how to clean our ear).

People having minor itching in the ear to the people hearing less- everybody want to quick fix the things with magical ear drop. If I mildly, jokingly or sometimes with force refuse the request to write the ear drops for relatives there is always a helping chemist to amuse them with the one perfect for the need.

So there are things which really don’t need an ear drops but at times it is absolutely necessary to talk about ear drops not to just prescribe the one.

Almost every one will agree that to be effective medicine should reach to the site of infection, so ear drops must also be delivered to the site of infection which is external ear canal in case of otitis externa & wax and middle ear in case of otitis media. Almost all cases of ototopical therapy failure are due to inadequate drug delivery.

Topical drug delivery can be improved in a number of ways–

Steps followed by the ENT professionals-

Hands should be cleaned with disinfectant.

Careful cleaning of ear (aural toilet) is prerequisite. The external auditory canal should be mopped dry prior to instillation of ear drops.

If too much of thick secretion is present irrigation of the external auditory canal with a small bulb syringe can be done before instillation of ear drop.

In case of refractory acute otitis media with tympanostomy tube fenestrated otowicks may be used to allow drainage and ventilation of the middle ear. Ear wicks of ribbon gauze may also be used in case of otitis externa.

In cases of failure to respond to drug health care provider should always keep in mind the possibility of diabetes, mastoiditis, cholesteatoma or MRSA ( methcillin resistant ) or immunocompromized status.

Steps to be explained to the patients

1. Wash hands with soap and water.

2. Clean outer part of the ear very gently ( do not use cotton buds inside the canal)

3. Shake the bottle well for 10 seconds to thoroughly mix

4. The patient should preferably be lying down with the affected ear up

5. Ear should be gently pulled backward and upward to straighten the canal to provide a linear path into middle ear (child younger than 3 years of age, pull backward )

6. Instill the number of drops in the ear as recommended.

7. Shake the ear and by one finger repeatedly press and release the tragus (small elevated part in front of the ear) to help better delivery of ear drops.

8. Keep the treated ear in the upright position for an average of 5-10 minutes (the longer, the better) after ear drops are instilled.

One thing I never fail to warn my patient with ear wax not to try to clean the wax by themselves after putting the drops however tempting it may be as wax may be further pushed inside and become impacted.

In case you experience pain or giddiness following an use of ear drop report to your doctor.