The ear is one of the sense organs with the function of hearing. The ear is made up of the external, middle, and inner portions. The outer ear is called the pinna and is made of ridged cartilage covered by skin. Sound passes through the pinna into the external auditory canal, a short tube that ends at the eardrum.

Ear infection can develop at any given time. An ear infection can affect the inner ear or outer ear. Basically, there are three main types of ear infections. The three types are:

Middle ear infections (acute otitis media (AOM).  A middle ear infection is an infection just behind the eardrum (tympanic membrane) with pus trapped in the adjacent hollow cavity (middle ear space) of the facial bone. Middle ear infections frequently are a complication of the common cold in children. Most middle ear infections are caused by viruses and will resolve spontaneously.

Inner ear infections: (otitis media with effusion-OME): Inner ear infections are caused by a virus. These “infections” are more accurately characterized as inflammation of the structures of the inner ear Since these structures affect hearing and balance, inner ear infections cause symptoms such as ringing of the ears (tinnitus) or dizziness and balance disruption (vertigo).otitis media with effusion (OME)

Outer ear infections (otitis externa) also known as swimmer’s ear. Swimmer’s ear is an infection of the outer ear and ear canal due to bacteria growing in a wet, dark environment. This infection usually is due to bacterial infection of the skin tissue covering the ear canal. Excessive immersion in water or injuring the ear canal by putting things in it (such as using cotton swabs in the canal to remove earwax) makes you more likely to develop an outer ear infection.

Ear infection can affect an individual but, children are at high risk of having ear infections. Also, certain risk factors or exposures can increase the risk for ear infections. They are:

  • Age: Children younger than age 3 are more susceptible to ear infections.
  • Family history: Children with parents who had frequent ear infections have a higher risk
  • Allergies and colds: Stuffy noses may also lead to more frequent ear infections.
  • Birth defects and medical conditions: Some underlying medical conditions such as immune deficiencies or craniofacial anomalies can cause ear infections.
  • Bottle-fed babies or babies who use a pacifier: Babies are especially more susceptible if fed while lying down. They more likely to get ear infections in their first year.
  • Weakened immune systems and previous history: Children with an ear infection before six months of age have a higher risk for future ear infections. Persistent fluid behind the ears also makes children more likely to get ear infections.

The symptoms of the three different types of ear infection share similarities. The most common symptoms of AOM are earache and fever, hearing loss, headaches, drainage from the ear, pain in the ear, and a feeling of fullness in the ear.

In some children who may not be able to describe the situaton, you may notice they are fussy, cry excessively, have trouble sleeping and have a reduced appetite. Pus or blood might drain from the ear if the ear drum has burst.

Otitis externa has symptoms that are very similar to middle ear infections, though people may also experience itchiness and pain to the outer part of their ear.

Otitis media with effusion happens when fluid stays trapped in the middle ear. OME may not present any symptoms and will often go away without notice.

An ear infection can be tested by examining the ears, throat and nasal passages at the physician’s office with a small, lighted instrument called an otoscope. An infected ear may have areas of dullness or redness or there may be air bubbles or fluid behind the eardrum. The doctor may also use a pneumatic otoscope, which can detect how much fluid is behind the eardrum.The doctor will also examine the throat and sinuses and see if the patient has any recent cold or allergy symptoms.

Although ear infections are usually caused by bacteria, and antibiotics are often prescribed, neither OME nor AOM should be treated with antibiotics at the initial onset.

Children from two months to 2 years with non-severe illness should be placed on observation for the initial 48 to 72 hours.  Antibiotics, specifically amoxicillin, could be prescribed if illness does not improve after the observation period. A standard 10-day course is recommended for younger children and for children with severe illness; whereas a five- to seven-day course is appropriate for children 6 and older with mild to moderate illness.

Unlike OME and AOM, otitis externa will usually require antibiotic treatment. Corticosteroids can also be used for reducing itching and inflammation.

In all types of ear infection, pain relievers like acetaminophen (such as Tylenol) or ibuprofen (such as Advil) can help reduce pain and fever.

Those with recurrent ear infections behind the ear drum and patients with fluid behind the ear drum for a few months are candidates for ear tube placement.

Most ear infections are caused by viruses. Active lifestyle can help in preventing an ear infection. One of the ways to prevent ear infections is to be up to date on the recommended vaccinations, avoid smoking/being around smoke, vigilant hand washing particularly during the cold and flu season, avoid touching the ears with sharp objects and as well as with dirty hands. Adequate rest and a healthy and balanced nutrition are important as well.

Touching the ears with dirty hands or sharp objects should be avoilded.

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