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A Guide to Ear Infections

Ear infections tend to occur in children far more often than they do in adults. However, when they do occur in adults they tend to be more serious, take longer to treat, and are often signs of a more complex health problem. Adults with ear infections should monitor their symptoms closely and visit their doctor to seek treatment.

Symptoms of ear infections

Ear infections can affect the inner ear, the middle ear, or the outer ear and symptoms vary depending on which part of the ear is infected.

Symptoms of inner ear infections include:

– Ear pain
– Dizziness
– Nausea and vomiting

Sometimes inner ear infections are actually inflammation of the tissue in this area. Problems with the inner ear can sometimes be signs of more serious health conditions such as meningitis.

Symptoms of middle ear infections include:

– Earache
– A sense of fullness in the ear
– Reduced hearing
– Fluid draining from the ear
– Fever

‘Otis media’ is the official name of a middle ear infection. The fluid becomes trapped behind the eardrum which causes it to bulge and cause pain.

Symptoms of outer ear infection include:

– Itchy rash
– Pain and tenderness
– Redness
– Swelling

‘Otis externa’ s the official name of an outer ear infection. The outer ear is the portion between your eardrum and the entire ear lobe.

What causes ear infections in adults?

Bacterial infections are often the cause of ear infections, but these can occur in different ways. Middle ear infections often occur as a result of a respiratory problem such as a cold. The infection moves from the back of the throat and nose to the ears via the eustachian tubes, which are responsible for regulating the air pressure in the ear. Infections cause the eustachian tubes to become irritated and swell, and this swelling inhibits proper draining of fluid. The fluid then builds up against the eardrum.

Outer infections usually occur as a result of water remaining in the ear after bathing, showering or swimming. That’s why outer ear infections are often referred to as ‘swimmer’s ear’. Moisture, in combination with warm temperatures, is a breeding ground for bacteria and this is how the infection begins. It’s also possible to develop an outer ear infection by scratching or irritating the lining of the outer ear by putting objects or your fingers into your ear.

Who is most at risk of an ear infection?

Ear infections are particularly common in children because the eustachian tubes are smaller than in adults and in a more horizontal position which can inhibit the draining of fluid. When it comes to adults, those who have particularly small eustachian tubes, or those who have not developed a significant slope of the eustachian tubes, are at increased risk of ear infections.

People who smoke or who are around second-hand smoke regularly are also at a higher risk of ear infections. Those with allergies are also at risk. Respiratory infections and colds also increase the risk of ear infections.

When should I see a doctor for a suspected ear infection?

Mild ear infections often resolve without any treatment within a few days. If you are experiencing earache and no other symptoms, you can wait a couple of days before seeing a doctor to see if the issue clears up by itself. If the pain persists, you develop a fever, are having hearing problems, or you notice fluid coming from the ear, you should visit a doctor as soon as possible.

How is an ear infection diagnosed?

Your doctor will first ask you about your symptoms and your medical history. Then, they will look inside the ear using a handheld device called an otoscope. This has a light and a magnifying lens to help the doctor check the appearance of the outer ear and the eardrum.

Sometimes pneumatic otoscopes are used to check the function of the eardrum. These emit a puff of air into the ear. When the air connects with the eardrum, it should make the eardrum move. If the eardrum barely moves this is a sign that there is fluid pressing against it from the middle ear and is a sign of a middle ear infection. If the eardrum moves easily, it’s likely that the middle ear is unaffected.

Sometimes tympanometry is performed to assess the health of the ear. This is a test that measures the movement of the tympanic membrane – a thin layer of tissue that separates the inner and outer ear. Hearing tests may also be performed if it seems that the ear infection has caused hearing loss.

How are ear infections treated?

Middle and outer ear infections often require antibiotics to tackle bacterial infections. These may be taken orally or they can be administered directly to the site in the form of ear drops. Anti-inflammatory drugs and painkillers – usually those which can be purchased over the counter – are often recommended to manage pain and inflammation.

With middle ear infections, nasal steroids, decongestants and antihistamines can be a helpful way to manage discomfort if you are still experiencing symptoms of allergy, cold or respiratory problems.

Autoinsufflation is a technique that can help to clear the eustachian tubes. Pinch your nostrils closed, close your mouth, and gently exhale. This pushes air through the eustachian tubes and can help to drain fluid.

With outer ear infections, it’s important to keep the outer ear clean. Anti-inflammatory and antimicrobial medications may be prescribed.

If a viral infection is the cause of the ear infection, it is often simply a case of waiting for the body to control the infection. Symptoms of irritation can be managed with some of the techniques described above. Specialist treatment might be necessary depending on what type of virus is to blame.

What is the outlook for ear infections in adults?

Provided that an ear infection is treated in good time, there shouldn’t be any serious complications. Leaving an infection untreated for long periods of time could lead to the infection spreading and affecting other parts of the head. There’s also a risk of permanent hearing loss. It’s important to consult a doctor quickly if you have symptoms that don’t resolve within a couple of days.

How can ear infections be prevented?

To avoid ear infections you should keep the outer ear clean with gentle washing and careful use of cotton swabs. Be sure not to push cotton swabs too deeply into the ear canal. Always dry the outer ear carefully after swimming showering or bathing.

Don’t smoke and avoid exposure to second-hand smoke as much as possible. If you have allergies, keep on top of your symptoms by using appropriate allergy treatments and avoiding triggers.

Always wash your hands thoroughly to minimise the risk of contracting a cold or other respiratory infection. Make sure your vaccines are up to date to minimise the risk of contracting a viral infection.