November 29, 2011

Ear Infection : Causes And Treatments

Ear infection is one of the nagging and painful diseases in the world. You cannot hear properly, there is continuous headache or pain in the ear or there may be nausea and vomiting. Ear infection is also very common in children. As there are three parts in our ears – the external ear, middle ear and the inner ear – ear infection is also categorized according to these parts.

External ear is comprised of the pinna (fan shaped part, extreme end of the ear), the ear canal and the tympanic membrane. Ear infection in the external ear is called ‘Otitis externa’. This is the commonest type of ear infection. There is inflammation of either the pinna or the canal of the ear. Bacterial infection is common for both the child and adult age group. There may be fungal infection (candidial infection) of the skin of the ear canal (Otomycosis). This is an extremely painful condition of the ear; even pressing the outer ear can cause severe pain (diagnostic point). Swimmers can be affected frequently by the bacteria present in contaminated water. Ear wax can lead to outer ear infection, if gets impacted and secondarily infected by bacteria.

Ear infection involving the middle ear is called ‘Otitis media’. This is common in early childhood. There is a connection from the nasopharynx and the middle ear called ‘Eustachian tube’. This maintains the barometric pressure balance between the ear and the outer environment. In any case, if bacteria or virus can get entry to the middle ear through this tube, it can cause severe damage. The acute otitis media is mainly seen in children and is viral in origin. It usually follows if a child has recurrent upper respiratory tract infection. It is self-limiting and does not cause much harm. But sometimes the infection can reach to the meninges (outer covering of the brain matter) producing meningitis. It is a life threatening condition.

In children, effusion can be present in the middle ear infection and can be seen through examination of the tympanic membrane. This condition is called ‘Glue ear’ or secretory otitis media. This is again viral in origin.

The most dangerous ear infection is, by far, the chronic suppurative otitis media (CSOM). It may be associated with perforation of the tympanic membrane causing deafness. Spread of the infection to the meninges may cause meningitis and extension to the small bones present in the middle ear cavity (maleus, incus and stapes) will produce pain and some degree of deafness.

Infection of the inner ear is not very common compared to the external and the middle ear cavity. However, ear infection can do occur in the cochlea and the vestibular apparatus present in the inner ear. Inner ear infection usually follows infection in either the external or the middle ear.

Pain in the ear is typically present in all otitis externa, but not always in otitis media. There may be some degree of deafness in both the occasions, which again depends upon the severity and place of ear infection. It is usually associated with different degrees of fever, body ache, nausea and vomiting. Ear infection in a child can make him irritable and crying.

Diagnosis is dependent upon complains and investigations like clinical examination of the ear, X-ray PNS and skull, CT scan and MRI scan of the head and neck.

Treatment of ear infection is done by antibiotics and proper pain killers. The choice of antibiotic will vary depending upon the suspected cause of infection.