Ear infections can be caused by a bacterium, virus, or fungus. Pain in the ear, reduced hearing, fever, and fluid draining are some of the symptoms.

There are three main types according to the location: Inner ear infection, middle ear infection, and outer ear infection. The inner and outer ear infections are called labyrinthitis and otitis externa, respectively.

The middle ear infection is further classified into otitis media and otitis media with effusion.

Depending on the location of the ear infection, the causes vary. Otitis externa is caused due to moisture in the external auditory canal after swimming.

Otitis media is caused when there is a blockage in the eustachian tube due to cold, swollen adenoids, and allergies. The blockages cause the fluid to accumulate inside the middle ear, leading to otitis media.

Ear infections commonly affect children. Children visiting daycare centers, being bottle-fed, and suffering from colds are likely to get this condition.

Secondhand smoke is a risk factor for ear infections. Adults who smoke are also at risk of suffering from an ear infection.

The complications of ear infection are ruptured eardrums, mastoiditis, temporary hearing loss, meningitis, and cholesteatoma. Hearing loss can lead to developmental delays in children.

The treatment of ear infection includes antibacterial, antifungal, or antiviral medications. For otitis media, myringotomy is a surgical procedure done to drain the accumulated fluid.

To prevent this condition you should keep your ears clean and dry. Keeping away from secondhand smoke and avoiding smoking can also prevent ear infections from developing.

Symptoms of outer ear infection

• Pain in ear
• Redness and swelling in the ear canal
• Fluid drainage

Symptoms of middle ear infection

• Earache
• Fever
• Reduced appetite
• Disturbed sleep
• Fluid draining from the ear; it can be colorless, yellow, or bloody
• Problems with hearing

Symptoms of inner ear infection

• Vertigo
• Dizziness
• Earache
• Nausea

Types

Outer ear infections

• Otitis externa

Otitis externa, also known as the swimmer's ear, is an outer ear infection caused by bacteria or fungal growth. The external auditory canal becomes inflamed in this condition.

Middle ear infections

Middle ear infections are further classified into:

• Acute Otitis media

Acute otitis media is an inflammatory disorder of the middle ear. It can be caused by viruses or bacteria.

• Otitis media with effusion

Otitis media with effusion is a condition in which there is fluid in the middle ear without an infection.

Inner ear infections

• Labyrinthitis

Labyrinthitis is an inflammatory condition in which the membranous labyrinth of the inner ear becomes inflamed due to infection by bacteria, viruses, or a fungus.

Causes of outer ear infection

Otitis externa is caused due to bacteria or fungi growing in the moisture in the outer ear after swimming or showering. Another reason for an outer ear infection is the damage to the skin of the ear canal due to continuous scratching, using headphones or cotton swabs.

Causes of middle ear infection

Otitis media occurs when there is swelling or blockage in the eustachian tubes. Eustachian tubes are the passage connecting the middle ear to the pharynx.

Blockage can be due to:

• Swelling of adenoids
• Upper respiratory infections
• Allergies
• Sinus infection

Eustachian tubes are responsible for keeping the air pressure equalized and for draining the fluid from the ear. Due to a blocked eustachian tube, fluid is unable to drain, leading to a build-up of fluid inside the middle ear.

The fluid accumulating in the middle ear can become infected with a virus or a bacterium.

Causes of inner ear infection

Labyrinthitis is caused by viruses, such as herpes, measles, Epstein Barr virus, influenza, herpes virus, polio, and rubella.

Risk factors

• Age: Infants and toddlers are more prone. This is because they have a short and horizontal eustachian tube.

Another reason for their susceptibility to ear infection is that their immune system has not fully developed, yet.

• Second-hand smoking: Children and adults who are around smokers, being exposed to cigarette smoke have a higher risk of suffering from this condition.
• Allergies: People suffering from allergic rhinitis are at risk of suffering from this condition.
• Upper respiratory infection: Children or adults who are suffering from an upper respiratory infectionn are more likely to get an ear infection.
• Weak immune system: The immune system being weak is also a risk factor.
• Family history: If there is a history of ear infections in a person's family, they stand at a risk of getting this conditio.
• Daycare centers: The big daycare centers are places where there is greater exposure to viruses causing upper respiratory infections. Therefore, children who go to daycare centers are likely to get their ears infected.
• Feeding by bottles: Bottle-fed children are at risk of developing.
• Cleft palate: Children born with a cleft palate are also susceptible to suffer from an ear infection.

Complications

·        Loss of hearing

Temporary loss of hearing is a common occurrence. When ear infections keep recurring, there is a risk of becoming permanently deaf.

Hearing loss can be a source of worry for parents whose children are suffering from an ear infection. It can affect their speaking and understanding of speech.

·        Mastoiditis

Mastoiditis is a condition in which the mastoid, a bone present behind the ear, becomes infected and develops inflammation. Repeated infections can lead to the mastoid getting infected.

It is characterized by the area where the bone is located becoming red or swollen, swelling in earlobes, and headache. If mastoiditis is not treated, it can cause loss of hearing, brain abscess, and meningitis.

·        Ruptured eardrum

Rupturing of an eardrum is a common complication. The build-up of fluid due to the infection can lead to rupturing of the eardrum, creating a small hole.

This small hole heals itself within 2 weeks or so.

·        Meningitis

Meningitis is an uncommon but serious complication. It happens when there is a spread of ear infection to the meninges; meninges are layers present outside the brain and spinal cord.

Meningitis can cause serious damage to the brain. It needs to be treated immediately after the affected person notices its signs and symptom, such as severe headache and pain in the neck when it is bent over.

·        Cholesteatoma

Cholesteatoma is an abnormal growth of skin cells in the area behind the eardrum. It is a condition that can cause damage to the eardrum and bones of the middle ear, leading to hearing loss.

Cholesteatoma is a serious complication that needs to be treated through surgery.

When to see a doctor?

Following are the situations when the doctor should be visited:

• Symptoms are failing to improve in a period of 3 days
• There is severe pain in the ear
• There is a high fever above 100 degrees
• Pus or blood containing fluid is getting discharged from the affected ear
• child who is younger than 6 months
• The affected person is experiencing swelling behind or under the ear
• There is a development of additional symptoms, such as headaches, stiffness in the neck, drowsiness, and vomiting.
• if a child suffering from pain and showing personality changes, such as crying,or shwoing tantrum or stop eating.

Diagnosis

·        Otoscopy

Doctors perform otoscopy on the patient to examine the outer ear, eardrum, and middle ear. An otoscope is an instrument used and it has a magnifying glass and a light to help the doctors in the examination of the ear.

There is another otoscope that releases air into the ear called a pneumatic otoscope. The movement in the eardrum after air hits it helps the doctor to know if there is a build-up of fluid behind the eardrum due to a middle ear infection.

·        Tympanometry

Tympanometry is another procedure that helps with the diagnosis. In this procedure, a probe is placed inside the ear, sealing the ear canal.

The response of the eardrum to the air pressure inside the ear is recorded on the tympanogram.

·        Acoustic reflectometry

Acoustic reflectometry is another test done for the diagnosis of ear infection. In this test, doctors measure how much sound is absorbed or reflected by the eardrum.

A normal eardrum absorbs a greater percentage of sound waves hitting it. When there is fluid due to an ear infection, it puts pressure on the eardrum, leading to most of the sound getting reflected.

·        Hearing test

A hearing test is performed by an audiologist to check if there has been a loss of hearing due to an ear infection.

·        Tympanocentesis

Tympanocentesis is a procedure in which fluid inside the middle ear is collected using a small tube. The fluid sample is sent to the laboratory to detect the type of bacteria or virus present.

Treatment for ear infections

Mostly resolve on their own but, if they persist after 3 days, then doctors start the treatment.

Outer ear infections treatment

This type is mostly caused by bacteria or fungi, antibacterial or antifungal ear drops or sprays are prescribed to treat the infection, respectively.

Pain relievers, such as ibuprofen and acetaminophen, help in relieving the pain.

Middle ear infections treatment

Medication

• Antibacterial

Antibiotics are prescribed by doctors if a bacterium is causing the middle ear infection. These antibiotics are given orally or through ear drops.

• Pain relievers and anti-inflammatory drugs

Over-the-counter pain relievers are taken for the pain. Acetaminophen and ibuprofen are the two pain relievers taken to reduce pain.

• Decongestants, antihistamines, and nasal steroids

If the patient is having symptoms of allergy or cold, they are asked to take decongestants, antihistamines, or nasal steroids.

Surgical procedures

• Myringotomy

Myringotomy is a surgical procedure in which a surgeon cuts an incision in the eardrum. Through the incision, fluid starts draining, which alleviates the pain caused due to infection.

Sometimes, the incision is kept open and a ventilation tube is placed into it to prevent the build-up of fluid. This tube keeps draining the fluid until the infection resolves.

• Adenoidectomy

If swollen adenoids are the reason behind the blockage of the eustachian tube, adenoidectomy is performed to remove the adenoids.

• Inner ear infections treatment

To treat the infections of the outer ear, antiviral or antibacterial medications are prescribed to the patient. The doctor may prescribe a corticosteroid, such as prednisolone, to reduce the inflammation.

Home Remedies

The home remedies are:

• Warm or cold compresses on the affected air to relieve the pain.
• Naturopathic ear drops can also be used at home.
• A sleeping position in which the affected ear is up can help in managing pain.
• Doing neck exercises to reduce the pressure inside the ear canal.
• Ginger oil can be applied to pinna as it has anti-inflammatory properties.

Preventions for ear infections

It can be prevented in children and adults by:

• Washing ears to keep them clean and tidy.
• Carefully using cotton swabs.
• Drying ears after swimming or showering
• Avoiding irritants that can trigger allergic reactions and taking medicine for allergies
• Avoiding smoking
• Avoiding being around people who smoke to prevent inhalation of secondhand smoke.
• Maintaining a distance from people who are suffering from an upper respiratory infection.
• Ensuring that hands are thoroughly washed and cleaned.
• Sending children to smaller daycare centers
• Breastfeeding children instead of using bottles to feed them
• Keeping the child upright while feeding them with a bottle
• Keeping vaccination of children up to date