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  • Outer Ear Infection

    The Facts

    The ear is divided into three separate compartments: the inner, middle,
    and outer ear.
    The inner ear contains the balance organs and the
    nerves vital to hearing. The middle ear contains the bones that link the
    eardrum to the inner ear. The eardrum separates the middle and outer ears. The
    outer ear is simply the earlobe and a short tube leading to the eardrum.

    Infection of the inner ear is called labyrinthitis. Infection of the middle ear is called otitis media. It can cause temporary hearing loss and can progress to the inner ear if ignored. Infection of the outer ear is called otitis externa or swimmer’s ear. It’s rarely serious.

    Outer ear infections can be acute (short-term) or chronic (lasting 3 or more
    months) and are more common in children 7 to 12 years of age. Outer ear
    infections also more commonly affect people in warm and humid climates, people
    who swim, and people who use devices that protect hearing.

    Causes

    Swimming isn’t the only way to get an outer ear infection. You can
    also be infected if hairspray or other liquids get into the ear canal. The
    bacteria (and occasionally fungi) that cause an outer ear infection don’t
    necessarily live in the water. Many of them are already in the ear canal or are
    picked up in everyday life. However, water or other foreign liquids in the ear
    can provide an ideal breeding ground for them.

    You can also trap bacteria in the ear by using cotton ear swabs. The skin of
    the ear canal slowly moves outward like a conveyor belt, carrying shed
    fragments of skin away from the eardrum. Pushing a cotton swab into the ear
    goes against this process, and causes dead skin and earwax to build up.
    Occasionally, scratching the ear canal can also promote infection. This tends
    to trap moisture in the ear. Moist skin and tissue create a friendly
    environment for bacteria and allow them to multiply, causing infection.

    People with the following conditions get outer ear infections more
    easily:

    • allergies
    • eczema
    • psoriasis
    • seborrheic dermatitis (in which dandruff is the most common symptom)
    Symptoms and Complications

    The main symptoms of an outer ear infection are severe pain, itching, or
    redness in the ear and tenderness in the earlobes.

    The tissue in front of and below the ear may become swollen and tender.
    There’s often a lot of earwax and skin debris in the ear canal. More severe
    bacterial infection sometimes causes yellowish pus to drain out. This may have
    an unpleasant smell. Fungal infections can create a grey-white pus.

    Pus, wax, and skin debris may block sound waves from reaching the eardrum, causing temporary reduced hearing. This isn’t a sign of ear damage. Generally, you don’t need to worry about the infection spreading to the middle or inner ear, as the eardrum won’t let fungus and bacteria to pass through. The middle ear is usually only infected through the tubes that connect it to the throat (the Eustachian tubes). The eardrum itself is not as delicate as most people think.

    Complications of outer ear infections are extremely rare, except in people with diabetes or with weakened immune systems. One of the ear’s main ways of defending against bacteria is the acidity of earwax. Unfortunately, earwax in people with diabetes is often quite alkaline. A low level of acid in earwax encourages particularly severe infections that can spread into the surrounding bone. This is called malignant otitis externa.

    Making the Diagnosis

    A doctor will check to see if pulling the earlobe gently or pushing the tragus,
    the small flap of ear just in front of the canal opening, causes pain.
    If
    these symptoms are present, you can be pretty sure it’s an external infection
    and not otitis media. The doctor can often make the diagnosis simply by looking
    in the ear with an otoscope (an instrument for examining the ear).

    A lab culture may be ordered to identify the particular organism only if the
    first treatment recommended by the doctor doesn’t seem to be working.

    Treatment and Prevention

    A doctor will check to see if pulling the earlobe gently or pushing the tragus,
    the small flap of ear just in front of the canal opening, causes pain.
    If
    these symptoms are present, you can be pretty sure it’s an external infection
    and not otitis media. The doctor can often make the diagnosis simply by looking
    in the ear with an otoscope (an instrument for examining the ear).

    A lab culture may be ordered to identify the particular organism only if the
    first treatment recommended by the doctor doesn’t seem to be working.

    Treatment and
    Prevention

    For most outer ear infections, your doctor will prescribe an eardrop that
    contains a combination of:

    • an acidic solution to make the ear canal a less
      favourable environment for bacteria to grow
    • a steroid to reduce swelling and inflammation
    • an antibiotic or antifungal

    Your doctor will first clear the debris out of the ear canal. In severe
    cases, if the canal is partly closed by inflammation, a wick can be inserted to
    draw the eardrops in. The wick expands and holds the medication close to the
    infected area in the ear. When using eardrops, warm them to body temperature by
    holding the container in your hand for a few minutes before putting the drops
    in.

    For severe infections, antibiotics taken by mouth will be prescribed.
    Treatment of malignant otitis externa requires several weeks of antibiotics
    given into a vein.

    To help ease the pain associated with an outer ear infection, pain relievers
    such as acetaminophen*, ibuprofen, or naproxen can be used. Talk to your
    pharmacist or doctor about which pain medication is best for you.

    While you are being treated for an outer ear infection, don’t swim or fly
    and keep water out of your ear.

    To help prevent outer ear infections, it’s always a good idea to dry the
    ears thoroughly after showering or swimming. You can use a hair dryer set on
    the lowest setting. Never direct a shower jet directly into the ear canal.
    Also, don’t use cotton swabs to clean or dry the ear canal. To prevent outer
    ear infections due to swimming, wear a swimming cap or use over-the-counter ear
    drops with acetic acid or alcohol after swimming. Avoid ear plugs, as they actually
    can increase the risk of outer ear infections. If you or your child get
    recurrent infections, or if these preventative measures do not work, contact
    your doctor.


    *All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.

    All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Outer-Ear-Infection