Thursday, April 11, 2024

Chronic Ear Infection In Adults

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Balloon Dilation Of Eustachian Tubes

Ear Infections? Do This! | Dr K & Dr Wil

The eustachian tubes that connect the middle ear to the back of the nose are typically closed until you chew, swallow, or yawn. If you try to pop your ears with a yawn, for example, the popping sensation is the opening of the eustachian tubes.If you are regularly unable to pop your own ears when clogged, or if conservative treatment methods like medication dont relieve your chronic ear infection symptoms, you might want to ask Dr. Franklin about balloon dilation of the eustachian tubes.

Also sometimes called a balloon eustachian tuboplasty, this simple and safe procedure can be performed on children as well as adults.

In this minimally invasive procedure, a balloon catheter is inserted through the nostrils into the eustachian tube and inflated to gently dilate the tube, which relieves eardrum pressure and allows fluid to drain from the ear.

The balloon is then deflated and removed. No tissues are cut and nothing remains in the eustachian tube. For these reasons, many patients who experience recurring middle ear infections are beginning to prefer balloon dilation to the more traditional ear tube surgery.

Can Adults Prevent Ear Infections

For adults, preventing ear infections often includes routine best practices for good health. You can help prevent ear infections by:

  • getting your annual flu shot
  • practicing good handwashing and hygiene techniques
  • never using cotton swabs in your ear
  • routinely disinfecting earbuds and hearing aids
  • getting enough rest, eating a balanced diet, and exercising

What’s The Difference Between The Middle Ear Infections We Get As Children Versus The Middle Ear Infections We Get As Adults

Dr. Wang: The underlying causes are usually different. They are more frequent in children because their shorter, more horizontal Eustachian tubes are more likely to get blocked. Also, their adenoids are larger compared to the rest of the throat and can interfere with the opening of the Eustachian tubes. And finally, children’s immune systems are immature and colds and viruses are often passed around day care and school.

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Any Other Recent Innovations In The Treatment Of Ear Infections

Dr. Wang: Theres a procedure Ive been doing for a few years called Eustachian tube dilation. Using endoscopic guidance through the nose, you insert a balloon in the Eustachian tube, blow it up and leave it there for up to two minutes. This can address the Eustachian tube dysfunction that leads to middle ear infections. Ive found it works in about 50% of patients, so it doesnt work for everyone. But its so noninvasive, its a good place to start with certain patients who are good candidates for it. Theres also a new drug that is almost like a gel that you can squirt into the ear canal. It slowly dissolves and may be easier to get into those really clogged areas than traditional drops.

How Do Cotton Swabs Cause Outer Ear Infections

Hearing Loss

Dr. Wang: Earwax is a natural way for your body to trap and slow the growth of bacteria that may have entered your ear. When you apply cotton swabs, you often wind up pushing earwax further into the ear canal. This impacted wax can then trap water or moisture deep in the canal, setting you up for an infection.

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What Are The Harms Of Fluid Buildup In Your Ears Or Repeated Or Ongoing Ear Infections

Most ear infections dont cause long-term problems, but when they do happen, complications can include:

  • Loss of hearing: Some mild, temporary hearing loss usually occurs during an ear infection. Ongoing infections, infections that repeatedly occur, damage to internal structures in the ear from a buildup of fluid can cause more significant hearing loss.
  • Delayed speech and language development: Children need to hear to learn language and develop speech. Muffled hearing for any length of time or loss of hearing can significantly delay or hamper development.
  • Tear in the eardrum: A tear can develop in the eardrum from pressure from the long-lasting presence of fluid in the middle ear. About 5% to 10% of children with an ear infection develop a small tear in their eardrum. If the tear doesnt heal on its own, surgery may be needed. If you have drainage/discharge from your ear, do not place anything into your ear canal. Doing so can be dangerous if there is an accident with the item touching the ear drum.
  • Spread of the infection: Infection that doesnt go away on its own, is untreated or is not fully resolved with treatment may spread beyond the ear. Infection can damage the nearby mastoid bone . On rare occasions, infection can spread to the membranes surrounding the brain and spinal cord and cause meningitis.

Treating Inner Ear Infections

The inner ear is located next to the middle ear within the temporal bone. The inner ear contains the semicircular canals, which are essential to balance and equilibrium.

Inner ear infections are much more likely to be caused by a virus than a bacterial infection. They are much less common than outer ear infections or middle ear infections.

The most common inner ear infections include labyrinthitis or vestibular neuritis, which are slightly different conditions.

Labyrinthitis affects the labyrinth, which is a system of fluid-filled sacs that helps you hear and gives you a sense of balance. Labyrinthitis can cause both hearing changes and dizziness, or vertigo.

Vestibular neuritis is an inner ear infection that affects the vestibular nerve and usually causes dizziness and balance issues but no hearing changes.

There is no specific diagnostic test to identify an inner ear infection, so misdiagnosis or delayed diagnosis is common.

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Check If It’s An Ear Infection

The symptoms of an ear infection usually start quickly and include:

  • discharge running out of the ear
  • a feeling of pressure or fullness inside the ear
  • itching and irritation in and around the ear
  • scaly skin in and around the ear

Young children and babies with an ear infection may also:

  • rub or pull their ear
  • not react to some sounds
  • be irritable or restless
  • be off their food
  • keep losing their balance

Most ear infections clear up within 3 days, although sometimes symptoms can last up to a week.

If you, or your child, have a high temperature or you do not feel well enough to do your normal activities, try to stay at home and avoid contact with other people until you feel better.

Differences between middle and outer ear infections

Inner ear infection Middle ear infection Outer ear infection
Can affect both children and adults Usually affects children Usually affects adults aged 45 to 75
Caused by viral or bacterial infections Caused by viruses like colds and flu Caused by something irritating the ear canal, such as eczema, water or wearing earplugs
Affects parts of the inner ear like the labyrinth and vestibular system, and can lead to labyrinthitis Affects the eustachian tube, which connects the middle ear to the back of the nose Affects the ear canal

What Is A Chronic Ear Infection

Can Adults Get Ear Infections?

A chronic ear infection can be caused by an acute ear infection that does not completely go away or repeat ear infections. Acute otitis media is one of the most common types of ear infections. It can become chronic. Otitis media with effusion , which typically occurs in children, can also become chronic.

Otitis media with effusion can occur after an infection has cleared up but fluid remains trapped in the middle ear. When it becomes chronic, it is referred to as chronic chronic otitis media with effusion .

Acute otitis media can also lead to chronic suppurative otitis media , in which ear discharge does not go away or it keeps coming back. CSOM is considered a complication of a middle ear infection. The discharge in CSOM continues to leak out through a hole in the eardrum.

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When To See A Professional

Because ear infections are less common in adults, its wise to see a health care provider when you get an ear infection. A comprehensive evaluation provides valuable insight into the problem, and if there is an underlying issue, such as an allergy, we discuss your treatment options.

Southern ENT is a premier provider of ear, nose, and throat services in southern Louisiana. To schedule a visit with one of our top-quality providers, to get started. Our offices are located in Thibodaux, Houma, Raceland, Morgan City, New Iberia, and Youngsville, Louisiana.

What Increases Your Risk

Some things that increase your child’s risk of a middle ear infection are out of your control. These include:

  • Being 3 years old or younger.
  • Birth defects or other medical conditions, such as cleft palate or Down syndrome.
  • A weakened immune system.
  • A family history of ear infections.
  • Allergies that cause long-term stuffiness in the nose and can block one or both eustachian tubes.
  • Repeated colds and upper respiratory infections.

Other things can increase your child’s risk of ear infection. They include:

  • Being exposed to cigarette smoke.
  • Being bottle fed.

Things that increase the risk of repeated ear infections include:

  • Being in a child care centre with many other children.
  • Getting the first ear infection before 6 months of age.
  • Having persistent fluid behind the eardrum.
  • Having an ear infection in the last 3 months, especially if it was treated with antibiotics.

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Signs In Young Children

As babies are unable to communicate the source of their discomfort, it can be difficult to tell what’s wrong with them. Signs that a young child might have an ear infection include:

  • raised temperature
  • pulling, tugging or rubbing their ear
  • irritability, poor feeding or restlessness at night
  • coughing or a runny nose
  • unresponsiveness to quiet sounds or other signs of difficulty hearing, such as inattentiveness
  • loss of balance

Why Adults Get Ear Infections

Chronic Otitis Media Photograph by Professor Tony Wright, Institute Of ...

Ear infections are often considered a childhood disease. It almost seems a rite of passage for children to experience repeat ear infections. Then, around the beginning of their teenage years, it often stops entirely. By the time a person hits adulthood, it is quite common to be decades of years removed from the last time he or she experienced an ear infection. It almost seems as though it is impossible for adults to get an ear infection, right? Unfortunately, although not as common in adults as it is in children, it is still possible for adults to suffer an ear infection. In fact, around 20% of ear infections occur in adults. This begs the question, why can adults still get them?

How Adults Get an Ear InfectionAdult ear infections are just like the ear infections a person would have gotten when he or she was a child. Most middle ear infections are caused by either bacteria or viruses. A common cold, the flu, or allergy symptoms that cause congestion and swelling of the nasal passages, throat, and eustachian tubes can sometimes lead to an infection. Anything that makes the nose stuffy has a tendency to cause swelling and blockage of the eustachian tubes. Swelling from colds or allergies can keep the eustachian tubes from opening and this leads to pressure changes and the accumulation of fluid in the middle ear. This pressure and fluid will cause pain and sometimes persistent fluid can lead to an infection.

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What Are The Types Of Middle

Infections can affect the middle ear in several ways. They are:

  • Acute otitis media. This middle-ear infection occurs suddenly. It causes swelling and redness. Fluid and mucus become trapped inside the ear. You can have a fever and ear pain.

  • Otitis media with effusion. Fluid and mucus build up in the middle ear after the infection goes away. You may feel like your middle ear is full. This can continue for months and may affect your hearing.

  • Chronic otitis media with effusion. Fluid remains in the middle ear for a long time. Or it builds up again and again, even though there is no infection. This type of middle-ear infection may be hard to treat. It may also affect your hearing.

How Middle Ear Infections Are Treated

Most ear infections clear up within three to five days and donât need any specific treatment. If necessary, paracetamol or ibuprofen should be used to relieve pain and a high temperature.

Make sure any painkillers you give to your child are appropriate for their age. Read more about giving your child painkillers.

Antibiotics arenât routinely used to treat middle ear infections, although they may occasionally be prescribed if symptoms persist or are particularly severe.

Read more about treating middle ear infections

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How Is An Ear Infection Treated

Treatment for an ear infection in adults varies depending on the results of your evaluation. We can use antibiotics to treat ear infections caused by bacteria, while viral infections clear up as the virus passes.

If you have allergies, we may prescribe antihistamines or decongestants.

Over-the-counter pain relievers can be helpful in managing pain. During your examination, we may order tests to look for bacteria or a CT scan to find out if the infection has spread beyond the middle ear.

In some cases, infections that are left untreated can lead to serious problems such as hearing loss. In rare cases, surgery may be necessary to drain fluid from the ear or repair affected areas of the ear. This can help reduce recurrent ear infections.

What Are Common Causes Of Acute And Middle Ear Infection

Tiny Silver Implant Could Treat Chronic Ear Infections
  • Bottle-feeding: The position of the breastfeeding child is better than that of the bottle-feeding position in terms of the function of the Eustachian tube that leads into the middle ear. If an infant needs to be bottle-fed, it’s better to hold babies rather than allowing them to lie down with the bottle. Ideally, they should not take the bottle to bed.
  • Upper respiratory tract infection: Children often develop upper respiratory infections prior to developing this type of infection. Exposure to groups of children results in more frequent colds, and therefore more earaches.
  • Exposure to air with irritants, such as tobacco smoke
  • Birth defects: Children with cleft palate or Down syndrome are more prone to ear infections.
  • Eustachian tube problems: Any problems with the Eustachian tubes will increase the risk of infection. If the individual has allergies, he or she may have swelling and blockage of one or both Eustachian tubes.
  • Immunosuppressed: Individuals with suppressed immune response are at increased risk for ear infections.
  • Ear infections later in childhood: Children who have episodes of acute infections before six months of age tend to have more later in childhood.

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Canal Wall Down Mastoidectomy

For patients with cholesteatomas or infections that have destroyed the ear canal, a canal wall down mastoidectomy may be recommended. It is nearly always performed in conjunction with a tympanoplasty depending on the extent of the cholesteatoma. Generally, that area is filled with bone grafts and cartilage to not create a large defect in the ear canal. A bone graft may be necessary to help the ear heal property.

How Does The Eustachian Tube Change With Age

As a person ages, the Eustachian tube doubles in length and becomes more vertically positioned so that the nasopharyngeal orifice in the adult is significantly below the tympanic orifice than in a child.

The greater length and particularly the slope of the tube as it grows serves more effectively to protect, aerate and drain the middle ear.

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Why Do Infants And Young Children Tend To Have Ear Infections

The Eustachian tube, a canal that runs from the middle ear to the back of the nose and throat, is shorter and more horizontal in infants and young children than in older children and adults. This allows easier entry into the middle ear for the microorganisms that cause infection and leads to otitis media. Young children also have more immature immune systems.

The result is that infants and young children are at greater risk of acquiring ear infections than adults.

What Are The Symptoms Of Otitis Media

Otitis media

Symptoms of ear infection include:

  • Ear pain: This symptom is obvious in older children and adults. In infants too young to speak, look for signs of pain like rubbing or tugging ears, crying more than usual, trouble sleeping, acting fussy/irritable.
  • Loss of appetite: This may be most noticeable in young children, especially during bottle feedings. Pressure in the middle ear changes as the child swallows, causing more pain and less desire to eat.
  • Irritability: Any kind of continuing pain may cause irritability.
  • Poor sleep: Pain may be worse when the child is lying down because the pressure in the ear may worsen.
  • Fever: Ear infections can cause temperatures from 100° F up to 104° F. Some 50% of children will have a fever with their ear infection.
  • Drainage from the ear: Yellow, brown, or white fluid that is not earwax may seep from the ear. This may mean that the eardrum has ruptured .
  • Trouble hearing: Bones of the middle ear connect to the nerves that send electrical signals to the brain. Fluid behind the eardrums slows down movement of these electrical signals through the inner ear bones.

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How Is A Middle

Your health care provider will take a medical history and do a physicalexam. He or she will look at the outer ear and eardrum with an otoscope.The otoscope is a lighted tool that lets your provider see inside the ear.A pneumatic otoscope blows a puff of air into the ear to check how wellyour eardrum moves. If you eardrum doesnt move well, it may mean you havefluid behind it.

Your provider may also do a test called tympanometry. This test tells howwell the middle ear is working. It can find any changes in pressure in themiddle ear. Your provider may test your hearing with a tuning fork.

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