One of the most common childhood illnesses that every pediatrician and parent should recognize almost immediately is that of a ear infection. It is so common in fact that according to the National Institutes of Health, by the time they reach their 3'rd birthday, 5 out of 6 children will have experienced this very painful condition. Although it occurs mostly in childhood, it can actually affect adults as well. But what exactly causes an ear infection and when is it considered a chronic ear infection?
Otitis Media aka Ear Infection
Ear infection occurs when there is fluid buildup in the area known as the middle ear. Without any special equipment and with the naked eye, all that we are able to visualize of the ear is the outer portion. With an otoscope, your doctor can look into the ear canal and examine the eardrum which is the membrane separating the outer ear from the middle ear. When the eardrum is reddened and bulging, this is indicative that there might be an infection causing fluid buildup in the middle ear.
What Causes an Ear Infection?
Normally a very small amount of fluid is produced in the middle ear and is allowed to drain freely through the Eustachian tube which connects the middle ear to the upper part of the nasal and throat passage. When there is an infection from either bacteria or a virus, there can be swelling in the Eustachian tube or mucus that blocks its ability to drain thereby leading to a buildup of fluid in the middle ear.
What are the Symptoms?
Pain is one of the hallmark symptoms of ear infection in both children and adults. In very young children or infants it may be difficult to determine the cause of their crying and fussiness, but pulling or tugging at the ears is a good indicator of possible ear infection. Other symptoms of Otitis media cited by the Mayo Clinic could be:
- Fever greater than 100F
- Decreased appetite
- Drainage from the ear
- Trouble hearing
- Increased pain when lying down
- Loss of balance
Your doctor may initially recommend conservative treatment, perhaps "wait and see". But if after a few days, there is no change and perhaps a worsening of symptoms, they may prescribe antibiotic ear drops or oral antibiotics and an over the counter pain reliever. Other interventions that can decrease the chances of developing an ear infection are simple infection prevention tips such as staying up to date on vaccinations, minimizing spread of germs during cold and flu season and avoiding second hand smoke.
Acute Ear Infection Versus Chronic Ear Infection
If you have found yourself returning multiple times within the year for repeated infections, chances are you are dealing with a chronic condition. More than simply a question of treating a painful condition, if left unresolved, chronic Otitis media can actually lead to hearing loss and speech and learning deficits in children. Your family physician may now recommend that you see a doctor who specializes in this area, an Otolaryngologist or more commonly called, an ENT. How specifically can an ENT physician treat a chronic ear infection?
How Can the Expertise of an ENT Help in Treating a Chronic Ear Infection?
An ENT is commonly known as a physician who specializes in diseases of the Ear, Nose, Throat, Head and Neck. Their training specific to these interconnected parts of the upper body give them a unique insight into how best to treat complicated problems involving these areas of the body. When dealing with a chronic ear infection, the following are treatment options that may be pursued after conventional first-line treatment have been tried unsuccessfully:
Ear Tube Placement
To facilitate drainage from behind the eardrum, ear tubes may be placed through a surgery and under anesthesia. The procedure involves cutting a slit into the eardrum, and the insertion of plastic or metal tubes. These tubes vary in size depending on how long their use is indicated for. Short-term tubes may stay in place for 6 months to 2 years and fall out on their own, whereas long-term tubes may have to be removed by an ENT when no longer required.
The adenoids are lymphatic tissue located on the back of the nasal cavity. As a function of your bodies immune system, when threatened with bacteria or a virus, this tissue can become swollen as it traps these unwanted invaders. But unfortunately, as the adenoids are doing their job, as they swell they can cause additional problems when this puts pressure on the Eustachian tube thereby blocking drainage of liquid from the middle ear and leading to repeated ear infections.
A potential complication from chronic ear infections, a cholesteatoma is abnormal tissue growth behind the ear drum. This is a serious condition that must be treated by an ENT surgeon as if left untreated it could damage the delicate bones of the middle ear leading to dizziness and hearing loss. Your physician will complete a thorough examination that may include hearing tests and a CT scan. Surgical removal of the cholesteatoma is usually indicated and this is a procedure that an ENT surgeon will be qualified to perform.
Trauma can be the cause of a tear in the eardrum, but oftentimes this occurs from chronic infections or a Eustachian tube disorder. You may notice drainage from the ear or diminished hearing as a symptom. Sometimes, the tear will heal on its own but if healing does not occur then a surgical repair may be necessary
If you are the parent of a child or an adult dealing with recurrent ear infections, do not delay seeking treatment from a qualified professional. Damage to your middle ear from an untreated ear infection could lead to permanent hearing loss and diminished hearing could be affecting your child's speech development and ability to learn. An ENT surgeon not only assesses and diagnoses but is able to follow through on recommended treatment options including surgical interventions. Seek the expert advice of a local ENT surgeon today for any concerns you may have regarding chronic ear infections.