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Ear Infections, What Do You Need To Know?

I remember when my children were young, they seemed to tag team us with ear infections. My young lad, in particular, had a lot of problems with his ears and eventually he had to have grommets fitted. It was a quick ten-minute operation but at the time he had to go under general anaesthetic. Hard to believe that they are now fitting grommets in the office. Anyway, I have been thinking about ear infections since I spoke about the hearScope a couple of weeks ago, then, I had someone come and see me with Otitis Externa (that's outer ear infection in English). I thought to myself, hey Geoff, let's chat with the nice people about ear infections. 

Ear infections

Hearing Loss From Infection

Before we go into the ins and outs of ear infections I want to briefly speak about sudden hearing loss. Over the next few paragraphs, it will quickly become clear that hearing loss is a function of ear infections in many cases. However, it is important that you understand that any sudden hearing loss should be treated as a medical emergency. Sudden Sensorineural Hearing Loss is a problem of the inner ear, if you are to recover, it needs treatment within days. 

Outer Ear Infection

The chap who came to see me suffered from pretty bad outer ear infections. They were chronic and recurring and they had left his outer ear misshapen and swollen. At the time I saw him there was no infection active, but nevertheless, it had been a long and painful road for him. Unfortunately, he had a nervous habit of poking at his ears and this was causing the infection. 

Ear Infections & Hearing Aids

Steve (my business partner) has also suffered from otitis externa, he detailed his problems in the article Ear Infections. He spoke about the problems he had with ear infections as a hearing aid user, he also gave some pretty good tips about how to deal with it.

Intolerable Pain

An ear infection can deliver intolerable pain, all the worst because there is little you can physically do about it. Ear infections happen when germs such as bacteria, viruses or fungi cause swelling and irritation of the structures of your ear. They are most common in childhood, but they can happen at any age. There are generally two types of ear infections:

  • Otitis Media (middle ear infection) 
  • Otitis Externa (outer ear infection)

Otitis Media, Middle Ear Infection 

Middle ear infections or otitis media occur inside the middle ear, behind the eardrum. Middle ear infections are exceptionally common in young children but can happen in adults as well. In fact, most children will have a bout of otitis media during their early life even if there are no symptoms. The reason for it in children is often a combination of upper respiratory tract infection and eustachian tube dysfunction. Don't worry, I ain't getting all medical, the eustachian tube connects the middle ear and the back of the nose and throat. It is responsible for drainage and keeping the pressure in the middle ear equal. In children, the eustachian tube is smaller and more horizontal than adults. 

The Eustachian tube is pretty narrow, it also has an isthmus, means an even narrower bit. The middle ear cavity and the eustachian tube are lined with mucous membrane (the same as your nose). When you combine all these things with some sort of infection, you get a closed up eustachian tube, pressure and fluid build up in the middle ear and if the mucous build up gets infected, you get pain, deep, deep pain. The symptoms of middle ear infection are:

  • Pain
  • Fever
  • Pressure or fullness in the ear
  • Hearing loss
  • Puss or fluid draining from ear canal
  • Headaches

Otitis Externa, Outer Ear Infection

Sometimes this type of infection is called "Swimmer's Ear", it is an infection of the eardrum, ear canal or outer ear. The reason it is often referred to as swimmer's ear is that it is often caused by swimming. It often begins with water inside the ear canal, however, other things can cause it. In general, many outer ear infections are fungal in nature, but I have seen some whopping bacterial ones. While both types of ear infections can cause pain and discomfort, outer ear infections affect the visible part of the ear and canal, often appearing as swelling, redness and itchiness. Symptoms of outer ear infection:

  • Painful ear
  • Often tender to touch
  • Occasionally pus or fluid
  • Red appearance
  • Swollen

When do You Need to Visit a Doctor

In the case of mild outer ear infection, some antiseptic cream or medicated drops may do the job. In the case of a mild middle ear infection, the eustachian tube may open and relieve the pressure and drain fluid. If the infection doesn't clear up on its own after a week, or if it keeps returning. If you begin running a temperature combined with ear pain, you really ought to go and see your Doctor.


The type of treatment given depends on the type of ear infection and what may have caused it. In many cases of middle and outer ear infections, antibiotics are necessary. In some cases of outer ear infections, antifungal treatments are necessary.  

Treating middle ear infections

Many middle ear infections are treated with antibiotics. In most cases, the antibiotics will be taken orally. On some occasion, antibiotic ear drops may be prescribed. They will also prescribe pain medication or advise the use of over-the-counter pain relievers. Many Doctors will also advise the use of a decongestant, nasal steroids, or an antihistamine.

Opening The Eustachian Tubes

A helpful technique here can be popping your ears, the medical term is auto-insufflation. It is a technique taught to scuba divers to equalise pressure, it also is a favourite of anyone who flies regularly. It’s meant to help clear your eustachian tubes. You do this by squeezing your nose, closing your mouth, and very gently exhaling. This can send air into the eustachian tubes, causing them to open, relieving pressure and help drain the fluid. Be careful doing this, if your middle ears are well and truly infected this can be painful. 

Treating outer ear infections

First off, the outer ear should be carefully cleaned. That is then followed by the application of antibacterial or antifungal and anti-inflammatory medications on your ear. Antibiotics would be prescribed if your doctor thinks the infection is bacterial. Viral is different and irritating, viral infections don't really have a treatment, simply clean it and put antibacterial medication on it so that it doesn't turn bacterial. You then just have to wait for the infection to sort itself out. However, if it is something like herpes simplex (don't panic, it's a cold sore), more specialised treatment may be necessary.

Home Remedies or Alternative Treatments for Ear Infections

Don't do it, nope, nope, nope and nope. You can take some painkillers and hope it might pass, it might. It also might become chronic and if it is a mid ear infection eat away the attic of the middle ear and enter the brain. Yes, you heard that right, you just gave yourself meningitis, how cool, you didn't need that hearing or the hand or leg anyway.  

Preventing Future Infections

There are a couple of things you can do to prevent a further infection, especially in the case of outer ear infection. Here is what you can do:

  •  Don’t stick anything in your damned ear, no fingers, no bobby pins, no keys, nothing, de nada
  • Try to keep water out of your ears. If you’re a frequent swimmer, get earplugs or a swimming cap
  • If you didn't follow the rule above (idiot) shake out or drain any trapped water inside your ears once you get out of a pool or ocean.
  • If you are suffering from a bad cold, use a decongestant, this can help keep the eustachian tubes open
  • If you feel stuffed up, try clearing your eustachian tubes by auto-insufflation

If you have any questions about ear infections, give us a shout here at Know, better still, go see a doctor and tell us about it later.

Posted by

Geoffrey Cooling

Geoffrey Cooling

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Geoffrey (Geoff, anything else makes him nervous) Cooling has been involved with the hearing aid industry for over ten years. He has worked in private practice dispensing hearing aids and as a manufacturer's rep. He has written two books and they are both available on Amazon. He loves technology, passing on knowledge and is legendary for many other things, primarily the amount he curses, his dry and mischievous sense of humour and his complete intolerance of people who are full of themselves. Please feel free to connect with him

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