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A full text transcript of this video from Los Angeles ENT Specialists, Osborne Head and Neck Institute is available below.

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If you would like to speak with one of our ENT specialists about ear infection and earache symptoms and treatment options, we at OHNI will be happy to schedule an appointment or phone consultation with you.

Ear Infections And Earaches

What is an ear infection?

An ear infection can be in any three parts of the ear. It can be in the outer ear, the middle ear or the inner ear. An outer ear infection would be like a swimmer’s ear, where it’s very painful, red and swollen, and there may be fluid coming from the ear. Middle ear infection is when Otitis Media bacteria get behind the ear drum and cause inflammation and pain. An inner ear infection can be caused by a virus that infects the brain itself, like Encephalitis, or is isolated to the inner ear, most commonly giving symptoms of hearing loss or dizziness.

What is “otitis media”?

Otitis media is inflammation of the middle ear. The middle ear involves the eardrum itself and the bones or ossicles that help to amplify sound. Most commonly it involves children, and it can be caused by a blockage of the Eustachian tube, or it can be caused by bacteria that come from either the nose or the throat and work their way up the Eustachian tube into the middle ear. Otitis media is very painful, but it can be treated easily with antibiotics.

Why do children have more ear infections than adults?

Children have more ear infections than adults because of their Eustachian tube. Children’s’ Eustachian tubes are horizontal, so bacteria can travel from the back of the nose directly into the middle ear on a simpler path. In adults, the Eustachian tube is more vertical, so it’s more difficult for bacteria and fluids to get from the nose and throat up into the middle ear. That’s the simple reason why children get more ear infections. Bottle feeding or breast-feeding with the baby laying horizontally allows that fluid to travel easier from the nose or the throat up into the middle ear, and that’s another reason why babies get more infections than adults.

Is otitis media a serious medical problem?

Otitis media is less of a serious medical problem now because of antibiotics, but it is a serious condition if not treated. It can lead to facial paralysis, brain abscesses and death – all from the simple middle ear infection. Because of the advent of the antibiotics, we receive fewer cases of patients who have severe complications from otitis media, but otitis media should be taken very seriously and treated immediately if present or diagnosed by your pediatrician or your internist.

What causes otitis media?

Otitis media is usually caused by bacteria that travels into the middle ear through the Eustachian tube. It can also be caused by Eustachian tube blockage where a vacuum is formed in the middle ear and fluid leaks out from the surrounding tissues. There’s always a low level of bacteria throughout our body, but in a fluid environment the bacteria tend to grow and cause an infection in the middle ear.

What is “acute otitis media”?

Acute otitis media is a middle-ear infection. Some of the symptoms are ear pain or fullness. Commonly acute otitis media is associated with a fever. Patients may also have other symptoms, such as a flu, a cold or a sore throat. Usually the pain from acute otitis media lasts for about three to four days and it subsides after that. If patients are given antibiotics, the pain and swelling usually goes away more quickly.

What is “serous otitis media” or “middle ear effusion”?

Serous otitis media is a condition where fluid is in the middle ear space but there’s no bacterial infection. Serous otitis media is often called a Eustachian tube disfunction, where negative pressure is created in the middle ear and fluid leaks from the capillaries into that space. In and of itself, it’s not dangerous, but if left unmonitored it can lead to otitis media, if bacteria get involved. Or, it can lead to hearing loss if the fluid fills the middle ear completely.

What ear infection symptoms do children and teens experience?

Older children and teens, when they have an otitis media, typically don’t have fever but they will have ear pain. They’re usually able to communicate that to you more. The first sign of an ear infection is usually pain. If otitis media is left unchecked, it will eventually develop into a fever, and other symptoms such as fatigue or throat pain, as the infection spreads.

What should I do if I think my child has an ear infection?

If you think your child has an ear infection, you should see your pediatrician or otolaryngologist immediately. Typically, if caught early, they can be placed on antibiotics, and the ear infection usually goes away pretty rapidly. Before you get to see your physician, pain relief is probably the best thing that you can do. So Tylenol every 4 hours or every 6 hours as prescribed by the pharmacist will help to relieve the ear pain, but your child should still see the physician to get antibiotics.

How will the doctor diagnose my child’s ear infection?

The diagnosis of otitis media occurs with a otologic exam. The doctor will place an otoscope in the ear, which helps to magnify the ear canal and the eardrum, and look for signs of an ear infection. The most common sign of otitis media is a bulging red eardrum, or your doctor may see infection, such as pus in the ear canal. That will let them know that there’s an ear infection present.

How are ear infections treated?

Ear infections are typically treated with antibiotics. Sometimes it’s antibiotic drops if there’s an outer ear infection or oral antibiotics such as amoxicillin. For severe middle ear infections, sometimes they require surgery where a small tube is placed through the eardrum to allow fluid to drain. Ear wicks are also used to treat otitis externa, as when patients have otitis externa, the ear canal itself is swollen, almost to the point of being closed off. The ear wick is a sponge that expands the ear canal and allows antibiotic drops to get all the way down to the eardrum and treat the entire ear canal. Without the otowick, the ear drops would simply just fall out of the ear and not be able to treat all the bacteria there inside the ear canal itself.

What activities should I avoid if I have an ear infection?

If you have an outer ear infections, an otitis external, avoid getting water in the ear. That’s the most important thing. The water is a milieu for bacteria to propagate. You should also avoid putting anything in the ear when you have an ear infection, like Q-tips or your finger, and you should avoid strenuous blowing of your nose, where you can force more bacteria into the ear.

What is “swimmer’s ear”?

Swimmer’s ear is an outer ear infection caused by water that’s been left in the ear canal for a prolonged period of time. What happens is the water desiccates the ear canal and allows bacteria to migrate into the soft tissues of the ear. Over time, this develops into an infection that becomes very painful. Swimmer’s ear is very common in swimmers because they have the most water exposure to their ear canals. Some of the symptoms of swimmer’s ear are itching and a burning sensation in the outer ear. There’s usually pain to touch at the outer ear as well. You may experience some redness that involves the cheek area or the neck, and typically you have pain with opening and closing the jaw. The usual treatment for swimmer’s ear is to see your otolaryngologist or a primary care physician who will prescribe eardrops for you.

What are the most common causes of an earache?

The most common causes of earache would be ear infection. Other common causes that we don’t think of are TMJ, which is jaw pain or clicking in the jaw, which is transmitted to the ear. It could be caused from grinding the teeth at night or stress. Another cause of earache could be a tumor that involves the neck area, which is transmitted to the ear by common nerves that give sensation to the area.

Why does a change in air pressure make my ears hurt?

Ear pain caused from change in air pressure is usually due to a problem with the Eustachian tube. The Eustachian tube helps to balance and relieve pressure within the middle ear itself. Typically, on a plane flight or if you’re at high altitudes, like in the mountains, the air inside the middle ear expands. If you have problems with the Eustachian tube, which is a pop-off valve for this area, the air can’t get out of your ear and you feel pain or pressure as the air is forced against the eardrum.

The doctor featured in this informational video is Dr. Jason S. Hamilton, of the Osborne Head & Neck Institute in Los Angeles, California. He is Board-Certified in Facial Plastic and Reconstructive Surgery and Otolaryngology/Head and Neck Surgery and a member of the Academy of Facial Plastics and Reconstructive Surgery.

If you would like to learn more about Dr. Hamilton, view his biography and contact information on the OHNI main website: ENT Specialists in Los Angeles.

Contact a Physician at Osborne Head & Neck Institute

If you would like to speak with one of our physicians regarding this issue or another ear, nose, throat problem; or have other questions or concerns, please complete the contact form below or call us at 310-657-0123.

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Cedars Sinai Medical Towers
8631 W. Third Street, Suite 945E
Los Angeles, CA 90048

Tel: 310.657.0123
Fax: 310.657.0142
Beverly Hills, California
435 N. Roxbury Drive
Beverly Hills, CA, 90210

Tel: 310-657-0123
Fax: 310-657-0142

Contact a Physician at Osborne Head & Neck Institute

If you would like to speak with one of our physicians regarding this issue or another ear, nose, throat problem; or have other questions or concerns, please complete the contact form below or call us at 310-657-0123.
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