Types Of Ear Infections
Ear infections are diagnosed by physical examination and laboratory analysis of pus or discharge. In some cases, CT scans may also be taken.
The ear is made up of three parts. The outer ear includes the part you can see and the canal that leads to the eardrum. The middle ear is separated from the outer ear by the eardrum and contains tiny bones that amplify sound. The inner ear is where sounds are translated to electrical impulses and sent to the brain.
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Types of ear infection include:
- otitis externa
- otitis media – acute or chronic
- serous otitis media
- infectious myringitis
- acute mastoiditis
- vestibular neuronitis
- herpes zoster of the ear.
Otitis externa
Otitis externa is an infection or inflammation of the ear canal between the eardrum and the outer ear. It can be triggered by exposure to dirty water or by mechanical damage due to overzealous cleaning. The infectious agent can be either fungal or bacterial.
Treatment options include:
- professional cleaning of the ear canal, although syringing the ear should usually be avoided
- eardrops containing antibiotics and steroids, if the infection is bacterial in origin
- oral antibiotics
- ear drops containing antifungal medications and steroids, if the infection is fungal in origin
- pain-relieving medications
- keeping ears dry.
Otitis media
Otitis media is an infection of the middle ear, which can be either acute or chronic. Children are most commonly affected by acute otitis media because it is caused by colds and blocked Eustachian tubes – both typical ailments of childhood. The infectious agent can be either viral or bacterial, with research suggesting that viruses are responsible for most cases.
Sometimes the eardrum will burst, leading to pus in the ear canal, but usually the eardrum will heal up again by itself. Treatment options include:
- pain-relieving medications
- antibiotics – if the infection is bacterial in origin
- eardrops – if there is pus in the ear canal.
Frequent bouts of acute otitis media or one lingering attack can lead to chronic otitis media. Without medical intervention, the chronic infection can burst the eardrum or damage the delicate structures within the middle ear.
Other possible complications of untreated chronic otitis media include meningitis, infection of the balance organs within the ear (labyrinthitis), sensorineural deafness (permanent hearing loss) and paralysis of the face.
Treatment options include:
- thorough cleaning of the ear and use of topical antibiotic drops (with or without steroids)
- medication to treat the infection
- surgical repair of the perforated eardrum
- prevention strategies to reduce the risk of another infection.
Serous otitis media
Serous otitis media is known as glue ear. Children aged between six months and two years of age are most vulnerable to this type of ear infection. Glue ear commonly develops after a middle ear infection, and is characterised by the build-up of fluid and pus within the middle ear. Treatment options include antibiotics.
If antibiotics fail, or if the child is plagued by repeated attacks of glue ear, surgery to insert small drainage tubes (grommets) may be needed.
Infectious myringitis
Infectious myringitis is inflammation of the eardrum, caused by infection from either viruses or bacteria. The eardrum responds to the inflammation by forming small blisters. This can be quite painful. If fever is present, the infectious agent is almost certainly bacterial.
Treatment options include:
- antibiotics
- pain-relieving medications
- professional rupturing of the blisters
Acute mastoiditis
The bone that can be felt immediately behind the ear is called the mastoid. Acute mastoiditis is infection of this bone, caused by prior acute otitis media. The symptoms include reddened and swollen skin over the mastoid, fever, discharge from the ear and intense pain.
This is a serious condition. Untreated, acute mastoiditis can lead to deafness, blood poisoning, meningitis and paralysis of the face. Treatment options include:
- intravenous antibiotics
- surgical drainage of the infected bone.
Vestibular neuronitis
The inner ear contains the organs of balance – the vestibular system. It includes three fluid-filled loops (semi-circular canals) which respond to the rotation of the head. Near the semicircular canals are the utricle and saccule, which detect gravity and back-and-forth motion. When the head is moved, signals from these organs are sent via the vestibular nerve to the brain where it is processed
Vestibular neuronitis is inflammation of the vestibular nerve, probably caused by a viral infection. The main symptom is sudden and dramatic vertigo, which may be accompanied by nausea and vomiting. The eyes may also involuntarily flutter towards the affected side of the head.
Treatment options for vestibular neuronitis include:
- medications, including antihistamines
- anti-nausea medications
- vestibular physiotherapy – to help your brain to compensate or retrain.
Herpes zoster of the ear
Sound is sent as electrical impulses to the brain via the cochlear nerve. Herpes zoster of the ear is an infection of this auditory nerve by the herpes zoster virus. Symptoms include ear pain, vertigo, and small blisters on the outer ear and ear canal and perhaps on the face and neck.
The main nerve that services the facial muscles may also become infected, leading to swelling and partial paralysis. Treatment options include:
- antiviral medications such as steroids and acyclovir
- pain-relieving medications.
