By an ear infection, physicians understand an inflammatory change in the area of the ear. This can be an inflammation of the outer, middle or even inner ear. Depending on where the inflammation is located and how severe it is, it can possibly have negative effects on the further health of the affected person.
What is an ear infection?
An ear infection is also called otitis in medical circles. The disease refers to an inflammation in the area of the ear. A distinction is made here between otitis externa (an inflammation of the ear canal), otitis media (inflammation of the middle ear) and otitis interna (an inflammation of the inner ear). The type of ear infection depends on the exact location of the inflamed area. All forms of otitis are manifested in most cases by quite severe ear pain, which is not infrequently accompanied by other symptoms such as fever or hearing loss. Ear infections should be treated in principle, otherwise they can lead in the worst case, for example, to permanent hearing problems.
Causes
The causes of an ear infection often lie in an infection by bacteria or fungi. In principle, the ear canal and all areas of the ear behind it are well protected by fine hairs and earwax, among other things. Under certain circumstances, however, pathogens can enter these sensitive areas and cause unpleasant infections. The permanent wearing of inner earphones or earplugs can weaken the body’s own protection just as much as the penetration of water, for example, when swimming or showering. Allergies and eczema around the ears can also lead to otitis. Various childhood illnesses also often bring on ear infections, especially of the middle ear.
Symptoms, complaints and signs
Inflammation of the ears often occurs in children, but it is also a very common condition in adults. A typical sign of inflammation of the ears is a sharp and long-lasting pain. This pain is often quite unpleasant, so that affected individuals generally feel very ill and restricted. In most cases, the discharge of pus fluid is also a clear symptom and sign of a serious inflammation in the ear canal. If such a clinical picture remains without medical and drug treatment, then a significant worsening of the symptoms that occur is to be expected. In many cases, headaches and aching limbs also occur in connection with an ear infection, so that the person affected feels a general malaise. Only those who initiate medical and drug treatment at an early stage can expect a quick and complete recovery. In rare cases, however, inflammation of the ears is not caused by bacteria. Inflammation can also be caused by a foreign body in the ear canal. This also results in severe pain, so that even permanent damage can occur under certain circumstances. If you decide to seek professional treatment at an early stage, you can nip the symptoms described here in the bud. Otherwise, a significant aggravation of the individual symptoms is to be expected.
Diagnosis and course
Schematic diagram showing the anatomy of the ear in otitis externa. Click to enlarge. In most cases, an ear infection is noticeable by moderate to severe pain. If the affected person then visits a doctor, he or she will take a closer look at the ear. With the help of the so-called otoscope, he can examine the inside of the ear and in this way often already make a diagnosis. In addition, a comprehensive blood test may take place to confirm the presence of inflammation. If fluid is leaking, a swab can provide further important information. If an ear infection is left untreated, it can lead to permanent hearing loss in the worst case. Otitis interna in particular can spread to the brain, causing severe secondary damage.
Complications
The complications that can occur with otitis depend on which section of the sensory organ is affected by the infection. Complications are most likely to occur if inflammation of the middle ear is untreated or not treated in time.Acute otitis media is a medical emergency. The possible complications are categorized as extracranial (outside the skull) and intracranial (inside the skull). A common extracranial complication that predominantly affects children is mastoiditis. This is a purulent inflammation of the skull bone behind the ear. In addition, there is a risk of inflammatory facial paresis (facial paralysis) because the bony canal of the seventh cranial nerve runs close to the middle ear. This nerve controls facial expressions. If inflammation spreads from the middle ear to the nerve, this can lead to unilateral paralysis. Affected individuals lose control, usually temporarily, of one side of the face and become disfigured by severely drooping corners of the mouth and eyes. Dangerous intracranial complications include otogenic meningitis. Meningitis forms when the pathogens travel through the labyrinth in the ear or blood vessels to the meninges and infect them. In addition, intracranial abscesses, which are collections of pus inside the skull, can form and be life-threatening. In addition, if mastoiditis occurs, sinus vein thrombosis cannot be ruled out.
When should you go to the doctor?
Pain in the ear that persists for several days needs to be investigated. In the case of an ear infection, sufferers often describe a sharp pain that comes on suddenly. If there is an increase or spread of symptoms, a doctor should be consulted immediately. In addition, until a physician has been consulted, the patient should refrain from taking any analgesic medication. There is a risk of side effects, which should be prevented if possible. A pulling or whistling sensation inside the ear, unusual ringing in the ears or disturbances in balance are signs of an irregularity that should be clarified. If the affected person suffers from gait unsteadiness, dizziness or an increased risk of falling, a doctor is needed. Headaches or a feeling of pressure are also cause for concern. If pus or a foreign fluid forms inside the ear, this is an indication of a disorder present. Fever, a general feeling of malaise or an unpleasant odor in the ear should be presented to a physician. If limitations in hearing occur or if the sounds of the environment are perceived as muffled, a visit to the doctor is necessary. A strong feeling of illness, apathy or a loss of the usual physical as well as mental performance are signs of a health disorder. They should be presented to a physician so that clarification of the cause can be made.
Treatment and therapy
Once the attending physician (usually an otolaryngologist) has diagnosed an ear infection, he or she will initiate appropriate treatment. This is based particularly on which area of the ear is affected and what exactly is causing the infection. In the case of a bacterial infection, an antibiotic will most likely be prescribed to fight the bacteria and prevent the infection from germinating again. A fungal infection of the ear is treated with an antifungal medication. If the ear canal is inflamed, the medication can be applied in the form of an ointment; if the infection is deeper, tablets must be taken. In addition, the healing process can be supported with heat applications, for example, by red light. A middle ear infection can also be caused by a tear in the eardrum, among other things. In this case, surgical intervention may be necessary. This also applies if there is a chronic inflammation of the middle ear and the bone structure of the ear is attacked by the infection. In the case of otitis externa, surgical intervention is necessary, for example, if a larger accumulation of pus has formed and must be removed. If an ear infection is treated professionally in time, it usually remains without consequences for the hearing and the health of the affected person.
Outlook and prognosis
The prognosis of an ear infection, also called otitis, depends not only on the patient but also on the particular type of disease. The outlook for the simplest form of otitis is good. With timely medical treatment, the symptoms improve within a few days without consequences. However, if the reaction is too late, the inflammation can spread to the auricle.Inflammation of the entire ear canal also heals in a few weeks without consequences. In rare cases, there is a life-threatening risk if it turns into a more severe form. Diabetics may experience increased recurrence. Middle ear infection also generally has a good prognosis and heals within a few days without consequences. If the disease becomes chronic or complications arise, the inflammation can spread to the brain. Young children are particularly at risk. Repeated infections can lead to hearing loss, which has a negative effect on speech development. The inner ear infection also has good prospects, provided it is treated at an early stage. Then neither complications nor permanent damage occur. However, there are some risk groups. Children have a worse prognosis because their auditory canals are still growing. In rare cases, hearing can be permanently damaged. Pregnant women or people with pre-existing conditions are also at particular risk.
Prevention
An ear infection, especially in the outer area, can be prevented in various ways. For example, the ear canal should not be cleaned with cotton swabs to prevent pathogens from entering. If a lot of earwax forms regularly, the ear canal should be cleaned by a doctor to prevent infections from forming. If the first signs of otitis appear, a doctor should be consulted at an early stage to initiate appropriate therapy and rule out late effects.
Follow-up care
An ear infection usually heals completely with appropriate therapy. Because there is subsequently freedom from symptoms, there is no need for follow-up care. The patient can continue his or her normal life, but should observe preventive measures. This is because the body does not build up immunity to an ear infection. Above all, protecting the ears from wind and weather prevents a recurrence of the disease. This is the responsibility of the patient in his daily life. If necessary, the doctor will impart appropriate knowledge as part of the initial therapy. The treatment of a chronic ear infection is different. Here, permanent aftercare becomes necessary. The doctor tries to prevent constant infections and hearing loss by a close-meshed examination rhythm. For this purpose, control appointments are arranged individually. The otoscope and a blood test are suitable for determining the GEnesing process. Initially, the patient takes antibiotics. If necessary, surgery may be required afterwards. Thus, follow-up care for an ear infection pursues different goals in some cases than for cancer. This is because an ear infection cannot form a recurrence after successful therapy. Nor is there any life-threatening situation. In contrast, both forms of the disease are concerned with avoiding complications and supporting everyday life. The longer an ear infection is present, the more important competent follow-up care becomes.
Here’s what you can do yourself
An ear infection usually subsides after a few days. The sufferer can promote recovery by taking sufficient rest and protecting the affected ear from further stimuli. Physical exertion and stress should be avoided. If the body temperature is elevated, home remedies such as calf compresses are useful. The aching ear can be treated with onion bags or cherry stone pillows. Red light is also often used for an ear infection. Alternatively, herbal remedies, for example homeopathic ear drops or ointments with glycerin, help. Tympanostomy tubes, which are inserted into the ear under anesthesia and allow ventilation of the narrowed ear canal, are also particularly effective. Tympanostomy tubes are particularly useful in cases of chronic middle ear infections or when the child has poor hearing and shows signs of fever. If the symptoms have not subsided after a maximum of three days or even worsen, a doctor must be consulted. In consultation with the physician, further measures can be taken to cure the inflammation quickly. The patient should have another check-up a few days after recovery to make sure that the inflammation has completely receded.
