Brief overview
- Treatment: Pain-relieving medication, decongestant nasal drops or sprays, sometimes antibiotics, home remedies
- Symptoms: Earache on one or both sides, fever, general fatigue, sometimes hearing loss and dizziness
- Causes and risk factors: Infection with bacteria, more rarely with viruses or fungi; injuries to the ear canal
- Diagnostics:Medical history, external examination of the ear, otoscopy, hearing test, testing of the sense of balance
- Course and prognosis: Healing within a few days with treatment, occasionally complications such as mastoiditis occur.
- Prevention: Decongestant nasal sprays improve ventilation of the ear in the event of a cold; the Standing Committee on Vaccination (STIKO) also recommends a pneumococcal vaccination for children.
What is an ear infection?
The ear
The ear is both an organ of hearing and an organ of balance. It consists of three parts: The outer ear, middle ear and inner ear are responsible for hearing, while only the inner ear is responsible for the sense of balance.
The outer ear consists of the pinna and the external auditory canal and borders the middle ear with the eardrum. The glands located in the ear canal are used to produce earwax. This kills bacteria and fungi and prevents foreign bodies such as insects from entering the ear. The external auditory canal is bent downwards towards the front. In order to have a clear view of the eardrum during otoscopy, the doctor must therefore pull the ear backwards and upwards.
The auditory ossicles amplify the effect of the eardrum vibrations. An air channel between the middle ear and the nasopharynx (Eustachian tube) ensures that the middle ear is sufficiently ventilated and that any fluid that builds up drains away.
The inner ear is also known as the labyrinth. It contains the bony cochlea for hearing and the semicircular canals of the organ of balance.
Classification of ear infections
Depending on which section of the ear is inflamed, the doctor differentiates between
- Ear canal inflammation (otitis externa): inflammation of the outer ear
- Inflammation of the middle ear (otitis media): Inflammation of the middle ear
- Inner ear inflammation (otitis interna): This is usually referred to as labyrinthitis.
Treatment of an ear infection
You can read more about the treatment of inflammation in the outer or middle ear in the articles Ear canal inflammation and Middle ear inflammation.
Home remedies for inflammation in the ear
Many people also rely on home remedies for ear infections. Some use calf compresses to reduce the fever. Others warm the ear with a red light or place a bag of onions on it. However, the effect of these home remedies against inflammation in the ear has not yet been scientifically proven.
Home remedies have their limits. If the symptoms persist over a longer period of time and do not improve or even get worse, you should always consult a doctor.
Symptoms of an ear infection
Causes of an ear infection
In most cases, an infection with bacteria triggers an inflammation in the ear. Fungal or viral infections are rare causes. Pathogens can easily enter the ear canal when bathing or swimming and may cause inflammation.
Other possible causes of ear infections are minor injuries. They occur, for example, if the cotton bud is pushed too deep into the ear canal when cleaning. People who frequently wear in-ear headphones and people who are generally more susceptible to infections also have an increased risk of an ear infection.
Ear infection: examinations and diagnosis
When patients with ear pain consult a doctor, the doctor will first ask detailed questions about the patient’s medical history (anamnesis). For example, he will ask:
- When did the symptoms occur?
- Have you had similar complaints in the past?
- Do you have a fever?
- Do you feel dizzy?
- Is your hearing worse in one ear?
- Do you have another underlying condition such as diabetes or are you taking medication?
The doctor will then examine the ear. He or she will pay particular attention to redness, swelling and discharge. He then palpates the ear to see if it is painful to the touch.
The doctor will also perform an otoscopy. This involves pulling the ear backwards and upwards by the pinna to get a clear view of the eardrum. He uses a magnifying glass to look at the external auditory canal and the eardrum. Here, too, he looks for redness, swelling, discharge or foreign bodies.
Hearing tests and tests of the sense of balance are occasionally carried out to clarify an ear infection.
Ear infection: course and prognosis
Ear infection: Prevention
There are ways to prevent an ear infection. If you have a cold, using nasal drops or nasal sprays will help to reduce swelling of the mucous membranes and improve ventilation of the ear. Children with colds should also not go to the swimming pool or get caught in draughts with wet hair.
The Standing Committee on Vaccination of the Robert Koch Institute (STIKO) recommends vaccinating children against pneumococci. The spread of the pneumococcal vaccination has reduced the incidence of middle ear infections (otitis media) in children.
Read more about the pneumococcal vaccination here.