Fluid in the Ear: Causes, Treatment & Help

Fluid in the ear most often occurs after swimming or showering, but it can also be caused by serious medical conditions. Once the diagnosis is established, treatment can almost always resolve the symptoms.

What is fluid in the ear?

Fluid in the ear most often occurs after swimming or showering, but it can also have serious medical conditions as its cause. Fluid in the ear is a condition that occurs after contact with water. This collects in the ear and can no longer flow out freely. Normally, the fluid dissolves from the auditory canal after a few minutes. If this is not the case, medical treatment becomes necessary, otherwise inflammation and fungus may develop in the inner ear.

Causes

The causes of fluid getting into the ear can be quite different. Most often it happens during a visit to the swimming pool. Favored by the anatomy of the ear canals, the water collects in the auditory canal and can no longer flow out, because the constant movement of the eardrum stagnates the water, so to speak. If there is then also earwax at the entrance of the affected ear canal, a kind of plug quickly forms, which prevents the fluid from flowing out again unhindered.

Diseases with this symptom

  • Inner ear infection
  • Cholesteatoma
  • Mastoiditis
  • Tympanic effusion
  • Otitis media
  • Window rupture

Diagnosis and course

Fluid in the ear can be quickly detected. The feeling is perceived as unnatural and, in addition, the ability to hear is limited. Normally, this condition should only last a few minutes, as the fluid will flow out of the ear again on its own by simply shaking the head. If this is not the case and the water remains in the ear canal despite all efforts, an ENT specialist should be consulted after two days at the latest. He or she can then initiate appropriate measures to remove the fluid from the ear. Fluid in the ear can promote the development of bacteria and fungi and should therefore not be ignored. Basically, an ear, nose and throat specialist should be consulted after two days at the latest if there is fluid in the ear, in order to avoid the occurrence of so-called bathotitis. This initially manifests itself as itching, a slight feeling of pressure in the ear canal and poor hearing. If no action is then taken, the entire ear canal becomes inflamed and severe pain and purulent discharge from the ear occur. Therefore, it is important to consult a doctor at the first signs of inflammation in the ear. He can initiate appropriate therapies and treat the affected ear. Late consequences have fluid in the ear in the normal case not.

Complications

If large amounts of a milky fluid are emptied from the ear due to existing mastoiditis, which often occurs after a middle ear infection that has not been treated properly or to completion, refusal to eat and apathetic behavior may occur as the condition progresses. In young children, nausea and vomiting are also common. If mastoiditis is not treated, the collection of pus may not drain. As a result, a collection of pus may develop in the periosteum below the mastoid. Furthermore, there is a risk of an epidural abscess (collection of pus between the bone and the outer meninges). Pus can also penetrate into the area of the lateral cervical and neck muscles. A bezel abscess then forms. The most dangerous is the formation of a brain abscess. Different structures may be pinched off or squeezed. If the meninges are affected, there is a risk of meningitis. If the pus enters the inner ear, labyrinthitis may result. Sepsis (blood poisoning) can occur if the bacteria enter the bloodstream. If the fascial nerve is damaged, there is a risk of permanent deafness or facial paralysis. The various complications can be recognizably life-threatening. If the fluid in the ear is based on a tympanic effusion, children are more likely to have impaired speech development. Even after several years, destruction of the ossicles or a hole in the eardrum can occur. In particularly severe cases, an implant is required. If the inflammation spreads to neighboring areas, there is a risk of labyrinthitis, meningitis or mastoiditis.More rarely, retention pockets of the tympanic membrane are formed, resulting in a cholesteatoma, which in the further course can lead to chronic otitis media. The destruction of the middle ear and sometimes of adjacent structures that may occur as a result it can only be treated with surgery.

When should you go to the doctor?

It can happen so easily: While swimming or showering, water gets into the ear canal. In the affected ear, sounds are then only muffled audible. Often, the water that has entered the ear runs out again on its own shortly afterwards. But what can be done if this does not happen? There is only one answer to this: if there is fluid in the ear, see a doctor as soon as possible! It is urgently not advisable to try to remove the water that has penetrated the ear yourself. Again and again, ENT physicians have to deal with patients who have injured their ears in the process. At most, people with fluid in their ear can try to get rid of it by vigorously shaking their head or jumping. No kidding: Some doctors also recommend – careful! – Blow-drying until the infiltrated water has dried away. Fluid in the ear can combine with earwax to form a viscous mass, which also should only be removed by a doctor. With fluid in the ear, there is also a risk of germs getting into the ear. This can cause a severe inflammation to develop and, in addition to severe pain in the ear, can even cause permanent hearing damage. Water sports enthusiasts can also ask their doctor for tips on how to prevent fluid in the ear. For example, there are special earplugs that prevent water from entering the ear.

Treatment and therapy

Fluid in the ear can be treated in many ways. For example, it is often enough to shake the head, bounce up and down or clear the ear with the little finger so that the water flows out. However, the finger option is not recommended by doctors, nor is treatment with a cotton swab, as this pushes the earwax further into the ear canal. This can even injure the eardrum under certain circumstances. Other pointed objects are equally unsuitable and should not be used under any circumstances to get the fluid out of the ear. It is also possible to dry the ear with a hair dryer, but this should only be used with extreme caution, as there is also a risk of injuring the inner ear. If the fluid in the ear does not dissolve by itself, the ENT doctor can use various treatment methods. For example, it is possible to clean the ear with the help of an ear irrigation and thus also free it from the fluid. Special instruments are used to merely suck out the ear. If the ear is already inflamed by the fluid, mentioned methods are no longer sufficient. Then antibiotics must be taken to prevent the inflammation from spreading further. Treatment with hot water bottles or infrared is also possible.

Outlook and prognosis

No negative prognosis or symptoms usually develop with fluid in the ear. In most cases, the problem disappears on its own. Very often, the fluid in the ear occurs after a visit to the swimming pool and leads to an unpleasant feeling. In order for the fluid to disappear from the ear, it must be put into motion. Here it is advisable to lie on one side for a few minutes so that the fluid can escape from the ear. In most cases, only a few minutes are sufficient here to remove it. Therefore, direct treatment by the doctor is usually not performed. Even if the fluid is not specifically removed from the ear, it usually escapes on its own within a few hours. A doctor must be consulted if the fluid remains in the ear for several days. This can cause pain and inflammation in the ear. Since the ear has a very fragile structure, a doctor should be consulted. In most cases, however, the fluid in the ear causes only a brief disturbing sensation and poses no further impairment or danger to the body.

Prevention

Fluid in the ear basically cannot be prevented. The only way is to always wear a bathing cap when showering or in the pool. However, under normal circumstances, it is also not necessary to specifically ensure that the ear remains free of fluid.However, a possible inflammation can be prevented by not completely removing earwax from the ears. This is because the protective film is immensely important and prevents fluid from entering the inner ear. If there is fluid in the ear, there is usually no reason to worry. Only if the water has still not dissolved after two days should you see an ENT specialist. It is also advisable to talk to the family doctor if an inflammation of the inner ear is suspected. This person can take an initial look at the ear and arrange for referral to an otolaryngologist.

What you can do yourself

If you have fluid in your ear, there are a few things you can do that can save you a trip to the ENT doctor. However, there are also some self-help methods that are rather not recommended and can possibly worsen the problem. If water has gotten into your ear after swimming or bathing and just won’t drain out on its own, it’s easy to do yourself. Tilting the head in different directions is one measure to bring about relief. A gentle shaking of the head can also often be helpful. Often the water together with the earwax forms a plug. This can be gently pricked with a cotton swab. However, one should never penetrate too deeply into the ear with a cotton swab. Exhaling while holding the nose to get the water out by building up pressure is not recommended under any circumstances. Firstly, this method does not have much effect, and secondly, excessive pressure build-up in the body is always dangerous. If there are discharges from the ear in the course of an ear infection, one should in any case avoid removing the fluid by mechanical means. Otherwise, the inflamed ear canal may only become more irritated or come into contact with other pathogens, such as bacteria or fungi. In this case, a visit to an otolaryngologist is recommended.