Recurrent Ear Infections
Ear infections and fluid (otitis media and effusion) are very common problems in children age 6 months to 2 years. These infections often develop after or during an upper respiratory viral infection (URI), and are more frequent if the child is in a day care facility where URIs are common. Older children are less likely to suffer from chronic ear infections because their Eustachian tubes get bigger and tilt more downward with growth, allowing air to enter the middle ear space more readily.
Although the frequency of ear infections and ear fluid improves over time, repeated infections and persistent ear fluid can lead to ear pain, fever, irritability, ear drainage, hearing loss and delayed speech and language development.
Placement of ear tubes (PETubes) is a common outpatient procedure for children. Tubes allow air to enter the middle ear – usually preventing infections and allowing a return to normal hearing. In adults that have persistent fluid, this procedure is performed in the office.
A hole or perforation in the eardrum may occur for many different reasons including ear trauma, infection with rupture, poor Eustachian tube function, and growth of a skin cyst involving the eardrum or middle ear (cholesteatoma). The most common symptom of a perforated eardrum is hearing loss. Ear drainage and pain may also occur when a perforation is caused by a chronic ear infection. Cholesteatoma and chronic mastoiditis also cause tympanic membrane perforations.
If imaging of the ear is required a CT scan of the temporal(ear) bone is available, for which this facility is accredited.
If the eardrum does not heal after a period of time and with treatment, most can be successfully repaired with an outpatient surgical procedure known as tympanoplasty. Chronic ear perforations may require a tympanomastoidectomy.
Ear Canal Infections
Often called swimmer’s ear, otitis externa is a very common condition associated with ear pain, swelling, drainage and hearing loss. Usually antibiotic ear drops are effective in treating this condition. However, sometimes the ear canal needs to be cleaned of dead skin, debris and pus in order for the drops to get to the infected area. This is done in the office using a microscope for visualization. Occasionally a small soft wick needs to be placed if the swelling does not allow drops to go into the ear canal.
With chronic drainage, scaling and itching, there may be an eczema like skin condition which could require chronic ear drop treatment.
Sometimes ear wax (cerumen), can accumulate and not clear out naturally. Do not use Q-tips or ear candles which are ineffective and can damage the ear. The wax can be removed in the office with special instruments or suctioning, with the use of a microscope to prevent damage to the ear canal or eardrum.
Hearing Loss and Tinnitus
Our office offers complete evaluation of hearing and tinnitus (ringing in the ears) with discussion of etiology and treatments. Further diagnostic studies are discussed in our Audiology Services page.