ear infections

From itching and pressure, hearing and balance disorders to fever and unbearable pain - the spectrum of possible symptoms in inflammation of the ear is large. Especially children often suffer from ear problems. Read here, which causes earache and what you can do to prevent it.

The ear - structure and functions

The ear is not only for listening, but also has an important function for our sense of balance. Its structure serves to fulfill these two tasks:

Listen: The cartilaginous auricle captures the sound caused by acoustic signals. The external auditory canal leads it to the eardrum, the border to the middle ear. Behind the eardrum is the air-filled tympanic cavity with the three ossicles hammer, anvil and stirrup, the latter with about three millimeters in length, the smallest bone of the body. These dampen or amplify the sound and guide it further into the inner ear.

The two accesses to it, the oval and round windows, are each closed with a membrane. The tympanic cavity has a connection to the pharynx - this "Eustachian tube" ensures the pressure balance between the tympanic cavity and the outside air. In the inner ear, in the sensory cells of the snail, a cavity system, the sound waves are converted into electrical nerve signals and transmitted via the auditory nerve into the brain.

Balance: The inner ear also contains the sensory receptors of the organ of equilibrium, namely in the forecourt and the semicircular canals. They send information about the orientation and direction of the body in space at rest and movement through the balance nerve to the brain. Together with the information from eyes and muscles, these ensure that we can hold ourselves straight.

Inflammations of the ear are quite common. The causes are manifold, all parts of the ear can be affected.

Inflammation of the external ear (otitis externa)

The ear furrow is a deep purulent inflammation of a hair follicle in the ear canal, caused by certain bacteria. Not infrequently, the infection is exacerbated by the fact that the person concerned tries to manipulate the ear canal with cotton swabs or the like. The ear furrow is very painful, the ear canal is often swollen and the lymph nodes in the area are enlarged.

In the case of the painful auricular perichondritis, the cartilage skin is inflamed. It arises after injuries or operations on the ear.

The auditory canal eczema is an inflammation of the skin of the external auditory canal, which is caused by bacteria or fungi. Preliminary skin damage, allergies, antibiotic therapy or diseases such as diabetes favor the development. The skin is red and the eczema may be dry and scaly or wet. Often it itches or hurts.

Acute otitis media (otitis media acuta)

Inflammations of the middle ear space can occur suddenly (otitis media acuta) or occur over a long period of time (otitis media chronica).

Acute otitis media is most often due to a contagious infection with bacteria that have migrated from the throat to the middle ear through the Eustachian tube. If there is a hole in the eardrum, the pathogens can also creep in from the ear canal. Typical are sharp pains in the ear, deafness, fever and headache. Also ear noises occur. If the pain suddenly subsides and empties out pus, that speaks for a drum mouth opening.

The disease becomes dangerous if viruses (for example flu or measles) are the culprits. This is because they like to spread to the inner ear or even the brain and leave there eventually permanent damage. Even aggressive bacteria or bad internal defense can lead to complications. The most common is mastoiditis, which is the spread of inflammation in the mastoid process.

Chronic otitis media

Chronic otitis media (chronic otitis media) is due to ventilation disorders of the Eustachian tube, which lead to recurrent inflammation. There is a hole in the eardrum, causing the pus to drain. That's why the chronic form is not painful.

However, it makes it so the pathogens very easy to wander again and again in the middle ear and there to sustain the infection. There is a risk that the constant inflammation on the bones and ossicles and destroys them. This results in a permanent hearing loss.

Inner Ear Inflammation (Labyrinthitis)

Inflammation in the inner ear is always the result of an injury, surgery or disease of the ear, such as a redirected otitis media. Since the inner ear is also the organ of equilibrium, it comes not only to deafness and ear noises, but also to dizziness, nausea and vomiting.

Diagnosis of inflammation of the ear

The doctor will first listen to the medical history (anamnesis), especially if there have been similar problems in the past.

Then he will look at the affected ear and scan its surroundings including the lymph nodes. An important examination is the ear reflex, in which he can examine the auditory canal and the eardrum with microscopic magnification. Functional impairments can be determined with a hearing test.

Depending on the form and the suspected cause, a thorough examination of the entire ear, nose and throat, further audition, X-rays, neurological examinations and ear strokes may follow.

Treat earache

The treatment varies depending on the affected part of the ear and on severity and course. Often antibiotics are used, in some cases must be operated on. Triggering diseases such as allergies or diabetes need to be considered.

  • Outer ear inflammation: The doctor will carefully cleanse and disinfect the ear canal, often placing gauze strips soaked in antibiotics and / or cortisone. In fungal infections, fungicides are applied locally as drops or ointment. In addition, decongestant and analgesic measures are taken. An abscess must be cut open.
  • Acute otitis media: Nasal drops are administered every 3 to 4 hours - preferably when lying down - which also cause the mucous membrane to swell at the entrance of the Eustachian tube and thus improve the ventilation. Important is an antibiotic to fight the pathogens. However, this must be taken - Ear drops or ointments are ineffective, since they do not reach the tympanic cavity with the eardrum intact. Paracetamol tablets (or in children suppositories) help against the pain and reduce the fever. Irradiation with red light and inhalations with chamomile also relieve the symptoms. If the inflammation does not improve or if there are complications, it may be necessary to make a small eardrum incision (paracentesis) and insert a tympanostomy tube so that the fluid can drain off. This also has the advantage that it can isolate the pathogens and adjust the antibiotic therapy to it. If a mastitis has developed, it may need to be surgically cleared.
  • Chronic otitis media: If there is a purulent inflammation, antibiotics are given. The most important thing is to surgically close the hole in the eardrum after the inflammation subsides. If the ossicles are already affected, an operative restoration is attempted. Bony conduction is eroded or cleared during surgery.
  • Inner ear infection: antibiotics and circulation-promoting agents are given. If the original infection is known, this must be eliminated. For example, eardrum incision is made in the case of middle ear inflammation, a cholesteatoma (a benign middle ear tumor) is removed, and in case of inflammation of the mastoid it is surgically removed.

What must the sufferer pay attention to?

Certain risk factors are known that favor the development of acute otitis media. These include tobacco smoke and air pollution, in children sleeping with a pacifier, but also underlying diseases (such as cleft palate), enlarged tonsils, dysfunction of the Eustachian tube, a weakened immune system and allergies.

Inflammation of the outer ear occurs more often with repeated bathing or swimming, if longer water in the ear remains and chlorine dries out the skin. Also, skin diseases and allergies and frequent irritation of the ear canal (for example, by cotton swabs or ear plugs) increase the risk of infection.

As far as possible, these risks should be minimized or eliminated. It has been shown that children who had their first otitis media at a very early age, or in whose family ear infections are common, are most likely to suffer from ear infections again and again.

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