SAY WHAT???!!!...Selective deafness or an EAR INFECTION!!
Ear infections are one of the most common health problems during the holidays for both young and old. They can cause pain and distress especially in children and some ear infections can also affect children’s hearing. To fully understand how ear infections are caused and treated we need to look at the anatomy of the ear.
PARTS OF THE EAR
The ear has three main sections
- The outer ear (the ear canal and the ear lobe)
- The middle ear, which is separated from the outer ear by the ear drum
- The inner ear which is where nerves detect sound, and where the part of the ear involved with balance is.
The middle ear is normally filled with air so that the ear drum and the small bones which join the ear drum to the inner ear can move freely carrying sound clearly to the nerves of the inner ear. There is a tube (called the eustachian tube) which goes from the back of the throat to the middle ear so that air can get into the middle ear. When you yawn or swallow you will often hear a ‘pop’ as air goes up or down the eustachian tube, keeping the air pressure in the middle ear the same as the pressure outside of the ear.
OUTER EAR INFECTIONS.
Otitis externa, commonly known as “swimmers ear”, plagues swimmers and surfers all year round. This painful and troublesome condition is caused by water that is trapped in the external ear canal, causing a bacterial and sometimes fungal overgrowth in the canal. The canal becomes swollen, red, irritated and painful. This condition is easy to treat with antibiotic / anti-inflammatory drops, however you must ensure that the ear drum is not damaged before using ear drops; should these drops enter the middle ear chamber they may cause damage to the delicate structure and nerves. An easy way to prevent this condition is to ensure that the ears are clean and dry after swimming or bathing. In people that are prone to this type of infection, adding a few drops of surgical alcohol & vinegar solution to the ear canal after swimming will prevent any bacterial over growth. You should remember that this is a preventative and not a cure. Using ear plugs while swimming or surfing can also help, and if you cannot find ear plugs at the store, “blue tack” pliable adhesive will do the job just as well…and much cheaper too!
MIDDLE EAR INFECTIONS
Otitis media or a middle ear infection is an infection of the middle ear chamber. This often follows a cold, sinusitis, throat infection or hay-fever, when the eustachian tube often gets blocked, and air cannot get into the middle ear. This is more common in children due to the angle and the size of the eustachian tube.
- A sticky fluid collects in the middle ear, and this fluid can get infected with bacteria, causing the middle ear infection. The build up of fluid and pus causes a pressure which is painful.
- You cannot ‘catch’ an ear infection, but you can catch a cold from others, which then goes on to cause the ear infection.
- The most common age for middle ear infections is between 6 months and 2 years. Most children have grown out of middle ear infections by the age of around 6 years when the eustachian tube is larger and does not get blocked as easily.
- Up to 80% of children will have an ear infection at least once and many have it several times.
SIGNS OF MIDDLE EAR INFECTION
- An older child or adult will complain of ear pain, and headache, and they will have a temperature and feel unwell. They may complain of feeling “deaf’ in the affected ear and there may be signs of a cold, sinusitis, sore throat or hay-fever.
- In a younger child the signs may include getting upset easily, a raised temperature, not wanting food, and problems with sleeping. This will usually happen a couple of days after the start of a cold or other cause of the middle ear infection.
- Sometimes children will appear unwell, and may vomit or have diarrhoea without any clear signs that the infection causing them to be sick is an ear infection.
Treatment of middle ear infections
- Sometimes the ear drum will ‘burst’ during an attack. A small split develops in the ear drum and pus and blood stained fluid can drain out. This fluid can be seen in the ear canal. After the fluid drains out, and the pressure is relieved the child will feel better. The burst ear drum usually heals fully without treatment.
- For other children the infection will settle without treatment, but there can be fluid in the middle ear for several weeks or months and this can interfere with hearing (see GLUE EAR below).
- Most children will have healthy ears by about 2 weeks after the middle ear infection started, even if they do not get any antibiotics. Many children are prescribed antibiotics when they are seen by a doctor and found to have a middle ear infection which is generally contributing to antibiotic resistance in the community. These days antibiotic therapy is generally not recommended for simple ear infections.
- If a child is having many middle ear infections, removing the adenoids is often helpful (usually not done until the child is at least 3 years old), or artificial ducts may be inserted into the ear drum (called “grommets”) to avoid repeated rupture of the ear drum in children that suffer from frequent infections.
WHAT PARENTS CAN DO
- Most people feel more comfortable if they are given something for pain. Paracetamol is commonly used.
- Children need extra drinks and lots of comforting.
- Sleeping with the head raised seems to make some children more comfortable.
- Decongestant medicines and antihistamines are not thought to be useful.
- It is best not to send a child with an ear infection to school, even though they cannot pass on the ear infection, a child with an ear infection probably needs more care than can be provided by child care workers who have to look after other children as well.
- Children with ear infections need rest, extra cuddles and quiet activities.
GLUE EAR (Middle ear fluid)
- A glue ear is when the middle ear is filled with a sticky fluid that looks rather like honey, usually after ear infections, but it sometimes happens when there does not seem to have been an infection.
- The fluid in the middle ear makes it harder for the child to hear. Sounds are more muffled, and when it lasts a long time this may affect learning to talk and how clearly children speak. It can cause behaviour problems as well.
- Sometimes the child will be uncomfortable when lying down and so will wake at night.
- If the child has hearing problems the doctor may try antibiotics for a longer time than usual (e.g. 6 weeks).
Sometimes removal of the adenoids is recommended. The adenoids sit at the end of the eustachian tubes and can block the tubes if they become swollen.
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Kim Patra is a qualified Registered Nurse and Midwife that has been living and working in Bali for almost twenty years. She now runs her own private practice and medical referral service from her Kuta office. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at info@chcbali.com”.
