Ear infections are one of the most common reasons parents take their children to the doctor. While there are different types of ear infections, the most common is called otitis media, which means an inflammation and infection of the middle ear. The middle ear is located just behind the eardrum.
For each ear, a eustachian tube runs from the middle ear to the back of the throat. This tube drains fluid that is normally made in the middle ear. If the eustachian tube becomes blocked, fluid can build up. When this happens, germs such as bacteria and viruses can multiply and cause an infection.
Ear infections are common in infants and children, in part because the eustachian tubes become easily clogged. Anything that causes the eustachian tubes to become swollen or blocked causes more fluids to build up in the middle ear behind the eardrum. These causes include:
- Colds and sinus infections
- Tobacco smoke or other irritants
- Infected or overgrown adenoids
- Excess mucus and saliva produced during teething
In infants, the clearest sign is often irritability and inconsolable crying. Many infants and children develop a fever or have trouble sleeping. Parents often think that tugging on the ear is a symptom of an ear infection, but studies have shown that the same number of children going to the doctor tug on the ear whether or not the ear is infected.
Symptoms in older children or adults include:
- Ear pain or earache
- Fullness in the ear
- Feeling of general illness
- Hearing loss in the affected ear
The child may have symptoms of a cold, or the ear infection may start shortly after having a cold.
All acute ear infections include fluid behind the eardrum. You can use an electronic ear monitor, such as EarCheck, to detect this fluid at home. The device is available at pharmacies, but you still need to see your doctor to confirm any possible ear infection.
Learn more about the symptoms, exams, and treatment of ear infection.
Tinnitus is the medical term for "hearing" noises in your ears when there is no outside source of the sounds.
The noises you hear can be soft or loud. They may sound like ringing, blowing, roaring, buzzing, hissing, humming, whistling, or sizzling. You may even think you are hearing air escaping, water running, the inside of a seashell, or musical notes.
Tinnitus is common. Almost everyone experiences a mild form of tinnitus once in awhile that only lasts a few minutes. However, constant or recurring tinnitus is stressful and can interfere with your ability to concentrate or sleep.
It is not known exactly what causes a person to "hear" sounds with no outside source of the noise. However, tinnitus can be a symptom of almost any ear problem, including ear infections, foreign objects or wax in the ear, and injury from loud noises. Alcohol, caffeine, antibiotics, aspirin, or other drugs can also cause ear noises.
Tinnitus may occur with hearing loss. Occasionally, it is a sign of high blood pressure, an allergy, or anemia. Rarely, tinnitus is a sign of a serious problem like a tumor or aneurysm.
- Tinnitus can be masked by competing sounds, such as low-level music, ticking clocks, or other noises. Tinnitus is often more noticeable when you go to bed at night because your surroundings are quieter. Any noise in the room, like a humidifier, white noise machine, or dishwasher, can help mask tinnitus and make it less irritating.
- Learn ways to relax. Feeling stressed or anxious can worsen tinnitus.
- Avoid caffeine, alcohol, and smoking.
- Get enough rest. Try sleeping with your head propped up in an elevated position. This lessens head congestion and noises may become less noticeable.
When to Contact a Medical Professional
Call your doctor if:
- Ear noises start after a head injury.
- The noises are associated with other unexplained symptoms like dizziness, feeling off balance, nausea, or vomiting.
- You have unexplained ear noises that bother you even after self-help measures.
Learn more about tinnitus.
Swimmer's ear is inflammation, irritation, or infection of the outer ear and ear canal. The medical term for swimmer's ear is otitis externa.
Swimmer's ear is fairly common, especially among teenagers and young adults.
Causes of swimmer's ear include:
- Swimming in polluted water
- Scratching the ear or inside the ear
- Object stuck in the ear
Trying to clean wax from the ear canal, especially with cotton swabs or small objects, can irritate or damage the skin.
Swimmer's ear is occasionally associated with middle ear infection (otitis media) or upper respiratory infections such as colds. Moisture in the ear makes the ear more prone to infection from water-loving bacteria such as pseudomonas. Other bacteria, and rarely, fungi, can also cause infection.
- Drainage from the ear - yellow, yellow-green, pus-like, or foul smelling
- Ear pain - may worsen when pulling the outer ear
- Itching - Itching of the ear or ear canal
Exams and Tests
The doctor will perform a physical exam, which includes looking inside the ears. The ear, including the ear canal, appears red and swollen. The skin inside the ear canal may be scaly or shedding.
Touching or moving the outer ear increases the pain. The eardrum may be difficult for the doctor to see because of a swelling in the outer ear.
The doctor may take a sample of fluid from the ear and send it to a lab so any bacteria or fungus can be identified.
The goal of treatment is to cure the infection. Medicines may include:
- Ear drops containing antibiotics
- Corticosteroids to reduce itching and inflammation
The ear canal should be cleaned of drainage. This allows the medicines to work better.
Four or five ear drops should be used at a time, so that the medicine can get into the end of the ear canal. If the ear canal is very swollen, a wick may be applied in the ear to allow the drops to travel to the end of the canal.
Analgesics may be used if the pain is severe. Placing something warm against the ears may reduce pain.
Learn more about the symptoms, exams, and treatment of swimmers ear.
Wax blockage is an obstruction of the ear canal with wax (cerumen).
The ear canal is lined with hair follicles and glands that produce a waxy oil called cerumen.
Ear wax protects the ear by trapping dust, bacteria and other microorganisms, and other foreign particles to prevent them from entering and damaging the ear. Ear wax also helps protect the delicate skin of the ear canal from becoming irritated when water is in the canal. The wax usually makes its way to the opening of the ear, where it falls out or is removed by washing.
In some people, the glands produce more wax than can be easily removed from the ear. This extra wax may harden in the ear canal and block the ear. More commonly, wax may block the ear canal if you try to clean the ear and accidentally push wax deeper into the ear canal.
Wax blockage is one of the most common causes of hearing loss.
- Fullness in the ear or a sensation that the ear is plugged
- Noises in the ear (tinnitus)
- Partial hearing loss, may get worse
Exams and Tests
During a physical examination, the health care provider will look into the ear for signs of wax blockage.
Most cases of ear wax blockage can be treated at home. The following can be ued to soften the wax in the ear:
- Baby oil
- Commercial drops
- Mineral oil
- Detergent drops such as hydrogen peroxide or carbamide peroxide may help remove the wax.
Learn more about the symptoms, exams, and treatment of wax blockage.