Main
- Ear inflammation can be external, middle or internal, but otitis media is the most common.
- Pathogens enter from the nasopharynx through the Eustachian tube, causing swelling, congestion and pressure on the eardrum.
- In children the Eustachian tube is shorter and wider, so infection reaches the ear noticeably more easily than in adults.
- Symptoms: ear pain, blocked ear, hearing loss, tinnitus, fever, and in a child — crying and refusal to eat.
- If there is discharge from the ear or a high temperature, an urgent appointment is needed; if there is a sharp deterioration — call an ambulance.
What is otitis
Otitis is an inflammation of the ear that often occurs against the background of a cold or infection. It can affect the outer, middle or inner ear and manifest as pain, hearing loss and other unpleasant sensations.
What happens in the body
Inflammation in the ear begins when bacteria or viruses enter its cavity. Most often the pathogens get there from the nasopharynx through the Eustachian tube, which connects the middle ear to the pharynx. The mucous membrane swells in response to the invasion, and the lumen of the tube narrows. Because of this, stagnation forms inside, where microorganisms multiply especially actively. The pressure on the eardrum increases, and the person feels pain, congestion and noise in the ear. Fluid in the middle ear impedes the free passage of sound, so hearing temporarily decreases. If the swelling and stagnation do not subside, the inflammation drags on and affects neighbouring tissues. When pain or congestion of the ear appears, it is sensible not to postpone a visit to the doctor.
What causes it to develop
- Upper respiratory tract infections: a cold or flu causes swelling of the nasopharyngeal mucosa, and the pathogens rise more easily along the Eustachian tube into the ear.
- Water getting into the ear: bathing and swimming create an environment in the moist outer canal in which microbes multiply faster than usual.
- Ear injuries: damage to the skin when cleaning the ears opens a path for microbes inside and triggers an inflammatory reaction in the outer section.
- Allergic reactions: they lead to swelling and stagnation in the nasopharynx, and this impedes the outflow of contents from the middle ear.
- Structural features of the Eustachian tube in children: it is shorter and wider, so infection from the nasopharynx reaches the ear noticeably more easily than in adults.
- Reduced immunity: after illnesses the body resists microbes worse, and inflammation develops under a lesser load.
Who encounters this more often
Most often it is children, especially of early age, who encounter ear inflammation. Their Eustachian tube is shorter and positioned almost horizontally, so infection from the nasopharynx reaches the middle ear faster. Adults fall ill less often, but the risk grows with frequent colds and weakened immunity. People who swim a lot or work in damp conditions more often get inflammation of the outer section. Those with allergies are also at risk: constant swelling of the mucosa impedes normal outflow from the ear. Chronic diseases of the nasopharynx maintain stagnation and make repeated episodes more likely. It has been noted that in smokers and in those who are often in smoke-filled rooms, irritation of the mucosa is more pronounced. If episodes recur, it is worth discussing their cause with a doctor rather than waiting for everything to pass on its own.
What symptoms can there be?
The symptoms of otitis depend on which part of the ear is inflamed. The condition often begins after a cold or an upper respiratory tract infection.
How it is noticed at the very beginning
Ear pain is the first sign that makes you wary, and it is often put down to tiredness or a chill. People frequently explain reduced hearing or a feeling of congestion by earwax and put off a visit to the doctor. A rise in body temperature is then perceived as an ordinary cold, although inflammation in the ear is already developing. Noise or ringing in the ear adds to the discomfort and makes it hard to concentrate at work or in studies. In children, restlessness, crying, refusal to eat and disturbed sleep are often attributed by parents to moodiness or teething. If these signals are not noticed in time, the condition may worsen and require more serious intervention. Book an appointment with an ENT doctor as soon as you notice at least one of these signs, without waiting for the pain to become unbearable.
Signs that occur most often
- Ear pain: sometimes throbbing or shooting, it gets worse at night and prevents sleep, and it is not worth enduring.
- Reduced hearing or a feeling of congestion: sounds become muffled, as if there is a plug in the ear, and this makes conversation difficult.
- Discharge from the ear: appears if there is damage to the eardrum, and requires a doctor's attention without delay.
- A rise in body temperature: often accompanies inflammation and indicates that the process is active and requires examination.
- Noise or ringing in the ear: a constant background sound is irritating and makes it hard to concentrate, and it does not go away on its own.
- In children — restlessness and crying: the child refuses to eat and sleeps poorly, and parents do not always understand the cause straight away.
When to seek help urgently
Examinations and tests
Examination for otitis media begins with an ear examination by an ENT doctor. Additional methods are used when it is necessary to clarify the condition of the eardrum, hearing or the causative agent.
How the examination begins
The first step at an appointment with an ENT doctor is taking the medical history and examining the ear with a special instrument. The doctor clarifies when the discomfort appeared, whether there was previously a runny nose or a cold, and whether hearing loss is a concern. Then he performs otoscopy and assesses the condition of the eardrum: its colour, integrity and position. Based on these signs, the specialist judges whether the middle ear is involved and whether there is fluid behind the eardrum. If the eardrum is poorly visible due to earwax or swelling, the doctor carefully removes the obstruction and repeats the examination. If there is discharge from the ear, a swab is taken to determine which causative agent caused the inflammation. Then, if necessary, a hearing test and tympanometry, which assesses the mobility of the eardrum, are added. Keep all the records and results obtained at this appointment: they will help the doctor compare the picture at a follow-up visit.
What is prescribed and what it shows
What to prepare for the appointment
- Discharge summaries: take records from other doctors so that the specialist can see how the condition developed and what has already been done.
- Previous images: if a hearing test or tympanometry was done before, bring the results for comparison with the current picture.
- Tests: the results of recent blood tests help the doctor assess the general condition and avoid ordering unnecessary repeat tests.
- Observations: write down when the complaints appeared, how hearing changed and whether there was any discharge, so as not to forget anything at the appointment.
- Questions: formulate in advance what you want to clarify with the doctor so that the appointment goes calmly and to the point.
Which doctor should I see?
For otitis, an ENT doctor provides care, and in children — a paediatrician. Below it is explained which specialist manages the condition, what treatment consists of, and what depends on the patient themselves.
Which specialist manages this condition
Otitis in adults is managed by an ENT doctor; in children, care is often started by a paediatrician. The ENT doctor examines the ear, nose and throat, because inflammation in these areas is often interconnected. The paediatrician manages young patients and, if necessary, refers them to a narrow specialist. If there is no specialist doctor nearby, start with a therapist or paediatrician at your place of residence. Such a doctor will assess the general condition and advise where to go next. It is not worth delaying the visit if ear pain persists for several days. Early consultation helps avoid the inflammation progressing to a more severe form.
What treatment consists of
- Selection of therapy: the doctor takes into account the type of otitis and the causative agent, so that the care is precise rather than universal for all cases.
- Pain relief and anti-inflammatory treatment: these measures relieve pain and reduce inflammation, which noticeably eases the condition in the first days.
- Antibacterial therapy: it is added when the disease is bacterial in nature, when without it the inflammation may drag on or cause complications.
- Physiotherapy: the procedures accelerate healing and help tissues recover after the acute stage, when the acute symptoms have already subsided.
- Surgical intervention: it is resorted to in case of complications or special indications, when other areas of care do not give the needed effect.
What depends on the patient themselves
The regularity of follow-up with the doctor largely determines how recovery after otitis will proceed. If you come for appointments at the appointed times, the specialist will notice in time that the condition is changing not as expected. The patient decides for themselves whether to follow the doctor's recommendations and whether to report new sensations in the ear. Refusing a visit when the pain is subsiding creates a false sense that everything has passed on its own. Full compliance with the doctor's instructions reduces the risk that the inflammation will return or cause a complication. It is worth clarifying in advance with the specialist which signs require an unscheduled visit. Then the decision on further steps is made in time, rather than after the fact.
What helps prevent an exacerbation?
Prevention of otitis is aimed at reducing the risk of ear infections and injuries. Some measures depend on the person themselves, and regular monitoring helps to notice problems earlier.
What to change in habits
Timely treatment of upper respiratory tract infections directly reduces the risk of inflammation in the ear. When a runny nose or sore throat drags on, inflammation can spread through the Eustachian tube into the middle ear. The habit of not carrying a cold on your feet and not putting off a visit to the doctor reduces this likelihood. When swimming, it is worth protecting the ears from water getting in, especially if there is a tendency to inflammation. Giving up cotton buds for cleaning the ears is also important: they injure the skin of the ear canal and introduce infection. Strengthening the immune system and hardening make the body more resistant to seasonal infections. Vaccination against flu and other infections as recommended by a doctor reduces the frequency of colds, and therefore the risk of otitis.
What should be kept under control
- Condition of the upper respiratory tract: a prolonged runny nose or sore throat requires attention, because an infection near the ear easily spreads further.
- Water getting into the ears: after swimming in a body of water or a pool, it is worth making sure that water has not remained in the ear canal.
- Cleaning the ears: giving up cotton buds and other objects inside the ear helps to avoid injuring the skin and introducing infection.
- General well-being: fatigue, lack of sleep and getting cold weaken the defences, so they should be noticed and not allowed to accumulate.
- Vaccination: vaccinations against flu and other infections as recommended by a doctor reduce the number of colds and the flare-ups associated with them.
How often to see a doctor
A regular examination by a doctor is needed even when the ear is not bothering you and your well-being seems good. After otitis or frequent colds, it is worth checking with a specialist how often to come for monitoring. The doctor assesses the condition of the ear canal and the eardrum, and also asks about past infections. If congestion, hearing loss or discomfort appears, the visit should not be postponed until the scheduled date. For children and people with chronic diseases of the nose and throat, the schedule of examinations may be more frequent. Such monitoring helps to notice changes before they become pronounced. It is better to plan visits together with the doctor, and not based on your own feeling of well-being.
What is worth remembering
Otitis remains a condition in which much depends on seeking help in good time and paying attention to your own sensations. Below are several conclusions that help you make a considered decision and avoid harming yourself.
Key conclusions
Otitis is an inflammation in the ear, and its course varies: in one person everything is limited to unpleasant sensations, while in another marked pain, hearing loss and discharge appear. Otitis can be suspected from ear pain, a feeling of congestion, worsening hearing, and in a child — from restlessness, crying and refusal to eat. It is impossible to distinguish otitis externa from otitis media on your own, and this determines what steps the doctor will take. Attempts to warm the ear, instil anything or clean the ear canal with cotton buds can intensify the inflammation and damage the skin. If the pain persists for more than a day or intensifies, and especially if the temperature has risen or discharge has appeared, it is not worth putting off a visit to the doctor. Otitis endured on your feet or left unattended sometimes causes complications and becomes a protracted form. Therefore rely on an examination by a specialist, not on advice from the internet, and do not cancel what has been prescribed on your own.
