Common Ear Ache, Otitis Media and Otitis Externus

Otitis Media or ear ache and ear pain is one of the most common reasons that people seek medical care for themselves and their children. In childhood the ear is commonly associated with colds, viruses, congestion and in general upper respiratory infections from any cause. The anatomy of the child’s ear and its connecting eustacian (you-stay-shen) tube has a lot to do with the movement of the virus or bacteria from the mouth, nose or throat.

This potential offender (virus or bacteria) may be a usual resident (normal flora) of these areas throat, mouth, nose etc., all the time, but when it is sucked into the eustacian tube by negative pressure and goes down into the middle ear it is not a welcome guest and causes a reaction by the body. The body defenses and the offender then start fighting and the offender hunkers down in the middle ear and starts reproducing for more soldiers, eating and growing. This invasion triggers the body to respond by trying to fight this little battle with its own soldiers, white blood cells, lymphocytes, inflammatory chemicals and other cell soldiers. The body then echo’s the familiar refrain Bugs Bunny used to say, “YOU KNOW WHAT THIS MEANS………THIS MEANS WAR!” This fight that ensues between the body and the offenders causing inflammation leading to swelling, pain, fever, redness, bulging ear drum, decreased hearing and the potential  for a perforated ear drum and other bad things. There are other types of middle ear inflammations that do not need antibiotics such as residual swelling from the original battle that takes time to go away and drain. The current trend in medicine is “watchful waiting” which means to closely monitor the ear and treat with acetaminophen, ibuprofen and benzocaine drops for the pain. This needs to be on a case by case basis and if the signs are that the patient needs antibiotics the first line medication is amoxicillin. If the patient has allergies to penicillins there are many other great antibiotics. The reason for the current “watchful waiting” stance in the literature today is that some bacteria are becoming resistant to the current available antibiotics and that many children and adults get better own their own with the body natural defenses.  I need to look into the ear to determine what is going on and then treat the problem accordingly.

Otitis Externa is a painful earache that occurs on the outside of the tympanic membrane (eardrum). This is also known as “swimmers ear” and is an infection of the ear canal or outer ear resulting in pain, swelling, diminished size of the outer ear canal, pain with movement of the visable part of the ear and occasionally some difficulty in hearing. Risk factors for this condition are swimming, use of hearing aid, external ear trauma, hot humid weather, immunocomprimised patients, such as diabetes type II, elderly, or people with debilitating diseases (Douglas S. Parks, 2012). The treatment for this ear ache is antibiotic drops and antibiotic pills. This condition is usually caused by a bacterium either Pseudomonas 90% of the time and Streptococcus or Staphlococcus 67% of the time. It may also be caused by a fungal infection which brings up one of my favorite sayings “ there’s a fungus among us!”. If it is a fungal infection it will be treated by another prescription such as 2% acetic acid drops  or clotrimazole and a prescription oral antifungal itraconazole or amphoptericin B (Douglas S. Parks, 2012).

I am here to help you with your medical needs. I want you to understand the process and become more educated if you desire. I will always strive to get you better as soon as possible and my phone is always on, so you can call me for questions.

If you, a friend, collegue, coworker, neighbor needs help with either of these painful conditions, or any other medical matter, call our office at    817-274-2343 and we will see you immediately.

  1. The 5 Minute Clinical Consult 2012, pp 930-931.  Douglas S. Parks