Ear Infections: Symptoms, Causes, and Treatment Options

Ear inflammation

Hello doctor, I have been experiencing yellow or dark brown discharge from my ears for several years now.
It originally started in my right ear, but now my left ear is also affected.
I have visited both a clinic and a large hospital.
The clinic diagnosed me with otitis media, while the hospital said it was otitis externa.
I frequently experience inflammation and itching, which leads me to dig in my ears more often, using cotton swabs, rolled-up tissue, or ear picks.
The discharge keeps recurring.
I feel that my hearing has worsened.
I had a hearing test, and the doctor mentioned something about auditory attention.
I was confused because I can hear, but if the TV volume is above 10, it sounds very loud to me; I might need it to be above 20 to hear clearly.
As a result, the TV is often turned up so loud that it can be heard on the floor above.
Additionally, my eardrum has been perforated several times due to external force in the past.

Xiao Zhen, 30~39 year old female. Ask Date: 2016/04/05

Dr. Zheng Jueyi reply Otolaryngology

Hello! Frequent discharge may indicate that if there is a perforation in the eardrum, it is often due to otitis media.
If the eardrum is intact, it is more likely to be otitis externa.
It is advisable to reduce excessive cleaning of the ear canal.
If discharge persists, a follow-up visit for medication treatment is necessary.
Wishing you health and happiness! Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/04/05

More Info

Understanding ear infections, particularly in the context of your symptoms, requires a comprehensive look at the various types of ear conditions, their causes, symptoms, and treatment options. Based on your description, it seems you have been experiencing chronic ear issues, including yellow or dark brown discharge, itching, and a perceived decrease in hearing ability.

Types of Ear Infections
1. Outer Ear Infection (Otitis Externa): This is commonly known as swimmer's ear and occurs when water remains in the ear canal, creating a moist environment that promotes bacterial growth. Symptoms include itching, redness, swelling, and discharge. The discharge can be yellow or brown, depending on the severity of the infection.

2. Middle Ear Infection (Otitis Media): This infection occurs behind the eardrum and is often associated with upper respiratory infections. Symptoms may include ear pain, fever, irritability in children, and sometimes discharge if the eardrum ruptures.

3. Chronic Ear Conditions: Given your history of frequent infections and the use of cotton swabs or other objects to clean your ears, you may be at risk for chronic ear conditions. This can lead to persistent inflammation and discharge, which can further complicate your hearing.

Symptoms and Their Implications
- Discharge: The presence of yellow or dark brown discharge from the ear is a significant indicator of infection. This could suggest either an outer ear infection or a chronic middle ear issue.

- Itching: Itching in the ear canal is often associated with outer ear infections. Frequent scratching or cleaning can exacerbate the condition, leading to more irritation and potential injury to the ear canal.

- Hearing Loss: Your description of needing to increase the volume significantly to hear clearly suggests that there may be a blockage or fluid buildup affecting your hearing. This could be due to inflammation, wax buildup, or even structural changes in the ear from repeated infections.

Causes
- Infection: Bacterial or fungal infections are common causes of ear infections. Your history of frequent infections may indicate a predisposition to these conditions, possibly exacerbated by your cleaning habits.

- Eustachian Tube Dysfunction: This can occur when the tube that connects the middle ear to the back of the throat becomes blocked or fails to open properly, leading to fluid buildup and infection.

- Trauma: Previous ruptures of the eardrum due to trauma can lead to scarring and increased susceptibility to infections.

Treatment Options
1. Medical Evaluation: It is crucial to have a thorough evaluation by an Ear, Nose, and Throat (ENT) specialist. They can perform a detailed examination, possibly including imaging studies, to assess the condition of your ears.

2. Medications: Depending on the diagnosis, treatment may include:
- Antibiotics for bacterial infections.

- Antifungal drops if a fungal infection is suspected.

- Steroid ear drops to reduce inflammation.

3. Ear Cleaning: Avoid using cotton swabs or other objects to clean your ears, as this can push wax further in and cause blockages. A healthcare provider can safely clean your ears if necessary.

4. Hearing Assessment: Since you mentioned a decrease in hearing clarity, a comprehensive audiological evaluation may be warranted to determine the extent of any hearing loss and to guide further treatment.

5. Preventive Measures: If you are prone to ear infections, consider preventive strategies such as avoiding water exposure during swimming, using earplugs, and managing allergies that may contribute to Eustachian tube dysfunction.

Conclusion
Given your symptoms and history, it is essential to seek further evaluation from an ENT specialist who can provide a tailored treatment plan. Chronic ear infections can lead to long-term complications, including permanent hearing loss, if not adequately addressed. Early intervention and proper management are key to restoring your ear health and preventing future issues.

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