Ear Infections: Causes, Symptoms, and Treatment Options - Otolaryngology

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Otitis media


For over a month, I have occasionally felt a bit of pressure in my left ear, and it hurts when I sneeze.
However, I did not experience any significant discomfort until December 15, when I attended my daughter's school event.
When the sound volume was high, my ear began to hurt and feel uncomfortable, prompting me to see a doctor.
After examination, the doctor diagnosed me with otitis media, indicating that there were blisters inside.
I was prescribed antibiotics, and after three days, I returned for a follow-up.
The doctor noted that the blisters had disappeared, but there were still yellowish traces.
He prescribed another three days of antibiotics, but on the fourth day, he said there was no improvement and that it was even redder than three days prior.
He then recommended that I go to a larger hospital for further examination, as he believed adults rarely get otitis media and that caution was warranted.

Today, I went to the hospital for an examination, where it was found that there was fluid accumulation in the middle ear.
An endoscopy revealed that one end of the Eustachian tube was covered with mucus.
The doctor said this was due to chronic pharyngitis, which caused mucus to cover the Eustachian tube, impairing its function and leading to fluid accumulation in the middle ear.
It was decided to place a tube in my ear, with the doctor stating that it would naturally fall out within three to six months.
However, during this period, I should avoid getting water in my ear.

I would like to know the causes of chronic pharyngitis and what I should pay attention to in my daily life.
I have mild nasal allergies, and I am also allergic to chlorine when swimming.
Is this related to my pharyngitis? Additionally, I wear earplugs while sleeping and swimming.
In the long term, will this be harmful to my ears? Can swimming cause otitis media? Given my situation, can I continue swimming long-term, or would you recommend switching to another form of exercise? Thank you for your assistance.

Ayin, 30~39 year old female. Ask Date: 2000/12/22

Dr. Cai Zhenggu reply Otolaryngology


Hello, Miss Ain:
1.
The feeling of fullness in the ears is due to Eustachian tube obstruction.
If not actively treated, it may lead to middle ear effusion.
2.
The causes of chronic pharyngitis include the following:
- Post-nasal drip: This can lead to chronic pharyngitis and persistent cough, requiring treatment for post-nasal drip first.
- Allergic constitution: Allergies can cause bronchitis, leading to cough, which necessitates treatment for bronchitis first.
- Gastroesophageal reflux: Acid reflux can cause chronic pharyngitis and cough, requiring treatment for acid reflux first.
- Dietary habits: Some individuals may have a preference for raw foods or irritating foods such as acidic, spicy, fried foods, or excessive alcohol, which can lead to chronic pharyngitis.
Improving dietary habits is essential for significant treatment effects.
3.
Important considerations:
- Wear a mask in crowded places to prevent air pollution.
- If experiencing post-nasal drip, consult an ENT specialist.
- If experiencing acid reflux, consult a gastroenterologist.
- Avoid irritating foods.
4.
Allergic rhinitis, chlorinated water sensitivity, and pharyngitis are unrelated.
5.
Wearing earplugs will not have adverse effects on the ears.
6.
Swimming will not cause otitis media.
7.
If ventilation tubes have been placed, swimming should be avoided in the short term.
8.
I recommend switching to a different form of exercise, such as jump rope.
ENT Specialist,
Cai Zhenggu

Reply Date: 2000/12/22

More Info


Understanding ear infections, particularly in the context of your symptoms and medical history, involves recognizing the interplay between various factors such as allergies, infections, and anatomical issues. Based on your description, it appears that you are experiencing a combination of middle ear inflammation (otitis media) and possibly chronic issues related to the Eustachian tube, which connects the middle ear to the back of the throat.


Causes of Ear Infections
1. Eustachian Tube Dysfunction: The Eustachian tube helps equalize pressure in the middle ear. If it becomes blocked due to inflammation (often from allergies or infections), fluid can accumulate, leading to infections. Chronic conditions like chronic pharyngitis can exacerbate this dysfunction.

2. Infections: Bacterial or viral infections can lead to middle ear infections. In your case, the presence of fluid and redness suggests an ongoing inflammatory process, possibly due to a bacterial infection that did not fully resolve with initial antibiotic treatment.

3. Allergies: Your mention of nasal allergies and sensitivity to chlorine can contribute to inflammation in the nasal passages and throat, which can affect the Eustachian tube's function. Allergies can lead to increased mucus production and swelling, which can block the Eustachian tube.


Symptoms of Ear Infections
Common symptoms of ear infections include:
- Ear pain or discomfort, especially when sneezing or during loud noises.

- A feeling of fullness or pressure in the ear.

- Hearing changes, such as muffled sounds or popping.

- Fluid drainage from the ear, which may indicate a more severe infection.


Treatment Options
1. Antibiotics: As you've experienced, antibiotics are often prescribed for bacterial infections. However, if symptoms persist, further evaluation is necessary to rule out complications or alternative diagnoses.

2. Eustachian Tube Dysfunction Management: In cases where the Eustachian tube is not functioning properly, treatments may include nasal decongestants, antihistamines, or nasal corticosteroids to reduce inflammation.

3. Tympanostomy Tubes: In your case, the decision to place tubes in the ear is a common procedure for chronic ear infections or fluid accumulation. These tubes help ventilate the middle ear and prevent fluid buildup.


Lifestyle and Preventive Measures
1. Avoiding Irritants: Since you have allergies, it’s crucial to minimize exposure to allergens. Consider using air purifiers and avoiding known triggers.

2. Swimming Precautions: While swimming can lead to ear infections, especially if water enters the ear canal, using earplugs can help. However, if you have a history of ear infections, it may be wise to consult your doctor about swimming, particularly in chlorinated pools.

3. Ear Protection: Wearing earplugs while swimming is generally safe and can help prevent water from entering the ear. However, ensure that they are properly fitted and do not cause irritation.

4. Regular Check-Ups: Given your history, regular follow-ups with an ENT specialist are essential to monitor your condition and adjust treatment as necessary.


Conclusion
Chronic pharyngitis and Eustachian tube dysfunction can significantly impact ear health, leading to recurrent infections. It’s essential to manage allergies effectively and follow your physician's recommendations regarding swimming and ear protection. If you continue to experience symptoms or have concerns about your ear health, do not hesitate to seek further medical advice. Your proactive approach to managing your health is commendable, especially as you navigate your interests in swimming and overall wellness.

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