Ear Infections

There are three basic classifications of ear infection conditions, and they depend on the location of the infection within the ear. The outer ear is the area ranging from the part you can see to the eardrum. Behind the eardrum is the middle ear. Behind that, the inner ear houses the semicircular canals of the cochlea.

Ear Drainage (Otorrhea)

If your eardrum is perforated, drainage (“otorrhea”) can leak through the middle ear space and out through the ear canal. Normally, the middle ear space is protected from the external environment by the eardrum, but when this protective covering is lost, the middle ear can become infected by bacteria. The resulting abnormal pressure in the middle ear can make the Eustachian tube dysfunction, causing a condition where fluid will accumulate and drain through the perforation. If this drainage is infected, it may appear green or otherwise discolored. However, a ruptured eardrum can also create clear or bloody otorrhea.  Drainage from the ear should always be evaluated by an Ear, Nose and Throat Specialist.

Earwax (Cerumen)

Cerumen, is a condition better known as earwax, is a natural oily substance produced by glands in your ear canal. It keeps the canal clean and protects it from foreign substances such as dust, microorganisms, and water. The amount of earwax your body produces is determined by genetic factors and some individuals are predisposed to produce more wax than others. This may become bothersome and difficult to manage. If earwax accumulates in large quantities, it may cause hearing loss, pain, or a feeling of fullness in the ear.

Attempting to remove earwax with a cotton swab could impact it further into your ear canal and up against your eardrum. Earwax that is left in the ear canal for a long time can become infected by bacteria or fungal microorganisms. In this case, an Ear, Nose and Throat Specialist can help remove excess wax and treat any external ear infection that may have developed. Some forms of earwax can easily be removed with a special tool, while other forms may require water irrigation. If earwax is a concern for you, consider scheduling annual appointments to have earwax cleared regularly.

Ruptured Eardrum

A ruptured eardrum, a condition also known as a perforated tympanic membrane, can be caused by many different things. For example, a middle ear infection can create an accumulation of fluid behind the eardrum that causes too much pressure. Ruptured eardrums can also occur from under-water or high altitude pressure, direct injury to the eardrum by a foreign object, damage caused by loud noises, or severe trauma to the head. Signs of a ruptured eardrum can include sharp pain, drainage from the ear that may be clear or bloody, dizziness or feelings of off-balance, sudden hearing loss in the affected ear, and ringing (tinnitus) in that ear.

Many perforations can heal on their own within a few weeks. However, in some conditions, it may require surgical intervention. A tape myringoplasty, the process of placing a small piece of special tape over the hole in the eardrum, can be performed in order to allow the hole to heal and keep debris from accumulating in the exposed middle ear. It’s always a good idea to have a suspected or confirmed ruptured eardrum evaluated by an Ear, Nose, and Throat Specialist for advice on appropriate treatment.


The mastoid bone runs behind your ear. In its normal, healthy state, this bone is similar to a honeycomb or sponge; the pores in the bone are filled with air. Two types of infection can occur in the mastoid bone: acute mastoiditis and chronic mastoiditis.

Acute mastoiditis condition is most likely to occur from a middle ear infection that hasn’t been treated properly. This type of infection is often caused by dysfunction of the Eustachian tube, which is supposed to act as a vacuum for the middle ear space. If it isn’t functioning correctly, fluid and bacteria can invade the middle ear and cause hearing loss or feelings of pressure and fullness. The mastoid bone is located directly behind the middle ear, so it can easily be affected if an infection is left to smolder. The normally well-aerated bone will begin to deteriorate and retain pus and fluid. Acute mastoiditis refers to an infection lasting less than three weeks and can be treated with antibiotics.

If the course of antibiotics used to treat acute mastoiditis is only partially completed, a chronic infection can develop. Chronic mastoiditis, therefore, results from an infection that lasts longer than three months. These types of infections often involve a perforation from which otorrhea (drainage from the ear) will intermittently leak out. Chronic mastoiditis can sometimes be treated with antibiotics but may call for surgical treatment if it is severe.

Secondhand Smoke and Ear Infection

Smoking is known to affect the normal, healthy mucous production of the nasal airways and sinuses. When mucous production is interrupted, the mucous can back up into the sinuses and nasal passages and become infected. The Eustachian tube is located near the area behind your nose, so contact with secondhand smoke can cause it to dysfunction. This compromises the cleanliness of the middle ear. All of this together increases the chance for an ear infection. Studies have shown that children exposed to secondhand smoke are more likely to suffer from ear infections than children who are not regularly exposed to secondhand smoke.

Ear Infections in Children

It is more common for children to suffer from more ear infections than adults. This is partially because children’s immune systems are still developing and are not as equipped to fight off infections. It’s also because the Eustachian tube, which is angled downward in most adults, runs more straight in children. This means that gravity can’t help as much in removing fluid from the middle ear if the child acquires an upper respiratory infection or other issue that would cause fluid to accumulate. What’s more, the adenoids can also become enlarged as they filter bacteria from the body. This bacteria can easily be passed from the adenoids to the middle ear.

Swimmer’s Ear

Swimmer’s ear is caused by water trapped in the ear canal. This creates a warm, moist environment that is attractive to bacteria and other microorganisms. Symptoms of swimmer’s ear include pain, itching, clear and odorless otorrhea (drainage), and redness and swelling of the ear. If left untreated, swimmer’s ear can cause the lymph nodes in the neck to swell or create a fever. An Ear, Nose and Throat Specialist can prescribe medication and clean the ear of infected debris. The best way to avoid swimmer’s ear is to keep your ears dry when you’re in water; swimmer’s plugs or a cotton ball with petroleum jelly on it will keep your ears dry and safe.

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