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Ear infections
Theearismadeupofthreeparts.Theouterearincludesthepartyoucanseeandthecanalthat leadstotheeardrum.Themiddleearisseparatedfromtheouterearbytheeardrumandcontains tinybonesthatamplifysound.Theinnereariswheresoundsaretranslatedtoelectricalimpulses andsenttothebrain.Anyofthesethreepartscanbecomeinfectedbybacteria,fungiorviruses,in eithertheearcanal,ortheeustachiantubethatconnectstheeartothethroat.Childrenare particularlypronetomiddleearinfections(otitismedia).Itisestimatedthataroundfouroutoffive childrenwillexperienceamiddleearinfectionatleastonce. Symptoms Thesymptomsofanearinfectiondependonthetypebutmayinclude: Earache Milddeafnessorthesensationthatsoundismuffled Eardischarge Fever Headache Lossofappetite Itchinessoftheouterear Blistersontheouterearoralongtheearcanal Noisesintheear,suchasbuzzingorhumming Vertigo(lossofbalance).

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The function of the eustachian tube Theearisconnectedtothebackofthenoseviatheeustachiantube.Thistubeequalisesair pressureinsidetheeartoallowbetterhearing,andfunnelssecretionsfromthemiddleearintothe throat.Thewallsoftheeustachiantubelieflatagainsteachothertopreventthemigrationof bacteriaorothergermsintotheearfromthenoseandthroat.Wheneverweswallow,aminuscule muscleflexesandopensthetube,allowingairpressureequalisationandthedrainageof secretions.Iftheeustachiantubeisblocked,secretionsandassociatedbacteriabuildupinsidethe middleear.Thiscancauseearinfections,milddeafnessandanincreasedlikelihoodofaruptured eardrum. A range of causes Someofthemanycausesofearinfectionandcontributingriskfactorsinclude: Upperrespiratorytractinfections Suddenchangesinairpressure,suchasduringairlinetravel Smallerthanaverageeustachiantubes Cleftpalate Youngage,sincebabiesandchildrenaremorepronetoearinfections Swimminginpollutedwaters Failingtodrytheouterearproperlyafterswimmingorbathing Overzealouscleaningoftheears,whichcanscratchthedelicatetissues.

Different types of infection Earinfectionsarediagnosedbyphysicalexaminationandlaboratoryanalysisofpusordischarge. Insomecases,CTscansmayalsobetaken.Typesofearinfectioninclude: Otitisexterna Otitismedia Serousotitismedia Infectiousmyringitis Acutemastoiditis

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Vestibularneuronitis Herpeszosteroftheear.

Otitis externa Otitisexternaisaninfectionorinflammationoftheearcanalbetweentheeardrumandtheouter ear.Thistypeofinfectionisalsoknownasswimmersear.Itcanbetriggeredbyexposuretodirty waterorbymechanicaldamageduetooverzealouscleaning.Theinfectiousagentcanbeeither fungalorbacterial.Treatmentoptionsinclude: Professionalcleaningoftheearcanal,althoughsyringingtheearisusuallyavoided Antibioticeardrops,iftheinfectionisbacterialinorigin Oralantibiotics Antifungalpreparations,iftheinfectionisfungalinorigin Pain-killingdrugs Keepingearsfreeofwater.

Acute otitis media Otitismediaisaninfectionofthemiddleear,whichcanbeeitheracuteorchronic.Childrenare mostcommonlyaffectedbyacuteotitismediabecauseitiscausedbycoldsandblocked eustachiantubes-bothtypicalailmentsofchildhood.Theinfectiousagentcanbeeitherviralor bacterial,withresearchsuggestingthatvirusesareresponsibleformostcases.Sometimesthe eardrumwillburst,leadingtopusintheearcanal,butusuallytheeardrumwillhealupagainby itself.Treatmentoptionsinclude: Pain-killingdrugs Antibiotics,iftheinfectionisbacterialinorigin Eardrops,ifthereispusintheearcanal.

Chronic otitis media Frequentboutsofacuteotitismediaoronelingeringattackcanleadtochronicotitismedia. Withoutmedicalintervention,thechronicinfectioncanbursttheeardrumordamagethedelicate structureswithinthemiddleear.Otherpossiblecomplicationsofuntreatedchronicotitismedia includemeningitis,infectionofthebalanceorganswithintheear(labyrinthitis),sensorineural deafnessandparalysisoftheface.Treatmentoptionsinclude: Thoroughcleaningoftheearanduseoftopicalantibioticdrops(withorwithoutsteroids) Aggressivetreatmenttokilltheinfection Surgicalrepairoftheperforatedeardrum Preventionstrategiestoreducetheriskofanotherinfection.

Serous otitis media Serousotitismediaisknownasglueear.Childrenagedbetweensixmonthsandtwoyearsofage aremostvulnerabletothistypeofearinfection.Glueearcommonlydevelopsafteramiddleear infection,andischaracterisedbythebuild-upoffluidandpuswithinthemiddleear.Treatment optionsinclude: Antibiotics Ifantibioticsfail,orifthechildisplaguedbyrepeatedattacksofglueear,surgerytoinsert smalldrainagetubes(grommets)maybeneeded.

Infectious myringitis Infectiousmyringitisisinflammationoftheeardrum,causedbyinfectionfromeithervirusesor bacteria.Theeardrumrespondstotheinflammationbyformingsmallblisters.Thiscanbequite painful.Iffeverispresent,theinfectiousagentisalmostcertainlybacterial.Treatmentoptions include: Antibiotics Pain-killingdrugs Professionalrupturingoftheblisters.

Acute mastoiditis

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Thebonethatcanbefeltimmediatelybehindtheeariscalledthemastoid.Acutemastoiditisis infectionofthisbone,causedbyprioracuteotitismedia.Thesymptomsincludereddenedand swollenskinoverthemastoid,fever,plentyofdischargefromtheearandintensepain.Thisisa seriouscondition.Untreated,acutemastoiditiscanleadtodeafness,bloodpoisoning,meningitis andparalysisoftheface.Treatmentoptionsinclude: Intravenousantibiotics Surgicaldrainageoftheinfectedbone.

Vestibular neuronitis Theinnerearcontainstheorganofbalance,thelabyrinth-threesemi-circularcanalsfilledwith fluid.Thecanalsarepositionedatdifferentangles.Whentheheadmoves,therollingofthefluid tellsthebrainexactlyhowfar,howfastandinwhatdirectiontheheadismoving.Informationfrom thesecanalsispassedtothebrainviathevestibularnerve.Vestibularneuronitisisinflammationof thevestibularnerve,probablycausedbyviralinfection.Themainsymptomissuddenanddramatic vertigo,whichmaybeaccompaniedbynauseaandvomiting.Theeyesmayalsoinvoluntarily fluttertowardstheaffectedsideofthehead.Treatmentoptionsforvestibularneuronitisinclude: Medications,includingantihistamines Anti-nauseadrugs.

Herpes zoster of the ear Soundissentaselectricalimpulsestothebrainviathecochlearnerve.Herpeszosteroftheearis aninfectionofthisauditorynervebytheherpeszostervirus.Symptomsincludeearpain,vertigo, andsmallblistersontheouterearandearcanalandperhapsonthefaceandneck.Themain nervethatservicesthefacialmusclesmayalsobecomeinfected,leadingtoswellingandpartial paralysis.Treatmentoptionsinclude: Antiviralmedicationssuchasacyclovir Pain-killingdrugs Surgerytorelievethepressureonthefacialnerve,ifrequired.

Where to get help Yourdoctor NurseonCallTel.1300606024forexperthealthinformationandadvice(24hours,7 days) Ear,noseandthroatspecialist TheRoyalVictorianEyeandEarHospitalTel.(03)99298666

Things to remember

Theearcanbecomeinfectedbybacteria,fungiorvirusesintheearcanal,orthe eustachiantubethatconnectstheeartothethroat. Treatmentdependsonthetypeofinfection,butcanincludeantibiotics,antiviraldrugs, painkillersandsurgery.

This page has been produced in consultation with, and approved by:

RoyalVictorianEyeandEarHospital(RVEEH)

Copyight 1999/2009StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)at nocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthe copyrightareprohibitedwithoutpermission. ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.Forthelatestupdatesandmore informationvisitwww.betterhealth.vic.gov.au.

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