Barotrauma of the Ear
Unequal air pressure on both sides of the eardrum can damage
the middle ear. This is called barotrauma. It is also called barotitis media or
aerotitis media.
The middle ear is separated from the ear canal by the
eardrum. The Eustachian tube connects the middle ear with the back of the nose
and allows outside air to enter the middle ear. This helps maintain equal
pressure on both sides of the eardrum. Sometimes, the outside air pressure may
change suddenly. For example, during deep-sea diving or when an airplane is
ascending or descending, the outside air pressure may change suddenly.
The Eustachian tube has to work to help equalize the
pressure in the middle ear. However, if it is partly or completely blocked, air
cannot move in and out of the middle ear. A blocked Eustachian tube may occur
due to scarring, tumor, infection, cold, or an allergy. This causes pressure on
the eardrum and it may lead to bruising, rupturing or bleeding of the eardrum.
In some cases, the entrance from the middle ear into the
inner ear (referred to as the oval window) can rupture causing fluid to leak
into the middle ear from the inner ear. If an individual experiences vertigo or
hearing loss during deep-sea diving or while an airplane is descending, it may
suggest that fluid leakage is occurring. If the same symptoms are experienced
by an individual while an airplane is ascending, it means that an air bubble
has formed in the inner ear.
Prevention and Treatment
Sudden changes in pressure cause fullness and pain in the
ear. The discomfort can be relieved through several methods for equalizing the
middle ear pressure.
If there is decrease in outside air pressure, for example
due to an airplane ascending, the individual should open his or her mouth and
try breathing through it. Chewing gum or swallowing may also help. These
measures open the Eustachian tube and the air can leave the middle ear.
If there is an increase in the outside air pressure, for
example when the airplane is descending or when an individual goes deep-sea diving,
the individual should close his or her nose by pinching it, keep the mouth
closed and blow gently through the nose. This maneuver forces the air to move
through the blocked Eustachian tube.
An infection or allergy which affects the nose and throat
can cause problems for an individual while flying or diving. A decongestant,
such as phenylephrine nasal spray or drops, can help relieve congestion and
open up the Eustachian tube. This can help equalize pressure and reduce
discomfort while flying. An individual should avoid diving until the infection
or allergy is controlled.
Benign Paroxysmal Positional Vertigo
Benign paroxysmal positional vertigo (BPPV) is a disorder in
which changes in the head position lead to short episodes of vertigo. Changes
in head position that stimulate the posterior semi-circular canal of the inner ear
cause these vertigo episodes. Vertigo is a false sensation that makes the
individual feel that they or their surroundings are moving or spinning. Nausea
and vomiting are also part of these episodes. The eyes of the individual may
also move abnormally.
Diagnosis is usually based on the symptoms and the
conditions in which they occur. A physical examination is also used for
diagnosis. The disorder can be cured by performing the Epley maneuver once or
twice.
Causes
Most vertigo episodes are triggered in two situations: when
the individual wakes up in the morning and turns his or her head over on the
pillow, or when he or she tips the head to reach a high shelf. Both these
situations involve a change in head position and usually trigger an episode of
vertigo.
There are three semi-circular canals in the inner ear and
these help with balance: anterior, horizontal and posterior. Unlike the other
two, the location of the posterior canal makes it the best canal to receive any
loose particles during the night due to gravity.
Otoconia or calcium particles are embedded in the utricle
and saccule of the inner ear. When these particles are displaced and move into
another part of the inner ear, mostly posterior semicircular canal, it causes
BPPV.
These calcium particles basically collect in the posterior
canal and form a chalky sludge and then a mass. When the individual changes
head position, this mass exaggerates the movement of fluid in the posterior
canal. This over-stimulates the nerve receptors (hair cells) present in the
canal. The result is that it makes the brain feel that the head is moving
differently or faster than it actually is.
The calcium particles can get displaced from the utricle and
saccule as people get older. Other conditions that may cause displacement of
the particles are the following:
·
Ear infections
·
Ear surgery
·
Head injury
·
Ear injury
·
Prolonged bed rest
·
Blockage of an artery going
to the inner ear
Symptoms
Although vertigo is quite scary for most people, it is
usually quite harmless. It also disappears by its own. A person may move his
head while rolling over in bed or while bending to pick something. This change
in head position may cause an episode of vertigo. The episode may last for a
few seconds to a few minutes. It may be experienced many times over a course of
a few days and then subside by its own.
Nausea, vomiting and nystagmus may accompany vertigo.
Nystagmus is involuntary movement of the eyes from one side to the other with a
slower drift back to the original position. Tinnitus or hearing loss is not
found in people with BPPV.
Diagnosis
The symptoms and the conditions in which they occur are used
by doctors to make a diagnosis. Doctors usually use a maneuver called
Dix-Hallpike to stimulate the posterior semi-circular inner ear canal and
trigger an episode of vertigo and nystagmus.
In this maneuver, the person is made to sit on the examining
table and turn his head 45 degrees to the right. With his head turned this way,
the person is then asked to lie down backward. In this position, the person’s
head hangs over the table by about 20 degrees. In individuals with BPPV, there
is a delay between 5-30 seconds before the vertigo and nystagmus occur. Symptoms
may last 10-30 seconds.
If the gaze is fixated on a single location, nystagmus may
be shortened or it may disappear. This is why the person going through the
maneuver is made to wear Frenzel lenses. These lenses make visual fixation
impossible and the individual is not able to fix his gaze on a single object.
When the maneuver is repeated, habituation may occur. This
means that the intensity of the vertigo and nystagmus decreases every time the
maneuver is repeated.
The above-mentioned conditions may not be met in individuals
with a brain disorder, such as multiple sclerosis or stroke. In such patients,
the maneuver is able to trigger symptoms immediately. The episode of vertigo
continues for as long as the head is held in this position. When the maneuver
is repeated, habituation does not occur either.
Treatment
Simply moving the calcium particles out of the posterior
semi-circular canal and into a part where they won’t cause any symptoms is
enough to treat BPPV. To do this, the canalith repositioning maneuver or Epley
maneuver is used. This is a somersault-like maneuver of the head which cures
vertigo in about 90% of the people. If the vertigo is not cured, the maneuver
can be repeated. Another 5% will benefit by repeating it. People can learn to
do this maneuver and use it at home whenever vertigo happens. In some people the
vertigo may recur at a later time. In such cases, the same maneuver can help
again.
Surgery is rarely needed for BPPV. Sometimes, the horizontal
canal in the inner ear may also be affected and cause vertigo. People can
relieve these symptoms by rolling over like a log in this case.
Eardrum Perforation
Overview
The word “perforation” means hole and eardrum perforation
means that there is a hole in the eardrum of the individual. These perforations
usually occur due to infection in the middle ear. Sudden ear pain, bleeding
from the ear, loss of hearing, and noise in the ear are some signs of a
perforated eardrum.
A doctor uses a device called otoscope to see the
perforation. An eardrum perforation usually heals by its own. However,
sometimes surgical repair may be required.
Causes
Otitis media or infection in the middle ear is the most
common cause of perforation in the eardrum. Sudden increase or decrease in
pressure can also cause a hole in the eardrum. An increase in pressure can
occur due to an explosion, diving underwater, or a slap. The pressure may
decrease while flying in an airplane.
Objects placed in the ear (such as a cotton swab for
cleaning the ear) or entering the ear accidentally (such as twig or pencil
entering the ear) may also puncture the eardrum. If the object penetrates the
eardrum, it may also fracture or dislocate the ossicles. The ossicles are small
bones that connect the inner ear to the eardrum. Broken pieces of the ossicles
or objects may penetrate the inner ear.
Barotrauma or severe imbalance of pressure due to a blocked
Eustachian tube may also cause perforation in the eardrum. The Eustachian tube
connects the middle ear to the back of the nose.
Symptoms
Symptoms of eardrum perforation may include the following:
·
Sudden severe pain
·
Bleeding from the ear
·
Loss of hearing
·
Tinnitus or noise in the
ear
·
Vertigo due to damage to
the inner ear
·
Pus oozing out from the ear
in about 24-48 hours, especially if water or a foreign object has entered the
middle ear
Diagnosis
A perforated eardrum is diagnosed with the help of a device
called otoscope. Format hearing tests may also be recommended.
Treatment
The patient is asked to keep the ear dry. If the ear is
infected, an antibiotic may be given by mouth. Ear drops may be prescribed for
infected injuries. No further treatment is usually required and the eardrum
heals by its own.
However, if it does not heal within 2 months, a surgical
procedure called tympanoplasty may be recommended to repair the eardrum.
If there is severe injury and it is accompanied by loss of
hearing and/or severe vertigo, immediate surgery may be recommended. It is
important to repair the perforation since it can cause chronic otitis media,
that is, chronic infection in the middle ear.
Persistent conductive hearing loss after perforation of the
eardrum suggests that there is disruption or fixation in the ossicles. This may
require surgical repair. If the injury causes sensorineural hearing loss or
vertigo for more than a few hours, it means the inner ear is injured or
damaged.
Herpes Zoster Oticus
When the ganglia (clusters of nerve cells) controlling 7th
and 8th cranial nerves are infected by the herpes zoster virus, the
condition is called herpes zoster oticus. The 7th cranial nerve
controls facial movement, whereas the 8th cranial nerve controls
hearing and balance.
Causes
Varicella-zoster virus is the virus that causes chicken pox.
The virus lies inactive in the nerve roots. When this virus is reactivated, it
travels down the nerve fibers to the skin. The reactivated virus creates
painful sores on the skin. The cause of reactivation is not known. However,
most experts believe that it may be reactivated when the immune system is
weakened, for example, when the person has a life-threatening disease, such as
cancer or AIDS, or when the person is taking certain drugs.
Reactivation of the varicella-zoster virus causes herpes
zoster infection. When the virus infects
the 7th and 8th cranial nerves, it leads to herpes zoster
oticus. These two nerves are responsible for controlling hearing, balances and
facial muscles.
Symptoms
Following are the symptoms of herpes zoster oticus:
·
Severe ear pain
·
Temporary or permanent
facial paralysis, which is quite similar to Bell Palsy
·
Vertigo or a false
sensation that you or your surroundings are spinning or moving
·
Temporary or permanent
hearing loss, which may resolve completely or partially
·
Fluid-filled blisters
called vesicles that occur on the pinna (outside of the ear) and inside the ear
canal
Although rare, some people may experience headaches, stiff
neck or confusion. The virus may sometimes affect other cranial nerves as well.
Diagnosis and Treatment
A doctor will conduct a physical examination. Although
medications are given to relieve the symptoms, not much is known about how much
these drugs actually help. Doctors may prescribe corticosteroids such as
prednisone to block inflammation. Anti-viral drugs such as acyclovir or
valacyclovir can help reduce the duration of the infection. The doctor may
prescribe Diazepam to reduce episodes of vertigo. For pain, oral opiods are
prescribed. If the individual has complete paralysis of the face, a surgical
procedure may be required to relieve pressure on the facial nerve.
Mastoiditis
Mastoid is the prominent bone behind the ear. Infection in
this bone is referred to as mastoiditis. It usually occurs when acute otitis
media is left untreated or is not properly treated, resulting in the infection
spreading from the middle ear to the mastoid process.
Symptoms
Symptoms of mastoiditis may develop from a few days to a few
weeks after the occurrence of acute otitis media. The infection spreads to the
mastoid process and begins to destroy the inner part, which may result in the
following symptoms:
·
Collection of pus forms in
the bone, called abscess
·
Redness, swelling,
tenderness in the skin covering the mastoid process
·
External ear is pushed
sideways and down
·
Fever
·
Persistent and throbbing
pain around and within the ear,
·
Creamy and heavy discharge
from the ear
·
Hearing loss which becomes
progressively worse
Diagnosis
A computer tomography (CT) is used to diagnose mastoiditis. In
case of mastoiditis, a CT will reveal that the air cells in the mastoid process
are filled with fluid. Air cells are spaces in the bone that are filled with
air. These spaces tend to enlarge as the mastoiditis continues to get worse.
Complications
If mastoiditis is left untreated or is not properly treated,
it can cause complications that may include the following:
·
Deafness
·
Sepsis or blood poisoning
·
Meningitis or infection of
the tissues that cover the brain
·
Brain abscess
If ignored, mastoiditis may even cause death.
Treatment
Intravenous antibiotics are the usual treatment for
mastoiditis. The doctor usually takes a sample of the ear discharge to help
identify the organism causing the infection. This will help the physician to determine
which antibiotics will be appropriate for killing the bacteria present in the
ear discharge.
Once the person begins to recover, antibiotics may be given
by mouth. These are continued for a minimum of 2 weeks. If an abscess is found
on the bone, a mastoidectomy or surgical drainage is required.
Infectious Myringitis
When the eardrum is infected by a
bacteria or virus it is called infectious myringitis. The condition can be
caused due to a variety of bacteria and viruses. One of the most common causes
of myringitis is a bacterium called Mycoplasma.
Symptoms
Symptoms of myringitis include the following:
·
Inflamed eardrum
·
Fluid-filled blisters or
vesicles on the surface of the eardrum
·
Sudden pain which lasts for
24-48 hours
·
Loss of hearing
Blisters are also found in otitis media or infection of the
middle ear. However, in that case the middle ear does not have any fluid or pus.
Diagnosis and Treatment
Myringitis is diagnosed by a doctor after looking at the
eardrum with a device called otoscope. It is not always possible to say whether
the infection has been caused by bacteria or by a virus. This is why doctors
usually treat myringitis with antibiotics and analgesics.
A small blade may also be used to rupture the blisters and
to relieve pain.
Meniere Disease
Overview
Disabling vertigo accompanied by fluctuating hearing loss
especially in the lower frequencies, and noise in the ear or tinnitus are
typical signs of Meniere disease. The individual in this case goes through
sudden and recurrent attacks of severe vertigo, nausea and vomiting which stop
the individual from performing his or her normal activities.
Doctors may recommend hearing tests and magnetic resonance
imaging (MRI) for diagnosing this condition. The frequency and severity of
attacks may be reduced by eating a low-salt diet and taking a diuretic. Doctors
may prescribe meclizine or lorazepam to relieve vertigo.
Causes
A pouch-like structure in the ear called endolymphatic sac
contains the inner ear fluid. A consistent amount of this fluid is maintained
in the ear by continuous secretion and reabsorption. However, sometimes there
may be an increase in the production of the fluid or decrease in its
reabsorption. This results in an imbalance of the inner ear fluid. Meniere disease
is caused due to this imbalance in the inner ear fluid.
Symptoms
Following are the main symptoms of Meniere disease:
·
Sudden, acute and
unprovoked attacks of severe, disabling vertigo (sense that the objects around
you are moving or spinning), nausea and vomiting which last for 1-6 hours; although
rare these may also last up to 24 hours
·
A feeling of fullness or
pressure in the affected ear before and during the attack
·
Fluctuating hearing which worsens
over the years
·
Ringing or noise in the ear
(tinnitus), which may be intermittent or constant; the noise may be worse
before, during, or after an attack
·
Loss of hearing and
tinnitus affect only one ear
·
Loss of hearing is worse at
lower frequencies
Ringing in the ear and loss of hearing may precede the first
attack of vertigo by months or even years in one form of Meniere disease. Once
the attacks of vertigo begin, the individual’s hearing may improve.
Diagnosis and Treatment
Typical symptoms of severe vertigo, tinnitus and hearing
loss in one ear are usually enough for a doctor to suspect Meniere disease. He
or she may recommend hearing tests and magnetic resonance imaging (MRI) to
ascertain the cause of the symptoms.
In most people, the frequency of vertigo attacks can be
lowered by taking the following steps:
·
Taking a low-salt diet
·
Avoiding caffeine and
alcohol
·
Taking diuretics, such as
hydrochlorothiazide or acetazolamide, that increase the frequency of urine
Treatment usually does not stop progressive hearing loss. Most
people will experience moderate to severe hearing loss in one ear within 10-15
years of the first attack.
A doctor may prescribe oral medications, such as meclizine
or lorazepam for vertigo attacks. Pills or suppositories containing prochlorperazine
can help relieve nausea and vomiting. Since these medications do not prevent
attacks, these should not be taken on a regular basis. The medications should
only be taken when an acute attack occurs. Doctors may also prescribe oral corticosteroids
such as prednisone or intravenous corticosteroids such as dexamethasone behind
the ear to relieve the symptoms.
There are several procedures available for individuals who
have frequent and severely disabling attacks of vertigo despite medications. While
some procedures aim at reducing fluid pressure in the ear, others may aim at
destroying the balance function of the inner ear.
Endolymphatic sac decompression is the least damaging of
these procedures. It involves exposing the bone that lies over the endolymphatic
sac. A thin sheet of flexible plastic material is then placed in the inner ear.
The procedure is quite safe since it rarely damages the hearing of the
individual. It rarely affects the balance of people.
In some cases, endolymphatic sac decompression may fail. In
such cases, the doctor will need to destroy the balance function of the inner
ear. This is done by injecting a solution of gentamicin into the inner ear,
right through the eardrum of the affected ear. Gentamicin destroys the balance
function of the inner ear and then proceeds towards damaging the hearing in the
ear. Hearing damage may be reduced if the gentamicin is injected only once and
a gap of several weeks is given before giving the next injection.
Some people may continue experiencing severe attacks of
vertigo despite having these procedures. Surgery is recommended for such
patients. Surgery usually involves cutting the vestibular nerve permanently.
This destroys the balance of the inner ear, but keeps the hearing intact in the
affected ear. In about 95% of the cases, this surgery is effective in
controlling vertigo attacks.
The surgery is usually performed when symptoms do not lessen
after undergoing endolymphatic sac decompression. People who do not want to
experience another vertigo attack may also want to go for this surgery.
If the hearing has deteriorated in the affected ear and
vertigo is severe and disabling, labyrinthectomy may be recommended. Labyrinthectomy
is a procedure that involves drilling away the semi-circular canals.
The surgical procedures offer relief in vertigo. However,
the hearing loss that accompanies Meniere disease cannot be helped by these
procedures.
Otitis Media (Acute)
Acute otitis media is caused due to an infection in the
middle ear. This infection can be bacterial or viral in nature and usually
occurs as a result of the common cold or respiratory allergies. While symptoms
and treatment of acute otitis media are similar in both adults and children,
the condition is more common in children than in adults.
Symptoms
Following are the symptoms of acute otitis media:
·
Pain in the infected ear
·
Red, bulging eardrum
Treatment
Otitis media usually gets better by its own without
treatment. However, it is difficult for any doctor to say which individual will
get better without medications. Therefore, most doctors treat people affected
with otitis media with antibiotics, such as amoxicillin. Others may wait for
about 72 hours to see if the symptoms lessen. These doctors only prescribe
antibiotics if the symptoms are severe or if they do not lessen even after 3
days.
Since pain relief is important, doctors may prescribe
acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). Decongestants
containing phenylephrine may be prescribed for adults, but they are not given
to children. People with allergies will benefit from antihistamines. However,
those with colds may not get relief with antihistamines.
Painful ear and bulging eardrum accompanied by fever may
require myringotomy. In this procedure, the doctor makes an opening in the
eardrum so that the fluid accumulated in the middle ear can drain out. This
opening does not cause hearing loss and heals by its own without treatment.
Tympanostomy tubes may be required for people who have
repeated episodes of acute otitis media. Tympanostomy tubes are drainage tubes
that are placed in eardrums to allow the fluid to drain out from the middle
ear.
Otitis Media (Secretory)
Overview
Accumulation of fluid in the middle ear is referred to as
secretory otitis media. When acute otitis media does not resolve or when
allergies block the eustachian tubes, secretory otitis media may occur. A sense
of fullness and temporary hearing loss in the affected ear are common symptoms
of secretory otitis media. The condition is diagnosed using tympanometry. An
opening may be made in the eardrum to allow the fluid to drain out.
Causes
Also known as serous otitis media, the condition develops
when acute otitis media has not completely cleared. It may also occur when the
tube connecting the middle ear and the back of the nose (eustachian tube) gets
blocked. Blockage may occur in the eustachian tube due to allergies.
The condition may occur in people of all ages. However, it
is more common in children.
The eustachian tube opens during swallowing and equalizes
the pressure in the middle ear 3-4 times a minute. When oxygen is absorbed from
the middle ear into the bloodstream, a blocked eustachian tube causes a
decrease in pressure in the middle ear. A decrease in pressure causes fluid to
accumulate in the middle ear. This makes it difficult for the eardrum to move.
Symptoms
The fluid accumulating in the middle ear may contain
bacteria. However, symptoms of an active infection, such as redness, pain and
pus, are rarely seen.
Following are the common symptoms of secretory otitis media:
·
Sense of fullness in the
affected ear
·
Popping or crackling sound
while swallowing
·
Some loss of hearing
Diagnosis and Treatment
The ear is examined and a tympanometry is used to determine
the presence of fluid in the middle ear.
Decongestants, such as phenylephrine and ephedrine are
prescribed. Nasal congestion can be reduced in people with allergies through
antihistamines. Antibiotics are not useful for the treatment of secretory
otitis media.
Forcing air past the blockage in the eustachian tube can
help increase the pressure in the middle ear. An individual can do this by
pinching his or her nose shut, keeping the mouth closed, and blowing out gently
through the nose.
Symptoms that do not subside even after 3 months may require
myringotomy. In this procedure, the doctor makes an opening through the eardrum
so that the fluid can drain out from the middle ear.
Tympanostomy tube can also be inserted into the opening of
the eardrum so that the fluid can drain out and air can enter the middle ear.
Vestibular Neuronitis
In vestibular neuronitis, the patient experiences a sudden
severe attack of vertigo. The sensation of vertigo makes the individual feel
that they or their surroundings are moving or spinning. The attack occurs due
to inflammation of the nerve that travels to the semi-circular canals. The
semi-circular canals are part of the vestibular system and help control
balance.
People with vestibular neuronitis usually have a single
attack of vertigo that lasts for several days. However, additional milder
attacks may be experienced for several weeks after that. Probably caused by a
virus, the first vertigo attack is the most severe. Vertigo may be accompanied
by nausea and vomiting which may last for 7-10 days. It may be accompanied by
nystagmus, which is rapid jerking movement of the eyes from one side to the
other with a slower drift back to the original position.
Subsequent attacks of vertigo are usually less severe and
also shorter. These attacks usually occur when the head is in a particular
position. Vestibular neuronitis usually does not affect hearing.
Diagnosis
Hearing tests and nystagmus tests may be recommended. The
doctor may also recommend magnetic resonance imaging (MRI) of the head to rule out
disorders such as a brain tumor.
Treatment
Treatment aims at relieving symptoms caused by the vertigo.
Medications such as meclizine, lorazepam, or scopolamine may be prescribed. Since
prolonged use of these drugs may increase the duration of the symptoms and
prevent the brain from compensating for vestibular loss, the drugs should be
taken only on a temporary basis.
Pills and suppositories containing prochlorperazine may be
used to relieve nausea and vomiting. If the vomiting does not stop for a long
time, the doctor may recommend giving fluids and electrolytes intravenously. The
vertigo usually subsides over the course of only a few days. However, dizziness
may continue for several weeks. The individual is encouraged to stay active
during this period by doctors.
Otitis Media (Chronic)
Overview
A persistent infection of the middle ear is referred to as
chronic otitis media. The condition is usually caused by a cholesteatoma or
perforated eardrum that hasn’t healed. Chronic otitis media may flare up after
an ear infection. Water entering the middle ear may also cause a flare-up. Persistent
discharge of foul-smelling pus is the main symptom of this condition. A doctor
may clean the ear canal and prescribe eardrops.
Causes
Dysfunction of the eustachian tube is the most common cause
of chronic otitis media. However, a perforated eardrum which has not healed
after trauma or acute infection of the middle ear may also cause this
condition. Cholesteatoma or a non-cancerous growth of the white skin-like
material may also occur. An eardrum perforation may not exhibit any symptoms.
However, a bacterial infection may occur, and cause a flare-up of chronic
otitis media. An infection of the nose and throat or water entering the middle
ear during bathing or swimming may also cause chronic otitis media to flare-up.
Symptoms and Complications
Discharge of pus, possibly with a foul smell, from the ear
is the main symptom of a flare-up. There is usually no pain. If the flare-ups
occur repeatedly, they may lead to the formation of polyps. These polyps are
protruding growths that can extend from the middle ear, pass through the
perforated portion of the eardrum, and enter the ear canal.
If the infection is persistent, it may destroy the ossicles.
Small bones present in the middle ear connecting the inner ear to the eardrum
are called ossicles. These small bones are responsible for conducting sounds
from the outer ear to the inner ear. Damage to the ossicles can cause
conductive hearing loss.
Chronic otitis media may also lead to other serious
complications. These include the following:
·
Inflammation of the inner
ear
·
Facial paralysis
·
Brain infections
·
Cholesteatoma in the middle
ear
A cholesteatoma in the middle ear that damages the bones
increases the chances of other serious complications. Presence of pus or
skin-like material in a hole or pocket in the eardrum with fluid oozing out is
usually taken as a sign of chronic otitis media by the doctor.
Treatment
A doctor treats a
flare-up of chronic otitis media by cleaning the ear canal and middle ear. This
is done with the help of suction and dry cotton wipes. The doctor will then
prescribe antibiotic ear drops or a solution that contains acetic acid with
hydrocortisone. If perforation is present, the individual should prevent water
from entering the ear.
Tympanoplasty can be used to repair the eardrum. If the
ossicles are damaged, these can be repaired during the same procedure. If a
cholesteatoma is present, it must be removed surgically or it may result in
serious complications.
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