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‘Can You Hear Me Now?’ Ear Infections in Adults

Barrord Lg HSJohn F. Barrord, MD, is an ear, nose and throat specialist with Atrium Medical Center in Middletown.

Q. Do adults get ear infections? Can they cause hearing loss? How are they treated?

A. Yes, adults do get ear infections. They’re not as frequent as they are in children, and they’re more diverse in location. Adult ear infections may originate in the outer, middle or inner ear. Because treatment differs depending on where the infection is, it’s important for your doctor or health care provider to clearly identify the infection site before treatment begins.

Anatomically, the outer ear includes the visible part of the ear and the ear canal leading to the eardrum. The outer ear is lined completely with skin that should be coated with protective wax to repel water, just like the wax that causes water to roll off a car’s hood. Excessive moisture — or removal of the protective wax — can lead to moisture penetration and result in a bacterial infection of the outer ear commonly called swimmer’s ear.

Keep Water Out to Avoid Outer Ear Infections

Your doctor will prescribe a topical antibiotic cream and steroid drops for early infections and a combination of drops and oral pill antibiotics for more advanced infections. Hearing loss is not typically an early symptom, but it can occur later if swelling is severe enough to block the ear canal. If the ear is swollen shut or at risk for swelling shut, a sponge wick saturated with an antibiotic can be a very helpful treatment after the ear is thoroughly cleaned. To prevent an outer ear infection, keep the ear dry and don’t remove the protective layer of wax with cotton swabs. If your ears frequently get wet and your eardrum is intact, you may find that applying vinegar, or vinegar with alcohol, in the outer ear can prevent bacteria and fungus infection.

The middle ear is an air-filled sinus cavity behind the eardrum lined with a moist, mucous-secreting membrane, just like the inside of the nose. This mucous drains to the back of the nose and is eventually swallowed, just as our nasal sinus cavities also drain. If this drainage pathway becomes blocked, fluid backs up in the middle ear and our hearing becomes muffled. If this fluid does not empty, it can become infected and cause pain. In a middle ear infection, pain follows hearing loss. In an outer ear infection, pain comes before hearing loss.

Treating Middle Ear Infections

Because the types of bacteria that infect the middle and outer ear are different, they’re treated with different antibiotics. Oral pill antibiotics are used for middle ear infections since drops cannot pass through the eardrum to reach the infection. Your doctor also may recommend surgical drainage through the eardrum to quickly resolve the infection, just like lancing a boil.

Adults with only a one-sided ear infection need to be examined deep in the back of the nose to be sure that no tumor or scar tissue is obstructing the drainage pathway. To prevent recurring middle ear infections, your doctor may treat any nasal congestion and allergy symptoms you have, as well as surgically vent the middle ear with a tube in the eardrum, similar to the tubes used to prevent childhood ear infections.

Vertigo from Inner Ear Infections

The inner ear contains the special sense organ of hearing, the cochlea, and our balance organ, the semicircular canals. Since the inner ear is only rarely infected with bacteria, it is not commonly treated with antibiotics. Inflammation or viral infection of the inner ear leads to a spinning balance disturbance called vertigo. It is treated with drugs that suppress the vertigo and sometimes steroids to calm down inflammation. Since inner ear infections are usually isolated and not repetitive, no preventive measures are needed.

Success in treating ear infections in adults depends on an accurate diagnosis of the location and type of infection within the outer, middle or inner ear. If you suspect you have an ear infection, visit your doctor or health care provider. They will correctly identify the location and type of infection and do lab tests, if needed, so that your infection can be treated effectively. 

This information is for educational purposes only. Please talk to your physician for advice in all matters related to your health.

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