One of the most common conditions treated by ear, nose and throat specialists are ear infections.  Ear infections are notorious for causing severe pain and occasionally drainage or even bleeding from the ear.  Two common types of ear infection include middle and outer ear infections.  Middle ear infections (otitis media) are more common than outer ear infections (otitis externa) and affect children more than adults.  Otitis media often causes ear pain, redness and fever.  Outer ear infections are less common than otitis media but can be also be very painful.  They occur when debris, bacteria or other infectious agents cause swelling in the ear canal.  The blockage and swelling from the infection can cause pain, swelling and often a greenish discharge.  Hearing can be affected in both middle and outer ear infections along with balance and other systemic symptoms such as fever, chills, nausea, vomiting and headaches.


Ear infections are diagnosed with a thorough history and physical exam by an experienced medical professional.  An otoscope is a medical instrument that allows the ear canal and eardrum to be visualized and is helpful in diagnosing ear infections.  Eardrums are often red in acute otitis media but redness can also occur from crying or a fever from an infection elsewhere in the body.  In otitis externa, the ear canal is red, swollen and sometimes completely blocked.  When outer ear infections become chronic or do not resolve with first-line treatments, cultures may be obtained with a cotton swab and sent to the lab for evaluation.


Treatment of otitis media usually only requires close monitoring and medication for pain and/or fever since most cases of otitis media are caused by viruses and the infection will often resolve on its own in a few days.  Antibiotics are helpful when ear infections become more complicate or do not resolve on their own.  Otitis externa, on the other hand, is typically caused by bacteria or even fungi so antibiotic drops or other types of medications are typically prescribed after diagnosis.  Diagnosis of ear infections and appropriate treatment should not be delayed because, although complications are rare, ear infections can lead to infections of a skull bone near the ear called the mastoid.  Rarely, ear infections can also lead to meningitis.


Although not foolproof, there are ways to reduce the chances of getting an ear infection. 

  • Breast feeding infants – Nursing through the first 3-6 months of life has been shown to protect against acute otitis media and recurrence in infants.
  • Decrease the use of pacifiers – Using pacifiers after 6 months of age can increase the risk of recurrent ear infections.
  • Treat allergies and avoid them when possible
  • Avoid exposure to cigarette smoke – Children exposed to secondhand smoke are more likely to have bacterial ear infections following a viral respiratory infection.
  • Choose smaller day cares – Fewer children in the day care facility decreases the spread of viral and bacterial infections.
  • Keep the ear canal dry – Moisture and debris in the ear canal can foster the growth of bacteria
  • Foster healthy habits – Plenty of sleep, low stress and good nutrition can improve immunity and fend off infections.