Earaches are often the most common reason for coming to the office. Now most are aware of the traditional ear infection (aka middle ear infection or otitis media) where fluid buildup occurs behind the eardrum (aka tympanic membrane), but keep in mind there are other reasons why your child's ear may be hurting; some of which will be shared here. But it’s probably best to begin with a brief description of the three different parts to the ear: the outer ear, middle ear, and inner ear. The outer ear includes the part of the ear you can see and the ear canal. The middle ear houses the eardrum and three tiny little bones — so very important in the hearing process. And think of the inner ear as the nerve "center" of the ear. And while ear infections can occur in each of the three different parts of the ear, the two more often seen in children include:
Middle Ear Infection (Otitis Media)
As mentioned above, this is probably one of the most common reasons for coming to the office. The typical story usually involves cold symptoms for a few days and then in some children, there is a predisposition for fluid (which includes bacteria) to build up behind the eardrum. It is that fluid buildup that creates the pain or discomfort for the child. As far treatment, children below 2 years of age are given an oral antibiotic that is typically used anywhere from 5-10 days. When a child is older, we will often try to hold off on antibiotic use and begin with pain control and supportive care (Tylenol/Motrin and possible ear drops to ease the pain).
Outer Ear Infection (Otitis Externa or aka Swimmer's Ear)
This typically follows moisture buildup in the ear canal — hence the name, swimmer's ear. This condition is often seen during the summer when children are swimming or in children with long hair who do not dry their hair after showering and moisture remains in the ear canals long after they are done swimming. Particular bacteria enjoy this type of environment, and ultimately, lead to a rather painful ear. Often, the pain from an outer ear infection is far more debilitating than from a middle ear infection. Something a parent can check for at home is pulling and tugging on the ear… if any pain, a pretty good indicator this is a swimmer's ear.
Two other reasons to consider when your child complains of an earache or you are suspicious of ear pain in your child who is unable to localize the pain for you include:
- Teething: When infant teeth break through the gums, particularly the molars, you may see your child grab or pull at the ears. This is referred ear pain and although many parents are concerned about an outer ear infection, it is the teething causing the ear pain. Unfortunately, it is sometimes difficult for parents to distinguish between a middle ear infection and teething as other teething symptoms include a low grade fever, runny nose, and fussiness — very similar to the cold that may precede an ear infection. A visit to the office will help to clarify between the two.
- Foreign body: You might be very surprised to know what can end up in your child's ear — beads, Legos, sand, and even insects. So if you have any concern that is the case, please come in to see us.