Diagnosing Ear Infections
To diagnose an ear infection, we begin with a thorough evaluation, which includes a:
- Discussion of medical history
- Discussion of symptoms and risk factors
- Physical exam
- Hearing test (audiometry exam)
Using an otoscope, an instrument that has a flashlight and magnifying lens, we’ll examine the patient’s ears, looking for signs such as redness, fluid inside the middle ear or draining from it, or a perforation (hole or tear) in the eardrum.
We may use a pneumatic otoscope, which uses a puff of air to evaluate eardrum movement. If the eardrum doesn’t move, it could mean there’s fluid behind it.
If a diagnosis isn’t clear and we need more information, we may order a:
- Computed tomography (CT) scan to create detailed images of the ear and surrounding structures, which will help us determine if the infection has spread
- Tympanometry, an acoustic test that measures eardrum and middle ear function
Patients who have chronic ear infections may be referred to a hearing specialist, development therapist, or speech therapist for tests that measure hearing, language, or speech function.
Treatment of Ear Infections
Most minor ear infections resolve on their own. Patients can manage symptoms by:
- Taking acetaminophen, ibuprofen, or another over-the-counter pain medication
- Applying a warm cloth to the ear
- Using anesthetic ear drops (should not be used if there’s a perforation in the eardrum)
If the infection doesn’t clear up after a period of observation, we may prescribe antibiotics.
If there are recurrent ear infections (four episodes in six months or six episodes in 12 months) or fluid in the middle ear space that persists for three months or more, particularly when associated with a hearing loss and/or speech delay, surgery to place tubes in the eardrum might be recommended. In most cases, these tubes are temporary and will fall out of the eardrum on their own.
For chronic ear disease, we may recommend more complex ear surgery. This may involve tympanoplasty, a type of surgery that repairs the eardrum and hearing bones. The surgery may be done with a mastoidectomy, a surgery in which part of the bone behind the ear canal and middle ear is opened with a surgical drill.