An ear infection is usually a bacterial infection of one or more parts of the ear. (The ear has three parts- the outer, middle, and inner ear. Outer ear refers to the external ear canal; Middle ear is the part just past the eardrum; inner ear is the part beyond which contains nerve endings.) The most common type in infection is of the middle ear, although outer ear infections occur more often in adults. Infections in one part of the ear rarely spread to other parts, although if there is a hole in the eardrum it's quite possible all parts can be infected at once.

The outer ear infection is commonly refered to as Swimmer's Ear. As the name suggests, it is usually caused by bacteria from water getting into the ear canal, which is a small, warm, dark place that's hard to clean. Bacteria love that kind of thing. They get in and grow, which causes itching and burning. Swimmer's ear is treated with eardrops and suction.

Middle ear infections are more complex. They're most often found in children, although it's not unheard of in adults. The middle ear is an airtight drum of sorts which converts sound waves to vibrations. It is connected to the sinus cavity through eustachian tubes, which keep the ear at more or less the same pressure as the outside air. (This is what allows your ears to pop on airplanes or underwater- without them your eardrums would explode at a change in pressure.) When the sinus cavity is full of infection, however, eustachian tubes don't work that well. The ears of children often aren't fully protected against infection since their tubes might not work as well as they should- the muscles that hold them may be weak, or they may not be fully formed. Infection spreads from the eustachian tube to the middle ear, where the bacteria go nuts, throwing little bacteria parties and eating whatever they can find in the inner ear. Probably earwax or something, I don't know. The drum then swells up and hurts like you would not believe. This type on infection will not heal on its own, and left untreated will eventually lead to hearing loss. (Hearing is often lost temporarily during the infection, but clears up after the fluid drains.)

Middle ear infections can be treated with antibiotics, which kills the bacteria. The fluid drains on its own in a short time. However, if it's not treated in time, the eardrum may burst. While this seems like it would be bad, it's actually not; the ear no longer has fluid in it, which is good. However, infection is likely to come back, and scar tissue will build up, which leads to hearing loss over time. Children with persistant ear infection may have to have surgery to implant tubes in the ears. This is usually a last resort, however. A small tube is placed in a small hole which is created in the eardrum. The tube either stays there or falls out over time, but either way it causes no damage or hearing loss.

Inner ear infections are very rare. It can affect hearing, balence... A whole lot of stuff. Your doctor will probably prescribe massive antibiotics and possibly surgery.

My experience with an ear infection:
I woke up at 3:30 this morning, screaming. There were bugs eating my ear, you see, from the inside. Little tiny ladybugs. They were on fire, also.

Eventually I woke up enough to realize that there were no combustable insects in my ear, that was just a dream. The pain, however, was real. I tried several things to stop the pain- pressure, no pressure, hot, cold, water, q-tips. It was all for naught. Finally I got my dad to take me to the ER (it was Sunday, my normal doctor was out playing golf.), where I got an antibiotic shot and more prescriptions than I've ever had in my life. I'm on vicodin for the pain, which isn't as interesting as dem bones says it is, Zithromax to kill the infection, and something else whose name I forgot to do something with the fluid.

I'm having trouble hearing with my right ear, and it's literally incredible pain. Other noders told me that they'd had ear infections lanced before, that is, cut open. The doctor I went to said that lancing isn't done anymore because it often fails to clear the whole ear of fluid, and the scar tissue that forms on the eardrum can cause hearing loss.

The best description I can think of for the pain is as follows. (I told this to my brother when he said I was faking.)

Take a small screwdriver. Heat it to about 300 degrees. Then, JAM it into your ear as FAR AS YOU CAN. Then, take a mallet and pound it in further.

That's one tenth as bad as the pain is.

Anotherone wrote a very good node above describing the three types of ear infections and just how painful a middle ear infection is. I’d like to expand a bit on infantile ear infections.

Middle ear infections are one of the things we know FOR SURE are prevented by breastfeeding. In other words, to put it more realistically; formula feeding raises the risk that a child will suffer repeatedly from this painful condition.

In our modern, formula feeding culture we have gotten to the twisted point where we think frequent colds and ear infections are to be expected in an child’s first few years. This is nonsense. Breastfed infants rarely suffer from these problems.

Breastfeeding is not just the optimal nutrition for an infant. It also provides a normal immune system. Formula fed infants have compromised immune systems and catch viruses and bacterial infections that breastfed infants are not susceptible to.

Colds, other viruses and bacterial infections lead to swollen tissue in the nasopharynx, (the place behind the nose where the nose and throat join) which in turn closes the Eustachian tube and prevents air from entering the middle ear. Air still gets out via the porous bones near by but can no longer get back in. This leads to a vacuum in the middle ear. If air can’t get in, fluid will. Remember the maxim...s nature abhors a vacuum. Fluid in the middle ear provides a lovely buffet for the germ party as well as causing hearing and pressure problems just from having fluid where air belongs.

Sometimes the fluid doesn’t get infected but may still lead to partial hearing losses. They may be temporary but they are occurring at the same time the child is developmentally trying to acquire language. This in turn can affect the development of speech as well as lead to increased frustration for parent and child. This may be part of the reason why formula fed children have more speech problems than breastfed children.

All of this is magnified by the anatomy of the Eustachian tube in infants. “A child's Eustachian tube is smaller than an adult's, and, because of differences in facial shape and structure, a child's Eustachian tube is much more prone to obstruction than an adult's.” We make an attempt to compensate for this with the instruction to always bottle feed with the infant upright and with angled bottles but these are just band aid solutions.

The real problem is, more infants in American day care group situations are receiving formula than breastmilk. Now not only is their immune system compromised but they are exposed to a concentrated and likely antibiotic resistant germ soup on a daily basis.

Breastfeeding develops the musculature of the face and jaw in a normal way. This is why formula fed infants have increased needs for orthodontia. Their muscle and bone development suffers from the lack of muscularly demanding breastfeeding. Muscles control the Eustachian tube opening. Underdeveloped muscles don’t do it as well.

Formula is a perfect medium for growth of bacteria. When bits of it sit in the little back pockets of the mouth or in the Eustachian tube the germs have a party . Breastmilk has living cells and other factors that prevent bacterial growth as well as factors that enhance epidermal growth.

Ear infections and colds in infancy are not normal. They are in large part caused by abnormal feeding patterns and compromised immune systems. They are also not trivial, they cause extreme pain, speech and hearing deficits, overuse of antibiotics and sometimes surgery.

Breastfeed your babies.
This web page is the source of the quote above and also has a nice illustration of the anatomy.

When I was little I had tubes put in my ears (why? no one ever satisfied me with a real answer). This caused me numerous ear infections until I was 12. One hot day in the middle of summer my Boy Scout troop was selling fireworks (the 4th of July was coming up), and I was feeling woozy.

Do you know how you can alter the pressure in your ears, using your eustachian tubes? My family has done a lot of traveling, often involving mountain passes. This got me used to 'playing around' with the pressure in my ears (the changes in altitude affected the pressure in my ears a lot). On that hot day in July, while my dad was talking with my scoutmaster, pressure started building in my right ear. I messed with it, but it just got worse. Then it started getting seriously painful (worse than ever before). I messed around some more, gingerly, trying to ease the pain. Suddenly, the pressure went way down. My eardrum had popped.

It was not earth-shattering. It didn't hurt as bad as I imagined getting a popped eardrum would. I found out later that the hole was so small that it was invisible (my doctor couldn't see it until over a year later). But right then fluid of some sort came out of my ear and I had relief from the pain. Instead of losing hearing, my right ear became somewhat more sensitive to sound for a time. In consequence, every time I had a doctor's appointment after that and the nurse went to check my ears, my right ear failed to hold any pressure.

To this day, the hole is still there. I can go under water and blow bubbles out of it. It makes a whistling sound sometimes (not under water). My right ear is as sensitive to sound as my left these days (and I have been careful with my hearing in both ears). I don't know what it would be like to not have that hole in my eardrum, except that I'd have ear infections again (probably). I haven't had an ear infection since that hot July day when I was 12.

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