Tag Archives: Otitis media

Straight, No Chaser: Ruptured Eardrums

December 6, 2016Head/Eyes/Ears/Nose/Throat844-SMA-TALK, Behind the Curtain, Ear, Ear Nose and Throat, Eardrum, health, Otitis media, Perforated eardrum, Sound, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

The manufacturers of Q-Tips used to run a commercial in which they said “Never place anything in your ear smaller than your elbow.” I wonder why they stopped the commercial, because it pretty much summarizes how your physicians feel about the practice.
Perforated tympanic membranes (aka ruptured eardrums) are holes in the sheet-like tissue that separates the ear canal from the middle ear. They are not a lot of fun. Because the ear is responsible for both hearing and balance, rupture can cause decreases of both. Common symptoms include pain, decreased hearing and bleeding.
Several different things can causes this, including the following:

infections (otitis media)
a pressure imbalance between the two sides of the eardrum (if it becomes too severe, you’ll suffer what’s known as barotrauma), as seen in diving and air travel
direct trauma from placing objects in your ear (Put those cotton swabs and down!) or from a severe blow to the head/face
blast injuries (called acoustic trauma), caused by sudden, loud noises (e.g. explosions and gun shots; what’s actually happening here is a sound wave is damaging the ear drum)

Most tympanic membrane perforations heal spontaneously. If the injury causing this was penetrating, your physician may refer you to an ear, nose, and throat specialist within 24 hours. If this ever occurs, you must be careful to avoid getting water in the ear. Finally, you won’t typically receive antibiotics for a ruptured eardrum unless the rupture is due to infection or forceful water injury, such as is seen in water skiing.
Just remember: the ears have been cleaning themselves for at least thousands of years prior to cotton swabs. Chasing that itch isn’t worth the consequences of the pain of a ruptured eardrum.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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Straight, No Chaser: Swimmer's Ear (Acute Otitis Externa)

May 14, 2014General Health and Wellness844-SMA-TALK, Conditions and Diseases, malignant otitis externa, osteomyelitis, Otitis externa, Otitis media, pseudomonas, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, swimmer's earJeffrey Sterling, MD

It’s that time of year. Whether you’re getting purified in Lake Minnetonka (obscure pop culture reference alert) or your local watering hole, as the weather warms, a lot of people end up with swimmer’s ear. This is the time of year when certain bacteria and other organisms have their day in the (dirty) water and are waiting to infect you.

Acute otitis externa (aka swimmer’s ear) is an infection or inflammation of the outer ear and ear canal. It is a different infection that those inner ear infections that kids seem to get all the time; that would be otitis media. Those two infections may occur at the same time, although it isn’t likely. Otitis externa isn’t just caused by polluted water; anything that causes inflammation or infection can cause it. For example, otitis externa may be a consequence of a bite or scratch to the ear or a foreign body in the ear (yet another reason to inserting cotton swabs or other objects into the ear).

If you develop acute otitis externa, you’ll know it. Symptoms include itching and pain, pus-like drainage from the ear and hearing loss. Unlike those inner ear infections, in otitis externa you may notice the pain is pronounced when you pull on the outer portion of the ear.
The interesting thing about treatment of otitis externa is it isn’t that complicated and usually gets better promptly. What is complicated about it is failure to get treated can result in some serious complications. Treatment is accomplished by giving antibiotic eardrops. Some of you who have have swimmer’s ear may recall the use of an ear wick to facilitate the drops making their way to the end of the ear canal. Other treatments may include oral antibiotics, topical steroids, pain medication and vinegar eardrops (the acid in the vinegar works to prevent further growth of bacteria).
Regarding you placing vinegar in the ear yourself: it is often stated that mixing one drop of white vinegar with one drop of alcohol and placing this into the ear can help. My advice to you is regardless of any home remedies or over-the-counter measures you take, you should get evaluated because of the risk of complications if not adequately treated. Placing any object – even fluid – in your ear presents additional risks, particularly in those rare instances in which the eardrum has ruptured. I subscribe to the old adage that you shouldn’t place anything in your ear smaller than your elbow.

Regarding complications, because of the aggressive nature of the bacteria causing acute otitis externa (named Pseudomonas), things can take a dramatic turn for the worst.

Infectious acute otitis externa may spread to other areas including the skull bone, causing an infection known as osteomyelitis.
In those with reduced immunity, diabetics or the elderly, the infection may become severe and life threatening. This is called malignant otitis externa.

Protecting yourself from swimmer’s ear isn’t that difficult. It mainly requires you to think about the possibility, mostly when you’re getting water in your ears.

Avoid swimming in polluted water.
Avoid placing any objects such as cotton swabs in your ears. It’s ok and helpful to use earplugs when swimming.
Ensure water doesn’t get into your ears when bathing, shampooing or showering. Thoroughly dry the ear after exposure to moisture.

We welcome any questions you may have.

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Straight, No Chaser: Ruptured Eardrums

November 16, 2013Head/Eyes/Ears/Nose/ThroatStraight No Chaser, Conditions and Diseases, Ear, Ear Nose and Throat, Eardrum, health, Otitis media, Perforated eardrum, Sound, Sterling Medical Advice, SterlingMedicalAdvice.comJeffrey Sterling, MD

The manufacturers of Q-Tips used to run a commercial in which they said “Never place anything in your ear smaller than your elbow.” I wonder why they stopped the commercial, because it pretty much summarizes how I feel about the situation.
Perforated tympanic membranes (aka ruptured eardrums) are holes in the sheet-like tissue that separates the ear canal from the middle ear. They are not a lot of fun. Because the ear is responsible for both hearing and balance, rupture can cause decreases of both. Common symptoms include pain, decreased hearing and bleeding.
Several different things can causes this, including the following:

infections (otitis media)
an imbalance between the two sides of the eardrum (if it becomes too severe, you’ll suffer what’s known as barotrauma), as seen in diving and air travel
direct trauma from placing objects in your ear (Put those cotton swabs and down!) or from a severe blow to the head/face
blast injuries (called acoustic trauma), caused by sudden, loud noises (e.g. explosions and gun shots; what’s actually happening here is a sound wave is damaging the ear drum)

Straight, No Chaser: Emergency Room Adventures – The Cauliflower Ear

September 28, 2013Medical Treatment, Trauma, Head/Eyes/Ears/Nose/ThroatWordPress, Cauliflower ear, Conditions and Diseases, Ear, health, Hematoma, Infection, Otitis, Otitis externa, Otitis media, Randy CoutureJeffrey Sterling, MD

So here I am again waiting for something interesting to walk in worthy of me telling you about, and lo and behold, a behemoth of a guy walks by. You know, one of those guys who works out way too much for it to be just about health. In any event, the nurse tells me the gentleman has ear pain, and she thinks it’s an infection. Well, that’s odd. Otitis media (middle ear infections) and otitis externa (external ear infections) usually happen in kids. So I get up to see him, and I see something that looks like an early version of Randy Couture’s ear… …and I immediately think of you.
A ‘cauliflower ear’ is something you should be aware of because it’s easily obtained, and it has very bad consequences if not addressed in a timely manner. It’s a deformity of the ear (usually the upper outer portion) mostly caused by blunt trauma. It happens a lot to wrestlers, boxers, MMA fighters and rugby players, but it’s also seen in those with infected high ear-piercings. It occurs when the ear gets hit, causing a hematoma (collection of clotting blood) to form. The hematoma prevents normal flow of blood through the ear. The problem with this is the ear is made of cartilage (a less sturdy form of tissue) than bone. No blood flow and the presence of clots cause the cartilage to wilt and deform, giving the lumpy appearance shown in the picture. This can be treated with drainage of the blood and clot from the ear, but if it’s not done early enough, the ear will become permanently deformed.
If you have trauma or infection to the upper ear, be on the lookout for redness or swelling. Don’t ignore it like you might be inclined to do elsewhere. Get it evaluated promptly, even if it seems minor because… Time is tissue.
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