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The Doctors Lounge - Primary Care Answers

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Forum Name: Ear Nose and Throat

Question: ears again


little_miss_mortisha - Tue Feb 01, 2005 8:02 pm

Hello again :)

I have been dealing with pain from fluid in my ear for a while but it was starting to egt really bad. I went ot the dr yesterday and she said that my left eardrum is inflamed and red so gave me an Antibiotic spray to use. The thing is since using the spray the pain is worse and ive started getting pain in my right ear. Is this just refered pain or could it indicate infection?

I would really appreciate any reply :)

Thanks you 8)
angelseakr - Wed Feb 02, 2005 3:03 am

Hope this helps.
Earaches are quite common. There are a number of reasons why people get earaches. It should always be considered to be a warning that something is wrong, although the problem causing it may not be serious. There are three different areas of the ear that can be involved in ear pain. The most serious problem occurs when there is infection. They are: 1) The outer ear canal, 2) the ear drum and the structures of the middle ear, the so called "bones" (the stapes, hammer and anvil) of the middle ear, and 3) the inner ear. (See Figure: 1.) The areas most commonly involved in creating pain or becoming infected are the outer ear and the middle ear.

Pain in the outer ear canal is usually caused by either a bacterial or fungal infection involving the lining of the outer ear canal. Often these infections may be predisposed by moisture in the ear canal resulting from warm, moist climates, from swimming (as in "swimmers ear") or bathing. Injury caused by attempts to clean or scratch the Itching ear is another common cause. Occasionally, ear pain can be caused by irritation of the skin of the external canal such as contact Dermatitis (from earrings, earphones, etc.), allergic Dermatitis (allergies to foods or external substances) or seborrhea Dermatitis.
Symptoms
Itching and pain along with dryness and scaling of the ear canal are the chief symptoms. A watery is generally first, once infections begins the discharge may turn into a purulent discharge and which may even contain small to large amounts of blood in it. This process in fairly common and while it implies that there is an infection does not necessarily mean something is extremely wrong. Pain may become extreme as the canal swells and blocked. This condition may be accompanied by enlarged and tender Lymph glands around the ear or in the neck. Any or all of these signs and symptoms are a warning that medical intervention is necessary.
Diagnoses
The diagnoses are generally made on the basis of the history and physical examination. When looking into the ear canal the lining is red, swollen, and possibly draining.
Treatment
Often irrigation of the ear canal with either hydrogen peroxide (equal parts of water and hydrogen peroxide warmed to body temperature using a soft ear syringe) or seventy percent alcohol can temporarily stop pain and Itching. This treatment may even resolve the problem before it can worsen. Topical Antibiotic suspension or ointments (a prescription is usually needed) applied to the ear canal with a cotton wick. Topical steroids decrease inflammation and swelling. Localized moist heat can also be used to help to decrease pain and discomfort
You should follow up with your physician espicially since your symptoms have worsened since your Antibiotic spray. You could try the above interventions for some relief in the mean time.
Good Luck
little_miss_mortisha - Wed Feb 02, 2005 12:26 pm

thank you very much for your quick reply.

I will try some of those to get rid of the pain :)

I have been using th spray otomise (SP?) for the past two days and it does seem that the pain is worse now when using it then before. And its in the other ear. I thought this may be due to pressure but im not sure. Could the pain just mean that the Antibiotic spray is doing its job?

Thank you again :)

Natalie x
angelseakr - Wed Feb 02, 2005 11:49 pm

Hi, I would say that the Antibiotic spray IS NOT working if your pain is worse.
little_miss_mortisha - Thu Feb 03, 2005 10:58 am

right, do you think that it would be good if I went back to my GP and got another spray/antibiotics? or give it a few more days?

Thanks for your reply,

Natalie x
angelseakr - Thu Feb 03, 2005 11:52 am

Hi Natalie, I would say to go back to your physician. You may need a something by mouth at this point. I hope you are feeling better soon!!
little_miss_mortisha - Thu Feb 03, 2005 11:54 am

Thank you so much for your help :) I will make an appointment very soon :)

Thanks again

Natalie xxxx
Edwina - Sat Apr 09, 2005 1:29 am

Hi, I have been having problems with my ears as far as I can remember. My ears swell up so badly that I cant even get the drops in them. They leak fluid and my god, this fluid has a foul smell to it. I have a lump right under my ear that is also very sore but this lump only appears when my ears are swollen. My ear feel plugged the whole time, and no matter how many pain killers I take, the pain does not go away. My doctor tells me my ears are fine and not to use Q-tips, well I took that advice and it has been 3 months since I used the Q-tips but my ears are swelled up again just like every other time. The drops I am on now this time is called Cipro HC and they don't help at all. I do wear a head set all day since I do work in a call center. Is there anything that you can advice me to do so I don't have these sore ears leaking anymore. Some times it is so bad that I get dizzy , but stil my doctor says nothing is wrong with me and there is no wax build up in my ears. She actually thinks Im crazy. Please Help, thanks :)
angelseakr - Sat Apr 09, 2005 2:41 am

Hi Edwina. Have you seen a specialists a ENT physician. Perhaps they could help better. Also you mentioned a foul smell is this from what you get if you clean your ears? and do you also have sinus problems?
Edwina - Sat Apr 09, 2005 8:07 pm

Hi, thanks for the fast reply

I can smell the foul smell just sitting down, I can smell it if I clean my ears or even touch them or just by sitting down I can still smell them. They leek that bad that in the morning , I have crust everywheres so when I use a face cloth or even my fingers to clean it out, it still has that same foul smell.

I havent been to a specialist but Im going to ask my doctor to make me an appointment with one as soon as she is back from vacation.
Dr. Anthony Solomon - Sun Apr 10, 2005 3:26 am

Hello Edwina,

I am of the opinion that you have a condition known as chronic otitis media, possibly with perforation of the eardrum. This occurs usually as a consequence of recurrent acute infections of the middle ear which may or may not have been adequately treated. Trauma to the eardrum and other diseases may also cause this condition.

The characteristic signs of chronic otitis media are intermittent or continuous leakage of a purulent discharge from the ear canal. Pain is uncommon unless during flaring of new attacks, but you may experience some hearing loss on the affected side. If the ear canal is swollen and you experience severe pain, then there is the possibilty that the continuous discharge from the middle ear is causing a secondary otitis externa.

An ENT surgeon should handle your case in order that well-known complications can be prevented. Instillation of eardrops and Analgesics will not solve the problem.

Has your primary care physician not offered to refer you to a specialist in spite of the persistence of symptoms?


Dr Anthony Solomon
MB BS DTM&H DIP. VEN FRSM
Consultant Physician, Tropical & Genitourinary Medicine

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