Ear Infection and its Possible Impact on a Patient’s Hearing

Ear infection is possibly the most common reason for a parent to book an appointment with a doctor during the first few years of a child’s life. Both bacteria and viruses are implicated as the causative agents and their effects may occur in one or more of the outer, middle and inner chambers of the auditory path and affect either one or both sides.

Adults and young children are aware that something appears to be wrong and able to draw attention to their pain and other symptoms. However, the same is not true of infants and so, in light of the potential consequences of failing to recognise and treat an ear infection, their parents need to be especially vigilant. Restlessness, crying and a tendency to repeatedly touch the affected organ may be the only clue, but it is more than sufficient to justify seeking the attention of a professional.

In most subjects, the condition is acute and, although it will usually be accompanied by some degree of hearing loss, this along with the causative organism should normally be eradicated with the help of a suitable antibiotic or, where the cause is viral, through the natural defences provided by the immune system. Antibiotics given in these cases are intended purely to prevent any secondary ear infection involving the already compromised tissues, by any opportunistic bacteria that may be present.

Acute incidents do not normally pose any long-term threat to a patient’s hearing. However, in some younger subjects in particular, there may be a tendency for these invasions by microorganisms to recur, posing the risk that, over time, the condition could become a chronic one. It is under these circumstances that the chances of permanent damage to a subject’s hearing are greatest and inevitable without suitably effective intervention. Often, this will mean that the services of an ENT surgeon will be required.

In the young, this incidence of repeated and chronic ear infections is commonly the result of an unusually narrow Eustachian tube which, although it will expand in time, prevents proper aeration of the middle ear that, in turn, can serve to encourage bacterial growth. In such cases, a procedure known as a myringotomy can alleviate the problem. It involves puncturing the eardrum and inserting a grommet through which pus can drain; fresh air can pass and treatment can be applied directly to the middle ear if indicated. Sometimes enlarged adenoid glands can compress the Eustachian tubes, causing similar problems. In this case, the surgeon may, instead, perform an adenoidectomy to relieve the constriction and may combine it with a myringotomy.

Ear infections cause fewer problems in adults, mainly because their Eustachian tubes are arranged at an angle of about 45° to the vertical, unlike the 10° angle in infants. This means that gravity prevents material from the mouth and throat entering an adult’s middle ear. Nevertheless, some still experience problems with narrow tubes that make equalising internal and external air pressure difficult, and sometimes extremely painful. In such cases, grommets can also provide a welcome relief.

For children though, the bottom line is that permanent damage to their hearing at this stage could jeopardise their learning and affect their entire future if parents are not alert to the signs of ear infection.

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