GIVE EAR
By Esther Williams
Consultant ENT Surgeon, Dr. R. S. Drahaman discusses some common ear problems
Injury with cotton buds: When parents clean the ears of their children or when children themselves pick their ears with ear buds, eardrums can be broken. Occasionally the ear bones, nerves and balance organs can get damaged. However, a minor trauma or a small break in the eardrum usually heals if uninfected.

An ENT surgeon would be in the best position to assess the damage and give appropriate attention. In the event of damage to the eardrum, never put in eardrops or water. Cotton buds should never be used to remove wax. Ear buds should be used to merely touch the inside of the ear to absorb any moisture soon after a bath.

Seeds, insects and foreign bodies such as plastic beads in the ear: Chances are that when you try to remove an insect from the ear it will go further in and bite. Using eardrops or water will reduce struggle, drown the insect and reduce pain. But care should be taken as more damage can be done in the process of removing the insect rather than what the insect causes.

Children are known to put all kinds of things into their ears. If the foreign body is a seed, water will make the seed swell up and block the ear. Attempts to remove it can push the object deeper into the middle ear and break a portion of the fragile ear structure. Hence it is advisable for an ENT surgeon who possesses the skill and the appropriate equipment to handle the job.

Middle Ear Infection (Acute Otitis Media): Such infections almost always occur following a cold or flu and can be avoided if early attention is given. Dr. Drahaman advises avoiding bathing children during this time to ensure that no water enters the ears. Decongestant nose drops should be used and children should be encouraged to blow out any phlegm. Steam inhalation may help, but should not be given to asthmatics.

Children are yet to achieve an immune status and hence are more prone to this infection as they catch colds from other children in school. Further the Eustachian tube in their ears is shorter, broader and positioned in such a way that makes it easier for the infection to go from nose to ear.

While a cold can give a block, pain means infection. Pain commonly occurs in the night causing rupture to the eardrums in the early hours of the morning. Since you may not be able to get a doctor at that time, Dr. Drahaman advises the use of nose drops, steam inhalation and a painkiller such as panadol. As a last resort, until you can see a doctor, patients are advised to take a front line antibiotic like Amoxicillin. Seeing a doctor is important because at times the pain could be caused by something other than an infection - like tooth ache or a peri-tonsil abscess. An operation may have to be performed to release pus from the middle ear, which would prevent rupture.

Chronic ear infections: Incomplete treatment of acute infection leads to chronic, persistent or intermittent ear discharge and pain. This can lead to progressive deafness, destruction of hearing structures and more dangerously spread of infection beyond the ear to the adjacent bones, nerves of the face and into the brain area, which can be fatal.

Swimming is a common cause of ear discharge. Those with frequent ear infections should not swim, because water infecting the ear can go deep, causing further infections. Those with normal ears can get fungal or bacterial infections while bathing in infected and unhygienic swimming pools or if they have a lot of wax or debris in their ears. "Cleaning such ears after a bath when there is mild infection and irritation usually makes it worse," cautions Dr. Drahaman. 70% of people can manage without special attention to the ears throughout their lives. The balance need help to remove wax and dirt. Softening the wax with a clean wax softening dropper and careful cleaning with a cloth wick helps. A small percentage of cases must have their ears cleaned by an ENT surgeon who has special skills, light and instruments.

Are ear infections contagious? Water in a pool, towels and common use of eardrops and ear droppers by several people can pass on ear infections. Are children who use feeding bottles more prone to infections? The position of a baby when feeding can send milk to the back of the nose and Eustachian tube causing ear infection. This is more so in children who drink from the bottle, as they lie flat, rather than in children who breast-feed, as they are held somewhat upright. Are boys more prone to infections? Statistics do show more boys having infections. It is simply because they are less obedient - swim longer, etc.