Ear Pain & Injuries
Injuries to the ear include Cauliflower ear which is a swelling or deformity due to impact and is common in contact sports such as Rugby. If you have an ear injury, particularly one which has affected your hearing it is important to seek medical attention. Other ear conditions include Swimmers ear, Ear wax, Glue ear and a Perforated ear drum.
Cauliflower ear is also known as hematoma auris. It is a deformity of the outer ear caused by repetitive friction or impact. It is common in contact sports that do not use head protection.
Cauliflower ear is a result of repeated injury and so may be symptom free. The initial injuries are usually contusions, symptoms of which include pain, swelling, bruising and a deformed appearance of the outer ear. In severe cases, hearing may be affected, with a loss of hearing and a ringing in the ears known as tinnitus.
Initial treatment of contusions should include ice or other forms of cold therapy. Ice or a cold pack can be applied for 5 to 10 minutes in a wet tea towel to avoid skin burns. The ear is sensitive with blood close to the surface so do not apply cold for long periods of time.
Anti-inflammatories may be prescribed by a doctor. Blood may be drained through an incision in the skin of the ear and a compressive dressing applied. Anti-biotics may be administered if necessary. If it causes hearing problems, the individual should be referred to an ear, nose and throat specialist.
Swimmer’s ear or otitis externa is an infection of the skin which lines the ear canal. This is common in swimmers and can be either a bacterial or a fungal infection.
Symptoms include ear ache, redness, itching and possible discharge from the ear. There may be excess wax and possible hearing loss. Pain is produced when pulling down on the ear lobe.
Swimmers ear is commonly found in those who swim regularly. Water trapped in the ear causes the bacteria usually found there to multiply as it creates an ideal, warm, moist environment. Swimming in unclean water increases the risk of getting the condition.
Other things can cause the condition, including damage to the ear canal for example cuts or damage from cotton buds etc, chemicals such as hair spray getting into the ears and skin conditions such as eczema.
Early treatment of otitis externa is advised to get the best results and to avoid any further damage. Treatment usually involves gently cleaning the ear and ear drops containing a mild acidic substance to kill the bacteria. Antibiotics may be prescribed by a Doctor for more severe cases. Antibiotic drops are usually used although oral antibiotics may also be prescribed if the infection has started to spread. Check ups will be required to ensure that treatment has been successful.
Use plugs when swimming to keep the ears dry. Dry thoroughly after swimming and showering with a hair dryer or clean, dry towel. Do not use cotton buds and avoid chemical substances around the area. Use ear plugs or cotton wool balls to stop chemicals entering.
Ear wax / impacted cerumen
Ear wax which is medically termed impacted cerumen is a build up of wax in the auditory canal. This can cause discomfort and affected hearing and is most common in children and older people.
Symptoms of impacted cerumen
The ear will be bunged up with excess wax. The patient may feel discomfort in the ear and have a lost of hearing. Dizziness and tinitius which is a ringing in the ears may be experienced.
Treatment for ear wax
Impacted cerumen is diagnosed by looking in the ear with a otoscope. Dry, hard wax can be seen within the auditory canal. Several methods may be used to treat the condition.
Irrigation of the ear is where the ear is flushed out. Wax can be removed with forceps and suction. Hard wax may be softened with olive oil or sodium bicarbonate. Once the was is softened, the ear may be syringed.
Glue ear is a childhood condition which can cause some loss of hearing. It affects the middle ear and there are usually no external symptoms.
Symptoms of glue ear
The main symptom of glue ear is hearing loss which may range from very mild to moderate. Other symptoms include ear ache, irritability, clumsiness, balance problems and difficulty sleeping.
Glue ear is a build up of fluid in the middle ear. This is the area directly behind the ear drum. The fluid prevents the three tiny ear bones from vibrating properly, meaning sounds aren't transmitted from the outer ear to the inner ear, resulting in sounds being muffled.
Glue ear is a common condition especially in children between the ages of 2 and 6. It may be unilateral (in one ear) or bilateral (both ears) and often occurs after an ear infection. It also occurs most frequently in the winter. Although the exact cause of the injury is unknown, what is known is that it is not caused by water in the ear or excess ear wax.
Glue ear is caused by the Eustachian tube (which runs from the middle ear to the nose) becoming blocked and not being able to drain away the mucus and fluid. Factors which may contribute to this loss of drainage include:
- Changes in ear pressure (as occur on flights and at altitude).
- Irritants such as cigarette smoke and chemicals.
- Gastric fluids from the stomach that leak up through the throat and into the Eustachian tube.
Treatment of glue ear
In most cases glue ear does not require any treatment and will clear on it's own within 3 months. There are currently no medications which have been shown to be effective in treating the condition.
Surgery is vary rarely offered for glue ear, unless hearing loss is significant and it affects both ears, or there is a pre-existing medical condition which may affect the child's development. Such conditions may include autism, down's syndrome, a cleft palate, blindness or other speech and language disorders.
Surgery usually involves the insertion of grommets to keep the eustachian tube open. Other procedures include the removal of the adenoids. These are glands at the back of the throat. If they become inflamed they can block the eustachian tube. Hearing aids may be used as an alternative to surgery.
A perforated or burst eardrum is a tear of the eardrum in the inner ear. This is uncomfortable but usually heals on its own within a few weeks. It may be caused by an impact, loud noise or infection.
Symptoms of a perforated eardrum
Symptoms include hearing loss which will be proportional to the extent of the tear. Earache with a ringing or buzzing sound in the ear is possible. Mucus may also be discharged from the ear.
One of the most common causes of a perforated ear drum is a trauma. This may be from a head injury such as an impact to the side fo the head, or may occur from an object being poked into the ear, such as a cotton bud!
Sudden loud noises such as an explosion can damage the ear, including the eardrum. This usually results in a severe loss of hearing and ringing in the ears. An ear infection can cause a perforated eardrum. A build-up of pus inside the ear can put pressure on the eardrum until it ruptures.
Sudden changes in air pressure can also cause the eardrum to perforate. This may happen with flying, scuba diving, sky diving or driving at high altitudes.
Treatment of a perforated eardrum
If you suspect a perforated eardrum, visit your Doctor. A Doctor will look inside the ear with an auriscope. They will be able to see if the eardrum is torn and how much. Most perforated eardrums will heal by themselves within 2 months.
A Doctor may prescribe painkillers or anti-inflammatory medication to ease any discomfort. If the perforation was caused by an infection, they may prescribe antibiotics to clear the infection and allow the eardrum to heal.
Keep the ear dry whilst the eardrum is healing. Also avoid any pressure changes. For this reason swimming, diving and flying should be avoided until the eardrum has healed. Occasionally, if the eardrum does not heal or in very severe cases, surgery may be required. The procedure is known as a myringoplasty and uses a small graft of skin from above the ear to fix the eardrum.