Merck Manuals Details Different Types of Ear Infections

Doctor shares what patients and parents need to know about antibiotics, cotton swabs and ear candling 

RAHWAY, N.J., Oct. 3, 2023 /PRNewswire/ — Most of us can remember the intense pain and bubble gum-flavored medicine that accompanied ear infections as kids. But not all ear infections are the same, and understanding the differences can be key to effective diagnosis and treatment.

In a new editorial from MerckManuals.com, Bradley W. Kesser, MD, University of Virginia School of Medicine, details the different parts of the ear and how infections in each area differ. He shares key information patients and parents should know before seeing a doctor for a possible ear infection.

1. All parts of the ear can get infected

The ear is made up of three parts – the external (outer ear), middle ear, and internal (inner ear). All three of these areas can get infected. Infection of the outer ear is marked by redness, pain, and swelling. Infections in the canal portion of the outer ear are often referred to as swimmer’s ear. Infections of the middle ear are also common and are typically caused by improper drainage of a young child’s Eustachian tube. In the inner ear, infections can affect the cochlea and the balance canals. Separate from infections marked by hearing loss, infection of the inner ear can affect balance, giving individuals extreme vertigo that can last days at a time.

2. Not all ear infections require oral antibiotics

For outer ear infections, a thorough cleaning of the ear along with a topical antibiotic applied directly to the outer ear is typically recommended. Middle ear infections may require oral antibiotics, says Kesser.

3. Some kids are more prone to ear infections than others

Persistent fluid in the middle ear is often a sign that a young child’s Eustachian tube is not draining properly. In young children, the Eustachian tube is not fully developed, which means fluid can get trapped in the ear. This persistent fluid can lead to repeat infections as well as hearing loss, which can affect language and other developmental milestones.

In these instances, doctors may recommend that a child have tubes put in their ears. This is a minor surgical procedure that involves making a tiny incision in the eardrum to remove any lingering fluid and placing a small tube (grommet) in the eardrum that helps prevent the return of fluid.

4. The ears are self-cleaning (that means no cotton swabs … or ear candles!)

There’s an old adage that nothing smaller than your elbow should go in your ear. That’s a good rule of thumb, says Kesser. He adds it’s especially true for cotton swabs, even after you’ve gone in the water. For clogged ears after swimming, Kesser recommends over-the-counter drops that can help evaporate water. Ear candling is also not recommended. It is ineffective, unnecessary, and can be dangerous, says Kesser.

You can read more about ear infections in Dr. Kesser’s editorial on MerckManuals.com.

About The Merck Manuals and MSD Manuals

First published in 1899 as a small reference book for physicians and pharmacists, The Merck Manual grew in size and scope to become one of the world’s most widely used comprehensive medical resources for professionals and consumers. As The Manual evolved, it continually expanded the reach and depth of its offerings to reflect the mission of providing the best medical information to a wide cross-section of users, including medical professionals and students, veterinarians and veterinary students, and consumers. In 2015, The Manuals kicked off Global Medical Knowledge 2020, a global initiative with the goal to make the best current medical information accessible by up to three billion professionals and patients around the world by 2020. The Manuals achieved that goal, and today its medical information is available in more than 241 countries and in 13 languages. It’s continuing its ambitious mission through outreach, education and creating new reliable medical resources. For access to thousands of medical topics with images, videos and a constantly expanding set of resources, visit MerckManuals.com or MSDManuals.com and connect with us on social media: For Consumers in the U.S. and its territories: Twitter and Facebook. For Professionals in the U.S. and its territories: Twitter and Facebook

About Merck

At Merck, known as MSD outside of the United States and Canada, we are unified around our purpose: We use the power of leading-edge science to save and improve lives around the world. For more than 130 years, we have brought hope to humanity through the development of important medicines and vaccines. We aspire to be the premier research-intensive biopharmaceutical company in the world – and today, we are at the forefront of research to deliver innovative health solutions that advance the prevention and treatment of diseases in people and animals. We foster a diverse and inclusive global workforce and operate responsibly every day to enable a safe, sustainable and healthy future for all people and communities. For more information, visit www.merck.com and connect with us on Twitter, Facebook, Instagram, YouTube and LinkedIn.

SOURCE The Merck Manuals