Ear problems both chronic and acute, can ruin two of life’s most simple pleasures this summer, like traveling and swimming. Anyone who has ever endured a ten hour plane ride with an ear infection (even if you were headed for Hawaii), could most likely relate. Or even worse, anyone who has ever had swimmer’s ear while vacationing off a remote island in Fiji (or the Bahamas or wherever the chances of finding an M.D. is nil to none), probably endured frustrations not unlike what the participants on that reality show Survivor endured. Except in this case you’d get none of the associated fame or fortune. All you’d probably get out of an ear infection is excruciating pain with some bouts of dizziness thrown in. Definitely not something you’d want on your next island adventure.
 
So, here are some guidelines that can help you to prevent if not avoid your most common ear infections this summer. Most of them are simple to manage on your own at home or abroad. Be sure to check them out before you “check in” (to a hotel of course).
 
Know The Problem, Find The Solution
 
Before I talk about prevention, let me start off by explaining some of the most common ear problems I see this at time of the year. Knowing what causes certain ear problems will aid you in understanding what you can do to avoid these problems altogether.
 
Ear Problem #1: Swimmer’s Ear
 
The organisms that cause ear infections like swimmers ear and a host of others like it love dark, warm, moist places, and your ears, unfortunately, are the perfect vacation spot for these types of visitors. In the case of swimmers ear, heat and moisture combine to cause swelling in the layer of skin inside of your ear, and add to that the additional water from swimming and in some cases the irritation of pool chemicals or polluted water from some swimming and diving areas, and the outer ear canal becomes even softer and more prone to infection. However, swimmer’s ear isn’t only for swimmers. Because swimmer’s ear is caused by water trapped in the outer structures of the ear, any water based activity can lead you in that direction. You can even get swimmer’s ear from baths or showers.
 
Itching, mild to moderate pain, a fever, a feeling of a blocked ear, decreased hearing, swollen lymph nodes, and drainage may accompany the condition.
 
Solution for Swimmer’s Ear
 
With some severe infections, antibiotic drops may be necessary to treat swimmer’s ear. However, mildly acidic solutions such as white vinegar (diluted with an equal part of water) can be highly effective for early infections. Of course, the best treatment for swimmer’s ear is to keep your ears free of moisture during and after water activities. But using Q-tips even to just dry the outer ear canal is NOT recommended. They have a tendency to pack the ear wax deeper into the ear canal, or worse, remove the protective layer of earwax in the ear canal. This can not only irritate the thin skin around the ear canal, but make the ear a more habitable place for bacteria to congregate. As such, the safest way to dry your ears is, believe it or not, with a hair dryer. If you do NOT have a perforated eardrum, rubbing alcohol or a 50:50 mixture of alcohol and white vinegar used as ear drops will evaporate excess water and keep your ears dry.
 
Ear Problem #2: Otitis Media
 
Otitis Media, or middle ear infections are common in children under the age of seven, and some children seem to have chronic ear infections throughout their early years. Symptoms can include fever, pain, crying, nausea, vomiting, diarrhea, and crankiness. Most middle ear infections are caused by blockage of the Eustachian tube openings in the back of the nose by a virus or allergies. Although few are caused by bacteria, the rate of antibiotic use for ear infections have become commonplace (see article in this month's newsletter – Antibiotics: When Does Use Become Abuse?). It is possible to have the symptoms without having an actual infection. This occurs when the tissues in the middle ear become inflamed and in turn causes a build up of pressure or fluid – with pain and hearing loss as the result.
 
Solution for Otitis Media
 
Again antibiotics are often used for treatment, but oftentimes an approach of “watchful waiting” is used. This entails a few days of, as you most likely guessed, waiting and watching to see if symptoms will begin to subside on their own. Several studies, along with my many years of observation have found this non-antibiotic approach has merit and can help reduce the occurrence of antibiotic resistant strains of bacteria from developing in the future. Sometimes tympanostomy, or the surgical insertion of tiny tubes into the ear, may be used for children with chronic otitis media that lasts months or more.
 
Ear Problem #3: Allergies & TMJ
 
Allergies can affect your ears by blocking the tube that connects the nose with the middle ear. Ear stuffiness, echoing, fullness and a sense of pressure are common complaints
 
Some other conditions that can cause ear pain are dental pain, jaw pain like TMJ and throat conditions. Sometimes when you have an infection or other medical problem with these areas of your head and neck, the pain can show up as ear pain. Often there are other symptoms in these specific areas too. For example dental and jaw pain can spread both upwards and downwards causing headaches, jaw stiffness and throbbing, face and neck pain, and pressure, as well as inner and outer ear pain and a sensation of fullness.
 
Solutions For Allergies and TMJ
 
As you’ve most likely guessed, the best way to prevent ear problems generated by allergies or dental pain is to treat the source of the pain itself. If you have seasonal allergies, the best way for you to keep them from affecting your ears is by using generous amounts of nasal saline or over the counter medications like Claritin®, Sudafed® or Afrin® (only for 2 or 3 days). For chronic sufferers, using prescription nasal sprays like Nasonex®, or Flonase® prior to an allergy attack can also help keep your Eustachian tubes open and therefore less prone to problems. For ear pain that’s generated by TMJ or other dental problems can be alleviated at home with warm compresses, eating a soft diet and and taking an anti-inflammatory medication like ibuprofen. Chronic TMJ sufferers may need to see a dentist about being fitted with a TMJ night guard.
 
The Ultimate Prevention Solution
 
Of course, keeping your ears dry while swimming and washing your hands frequently to reduce your exposure to upper respiratory infections are all typical ways of preventing ear infections. However, one thing that you might add to this regimen if you haven’t already done so, is a change in dietary and lifestyle habits. Although it’s not stressed nearly enough, quitting smoking, avoiding late night meals and getting quality restful sleep can all help to reduce your chances of suffering from ear pain.
 
Besides the fact that all of these are bad habits anyways, they can also aggravate acid reflux—the great nemesis that can cause many common ear, nose and throat problems. When gastric acid gets sucked up into the throat you can get LPRD or laryngo-pharyngeal reflux disease and this can wreak havoc on your throat tissues not to mention your ears. Research indicates that gastro-esophageal reflux disease as well as its counterpart, LPRD can cause swelling of the eustachian tubes. Now that you know, have fun, play wisely and win the battle against ear infections this summer.

West Side ENT