Ear infections can be painful conditions in adults. However, they are more common in toddlers and babies.
Acute infections are rarely anything to worry about. However, with chronic infections comes the risk of hearing loss.
This article discusses the types of ear infections, the risk of hearing loss, and what you can do about it.
About ear infections
Both viruses and bacteria are responsible for causing the majority of ear infections. Typically, the infection begins as a cold. Over time, germs migrate into the tubes that connect the ear to the back of the throat (called the eustachian canals). These then become inflamed and infection can spread to the middle and inner ear. Physicians call this otitis media.
In rarer cases, ear infections can start in the ear itself. This occurs because of damage to the eardrum or excessive wax buildup. When the ear cannot self-clean or tissues are compromised, germs can cause infection. Medical professionals call this type of infection otitis externa.
There are several other ear infection varieties that your doctor may diagnose. These include:
- Acute mastoiditis – an infection of the skin that covers the mastoid bone.
- Infectious myringitis – an infection of the eardrum that causes small blisters.
- Vestibular neuronitis – an infection of the fluid-filled loops in the ear that assist in balance.
- Herpes zoster of the ear – an infection of the cochlear nerves by the herpes zoster virus.
Ear infection symptoms vary according to the cause. Most patients will experience pain in the ear, slight loss of hearing, and discharge from the ear canal. Rarer symptoms include a high temperature (fever), loss of balance, tinnitus (persistent noises in the ear with no external cause), and loss of appetite.
Can ear infections cause hearing loss?
Hearing loss is a common complication of ear infections. However, in most acute infections (those that only occur once or come and go rarely), it returns to normal soon after.
Ear infections cause short-term hearing loss because they increase inflammation and the volume of fluid in the middle ear. As sound waves enter the ear, the eardrum can no longer transmit energy in a normal way. Noise becomes muffled or quieter as the fluid absorbs more energy.
Can untreated ear infections cause permanent hearing loss?
If left untreated, ear infections can cause permanent hearing loss. Over time, chronic infection damages the structures of the middle ear, including the eardrum. As tissues deteriorate, they find it more challenging to return to their original form. Eventually, this reduces their capacity to transmit sound.
Some people appear more susceptible to permanent hearing loss from infection than others. Chronic infection in babies and children appears to be more predictive of permanent hearing loss in later life than infections in adulthood.
How long does hearing loss from an ear infection last?
Hearing loss from an ear infection can last anywhere from two days to several weeks. In children, it tends to persist even after the infection goes away. This may occur because of changes in the shape of the middle ear due to inflammation.
In adults, hearing returns to normal faster. Most adults will notice their hearing returning within 72 hours.
How to treat and manage hearing loss?
If hearing loss is temporary because of an infection, follow the advice of your doctor. However, if you have permanent hearing loss, you will need to work with an audiologist.
The management and treatment you receive depend on the type of hearing loss you have. For sensorineural hearing loss, audiologists will recommend hearing aids. These amplify the sounds reaching your eardrum, making it easier to hear children’s voices, birdsong, and general conversation.
If hearing loss is more severe, audiologists may recommend cochlear implants. These devices stimulate the auditory nerve directly, bypassing damaged tissue in the middle ear.
In some cases, audiologists will remove impacted ear wax to reverse hearing loss. To do this, they either use a solution to wash the wax out or use a special tool to pull it out manually.
How to treat ear infections?
There are several ways that you can treat an ear infection at home. To reduce inflammation, take an over-the-counter anti-inflammatory painkiller, such as ibuprofen. These drugs calm the immune system, reducing both pain and symptoms at the same time. You can also try ear drops and decongestants.
When to see a doctor?
If you or your child has symptoms that don’t resolve or improve after two or three days, go and see a doctor. The immune system can sometimes fail to eliminate infections, increasing the risk of permanent damage to the middle ear.
Your doctor will prescribe antibiotics if they believe that the cause is a bacterial infection. These work by killing the bacteria directly or preventing them from replicating.
If the doctor believes that the cause is viral, they may adopt a “wait and see” approach.” Here, they simply wait a little longer for symptoms to resolve.
Get help from an online doctor
If you or your child has an ear infection and you are concerned about it causing long-term hearing loss, you can get help with DrHouse online. Simply sign up to get access to qualified and accredited clinicians. They can then evaluate your case and prescribe any medications or treatment that you may need.
Key Takeaways
So what have we learned?
- Both viruses and bacteria can cause ear infections
- Ear infections can affect multiple structures in the ear, all the way from the eardrum to the auditory nerve
- Acute ear infections rarely lead to permanent hearing loss, but chronic infections are more likely to
- If you can’t hear, you can manage it with the help of hearing aids or cochlear implants
- Home remedies for ear infections include taking over-the-counter anti-inflammatory painkillers, applying ear drops, and taking decongestants
- If severe symptoms persist, get a consultation. A doctor can prescribe antibiotics or recommend other types of treatment
Sources:
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- Müller, U., Barr-Gillespie, P. New treatment options for hearing loss. Nat Rev Drug Discov 14, 346–365 (2015). https://doi.org/10.1038/nrd4533
- Yiengprugsawan, V., Hogan, A. & Strazdins, L. Longitudinal analysis of ear infection and hearing impairment: findings from 6-year prospective cohorts of Australian children. BMC Pediatr 13, 28 (2013). https://doi.org/10.1186/1471-2431-13-28
- Blakley, Brian W.; Kim, Steven. Does Chronic Otitis Media Cause Sensorineural Hearing Loss? Journal of Otolaryngology . Jan/Feb1998, Vol. 27 Issue 1, p17-20. 4p.
- Kristian Tambs, Howard J. Hoffman, Hans M. Borchgrevink, Jostein Holmen & Sven O. Samuelsen (2003) Hearing loss induced by noise, ear infections, and head injuries: results from the Nord-Trøndelag Hearing Loss Study: Hipoacusia inducida por ruido, infecciones de oído y lesiones cefálicas: resultados del estudio Nord-Trøndelag sobre pérdidas auditivas, International Journal of Audiology, 42:2, 89-105, DOI: 10.3109/14992020309078340
- Szmuilowicz, Jacob et al. Infections of the Ear. Emergency Medicine Clinics, Volume 37, Issue 1, 1 – 9. Available from: https://doi.org/10.1016/j.emc.2018.09.001
DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.
