Sore Ears

Thanks for that detailed description of the ENT system. Now, what are some of the things that go wrong there? I’m sure there must be many. What about sore ears to start with?

An excellent starting point, for children often suffer from sore ears. I am afraid many of these are self-inflicted, for so many children, especially younger ones but older kids too, poke all manner of objects into the ears.

Such as?

You name it. Dried peas or beans, pieces of gravel, shells, plastic tips from ballpoint pens, eyes pulled from dolls, matches, pieces of paper, and rolled-up bits of cotton wool. The list is endless. Some older girls seem to prod, pick and poke with bobby pins, the head end of a pin, or even a safety pin.

That doesn’t sound a very good idea. It’s a bad habit, and I would like to promptly discourage them from these habits. But there are many other causes of problems of the outer ear, or the external auditory (hearing) canal as the passageway is called.

Stapes (Stirrup)

Incus (anvil)

Malleus (hammer)

What other adverse conditions can occur?

Foreign bodies can abrade the tender lining of the canal, causing infections to rapidly set up. Scraping the canal with pins and other metal devices can cause similar problems. But chemically treated water is also a hazard. Strongly chlorinated swimming pools, more common at the start of the swimming season, are notorious. Often a severe chemical reaction will occur. The drum and canal walls become red, inflamed and very painful. Often a discharge occurs, and in turn this may affect the outer part of the ear, and even the skin surrounding the side of the face. It may be red, raw and discharging and quite painful. Often the glands in front of the ear will become painful as a result.

How is this best treated?

Avoidance in the first place is the best starting point. If a rash extends to the outside skin of the ear and face, and is obviously infected, gentle bathing with a weak Condy’s crystal solution (water pink only) will eliminate the debris and help kill germs.

Gently removing obvious debris from the ear canal with a cotton wool bud dipped in liquid paraffin is often soothing, and will frequently eliminate much of the accumulated discharge.

If the ear is painful, I think it’s best to avoid too much fiddling, for this may aggravate the condition. Let the doctor peep inside with the instrument called an auriscope. This has a light and magnifying glass, and enables the physician to see deeply inside.

Will the doctor clean the canal out? Often the debris can be removed with special instruments. The doctor may insert an ear cream containing antibiotics aimed at killing a wide variety of germs. Frequently in these ears a combination of viruses, bacteria and fungi (all various kinds of troublemaking germs) combine to create the overall disorder. Sometimes the ear canal is filled with the cream for several days, and this is often successful.

Are antibiotics prescribed for infected ears?

Quite often the physician may prescribe a course. Often the so-called broad-spectrum semi-synthetic antibiotics are used. It is essential that the total course be taken, otherwise the infection may be only half-cured, and this is most unsatisfactory. For the relief of a fever or pain, the doctor might prescribe paracetamol elixir, a well-known antipyretic and analgesic, meaning it reduces elevated temperatures and kills pain at the same time. It is an invaluable medication for children. Check the label for the dose; this varies with the child’s age.

Sometimes a warm hot-water bottle Swimming in chemically treated water can sometimes cause an infection to become established in the outer ear applied to the side will also reduce pain, but make sure it is not too hot.