Monday, August 9, 2010

Mystery Medical Mondays: Ears

Good Morning everyone!! I hope you have a wonderful Monday!!

This week on Mystery Medical Mondays I'm going to be discussing ears. It is swimming season, which means lots of swimmers ear!!

First lets review some anatomy of the ear canal. There is an External, Middle, and Inner portion of the ear. The external ear canal is the passage way between the outside to the tympanic membrane. The Middle ear is where the ossicles (or ear bones) are housed and it is enclosed by the tympanic membrane and the Eustachian tube. The Inner ear is the part that does the "hearing" and it is formed by the cochlea and the semicircular canals.

Pictured borrowed from here

Usually the only thing a physician, or physician assistant can see when they look in your ears is the tympanic membrane. A normal one looks like this:

Pictured borrowed from here

So what is swimmers ear you ask? It is an infection of the external ear canal, also called otitis externa. It is usually due to "dirty" water getting into the ear canal and not drying up. Otitis externa can be caused by bacteria, fungus, or even yeast. Usually patients that complain of ear pain a few days after swimming have otitis externa. The most common test to distinguish the difference between external ear infection compared to a middle ear infection is the "Tragus test." The Tragus is little flap of cartilage in front of your ear "hole" or acoustic meatus, that when pushed to cover up the acoustic meatus causes pain. Also pulling or tugging the ear causes pain- this indicates an external ear infection and the most common treatment is ear drops (anti-fungal, or anti-bacterial). This is a classic case of otitis externa

Picture borrowed from here
A Middle ear infection is most common in small children, or seasonal allergy sufferers. This is usually caused by increase pressure in the middle ear due to swelling of the Eustachian tube. Bacterial multiply causing intense pain and pressure. Small children who have a fever and are "tugging" at their ears most likely have a middle ear infection. This is what a tympanic membrane looks like during a otitis media. This is treated with oral antibiotics, however sometimes a shot is given as well. 
Picture borrowed from here
When small children, or even some adults have chronic middle ear infections, they will sometimes have surgery to place "tubes" in their ears to help equalize pressure better. They often look like this:

Picture borrowed from here
I hope you learned a bit about the tympanic membrane and some of the most common complaints from children and adults during these warm swim-worthy months. 

Remember to rinse your ears with a swimmers ear solution after getting out of the water to prevent Otitis Externa!! 

Have a great day, and thanks for stopping by!!

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