Constant ear infections

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Hey, sorry to be late..! Let me see if I can help...

Late last fall/early winter I developed an inner ear infections, then about a month later a middle ear infection.

Not sure what this means... I know that it sounds pedantic, but here's a cut and paste from my response to another thread... a lot of these discussions tend to get confusing since all ear symptoms are lumped together.

Otitis externa (OE, outer ear infection, "swimmer's ear") and Otitis media (OM, middle ear infection, from barotrauma or infection), are two completely different things with different causes, physiology and risks.

OE is a skin inflammation of the canal of the ear that starts in the side of your head and travels down to the eardrum. It can be caused by aggressive instrumentation, diving, sweating or some types of ear drops. In severe cases, with swelling of the canal, it can cause some hearing loss but this is uncommon. Sometimes, accumulated earwax makes it worse, especially if you are packing it in with a q-tip in an attempt to remove it..!

OM is caused by bacterial infection in children (AOM, or acute otitis media), or by pressure injury in divers (OME, or otitis media with effusion). It causes a significant (but usually temporary) hearing loss. The problem in both cases is poor equalization/ventilation of the middle ear cleft (the space behind the eardrum) due to diving or (in children) due to poor function of the Eustachian tube. Diving when you can't equalize make you at risk for an eardrum perforation, or worse.

There are also INNER ear problems (DCI, perilymph fistulas, etc..) that can cause permanent deafness, but these are extremely rare, and when diving related, usually involve some pre-existing defect in the skull base or significant dive accident. They often involve severe hearing loss and/or vertigo that persists after exiting the water.

There is a small amount of overlap: OM can cause OE if the eardrum perforates and that infected fluid drains into the ear canal. OE can't really cause OM (although I suppose it is remotely possible to cause some barotrauma if your outer ear was sealed shut from inflammation and that affected the air pressure in the ear canal during descent).

2 weeks ago I started having pain in my left ear. I waited 3 days to see if it would clear up, but the pain got worse. The doc said she saw fluid behind my eardrum and diagnosed an inner ear infection.

Again, the devil is in the details. If someone sees fluid behind the drum (not yellow pus, but just liquid, or OME), that would be middle ear effusion, a common dive issue. Sometimes the fluid has blood in it, especially if it is from barotrauma. But adults (even divers) rarely get true middle ear infections with pus that require antibiotics.

She prescribed amoxicillin and my ear was filling better within 2 days. 4 days after being on antibiotics, I would still hear a little fluid behind my eardrum but the pain was gone.


There is no evidence that antibiotics have any effect on middle ear fluid. However, these things typically improve on their own with time, so antibiotics are often credited with the cure... :) It can take weeks or even months for fluid to resolve, especially in children.

I went diving and had no problems equalizing. I finished the antibiotics this past Friday and did 3 dives on Sat. No problems equalizing. Within 24 hours my left ear started hurting inside again and I have some hearing loss.

I wonder if I have something else going on that is causing these repeat ear infections.

This is one of those things -and I know that this sounds like a dodge - that just needs to be seen to give an intelligent opinion. Unfortunately, a hundred pages of description of symptoms, onset, history, etc.. is not as good as two seconds of someone with experience looking in your ear.

My ear feels better after a couple of days of taking antiobiotics, but could I have inflammation in my Eustachian tube causing the water to get trapped behind my ear drum leading to infection? The lake water is pretty nasty and it's probably safe to assume that bacteria is more prolific as the water gets warmer.

Again, two different things - you could certainly have some transient dysfunction of your Eustachian tube due to a cold, allergies, etc.. but exposure to contaminated water would mainly put you at risk for outer ear infections, which as I mentioned are very different things.

I should probably go see an ENT doc, but my ear hurts and I need to be seen today, and I want to be able to have an informed discussion with the doc.
What kind of underlying medical issues could cause repeated ear infections? Are there any preventative measures that can be taken for inner ear infections?

You have answered your own question! Obviously, I like commenting here, and I always try to help as best as I can, but the devil really is in the details. In this forum, people are quick to offer their own experience and cures. However, until you have an accurate diagnosis, there is no point in trying remedies...

If you want, PM me and tell me where you are, and I may be able to give you a local referral...

Mike
 
I hope your feeling better carrielsal after diving at lake travis or any south texas lake or jettys my estation tube swells up so far sample nasonex from my md has helped does any one know mix for ear wash-dryer Thanks Rockhunter
 
I hope your feeling better carrielsal after diving at lake travis or any south texas lake or jettys my estation tube swells up so far sample nasonex from my md has helped does any one know mix for ear wash-dryer Thanks Rockhunter

Thanks. I finished the second course of antibiotics, prednisone and antibiotic ear drops and haven't had a problem since, but then again it's only been a few weeks. I have done 7 dives this week and every night I put a couple of drops of the antiobiotic drops in my ears.
I talked to doctormike and he recommended going to see an otologist instead of an ent doc if I have any other problems.
 
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