Having read many threads on this forum and the articles on DAN, I was under the impression that otitis media can occur only if the eardrum is damaged? Please forgive me my ignorance, I'm very inexperienced..
Hi, Kay...
Thanks for writing!
This does come up a lot (will write a sticky when I get around to it!)....
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 that's for another day!
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).
Btw, I've got the infection again - in another ear this time, and not as bad b/c I recognized it and started taking antibiotics earlier. This is just... beyond frustrating... :depressed: After that first infection I made sure to wash my ears with fresh water after each dive, but apparently that wasn't enough.. Next time it will be with mineral oil and ear beer, many thanks to this forum...
I know that it is hard, but there is NO substitute for having someone who knows what he or she is looking at taking a look in your ear. Especially if you have a hearing loss, which means that it might be more than a simple OE that is treated with the topical methods that you are referring to...
Good luck!
Mike