Common Ear Infections with Dr. Silverstein

I’m Dr. Herbert Silverstein president of
the Ear Research Foundation and the Silverstein Institute first thing I’m
going to show you is a model of the ear and show you the three parts of the ear
so we have the outer ear the pinna and we have the ear canal here
most commonly gets plugged up with wax we now have the middle ear here the
eardrum is missing here but the little bones of hearing are in this area here
and then we have the station tube that connects to the nasopharynx that
equalizes the pressure in the middle ear we have the inner ear with the balance
canals the three balance canals and the cochlea for hearing first most common
infection of the year is the swimmers ear that’s caused by frequent swimming
in the in a pool and not drying the ears properly what happens the ears develop
fungus infection and sometimes a bacterial infection exacerbated by
putting q-tips in the ear and trying to put water in the ear to wash the ear out
actually you can just pull on the ear like this and touch the troika’s here or
the pull the pinna and that will hurt the patient because the ear canal skin
is involved sometimes this becomes very painful and the patients come in for
emergency care the way we diagnose it is with a microscope and we look in the ear
we can see debris fungus debris or bacterial debris in the ear canal the
best way to treat it is to remove that crud that’s in there with a suction and
clean the ear out thoroughly and then apply some antibiotic eardrops usually
in several weeks the infection goes away if they use antibiotic eardrops for a
prolonged period of time sometimes a fungus infection will develop
and then we have to treat the fungal infection so how do we prevent the
swimmers ear we try to keep the ears dry keeping wax from reaccumulating in
the ear is important and I developed a solution of alcohol and aloe that we
squirt in the ear twice a week in the shower discourages wax from forming
external otitis is very similar to swimmers ear
it comes from use of q-tips digging in the ear using hearing aids too often or
the molds irritating the ear canal it’s caused by water being used too often to
clean the ears and the ears remaining way many times the q-tip will push the
wax down into the ear and cause a hearing loss and cause damage to the ear
the treatment and prevention is very similar to swimmers ear the next topic
we’re going to talk about is acute middle ear infections and these
infections usually occurred from a sinus infection or an upper respiratory
infection the infection starts in the nose now are the sinus and it travels up
the eustachian tube and it goes into the middle ear when it does the ear fills up
with pus and the ear becomes very painful and the way you can tell just by
examining yourself that if you pull the ear and touch here it doesn’t hurt but
it’s still having a lot of pain in the ear and that’s because the pus is
causing pressure so when the doctor looks into the ear he sees a red eardrum
they sees a bulging of the eardrum and you can see the pus behind the eardrum
it’s usually treated for ten days to two weeks with oral antibiotics and that
usually takes care of the problem to help prevent the ear infections if you
have allergy sneezing runny nose itchy eyes you should have allergy diagnosis
with skin tests and have the allergies treated by desensitization
the drops under the tongue are a great advancement in allergy treatment because
the patient doesn’t have to come into the office to have the shots done we’re
going to talk now about chronic middle ear and mastoid infections these occur
in individuals with recurrent infections in their ear and what happens is a
perforation occurs in the eardrum and it becomes a chronic problem with recurrent
drainage in the ear they get a little water in their ear, ear will become
infected and it will start draining there’s a condition called cholesteatoma
of the year where a cist forms in the ear canal it starts growing and destroys
the bone and the little bones of hearing and destroys the eardrum and other
structures around the area of the ear such as the brain the facial nerve and
the balance canals we can diagnose that with mastoid x-rays and with lamination
of the ear under the microscope but when we see a patient with chronic
otitis media they usually have a perforation in the ear and drainage and
that’s cleaned out with a suction under the microscope and then antibiotic
eardrops are instilled into the ear sometimes we have to give oral
antibiotics also to quiet the infection down and the treatment is surgical to
repair the ear drum or to remove the cholesteatoma or the cyst when the ear
drum is destroyed and the little bones of the ear are destroyed we can replace
those with prosthesis and with tissue to repair the hole in the ear drum
the next type of ear infections that we have are inner ear infections and these
are usually caused by a virus and what they cause is an effective one the
balance and the hearing organ and the patient will have an episode of vertigo
that may last for several hours or days if the virus infection hits the inner
ear balance mechanism and if it hits the cochlea the patient will lose their
hearing and have a nerve or sensory neural hearing loss now these conditions
are an emergency for our treatment once we see somebody with sudden deafness and
losing their hearing from a viral infection the treatment is high doses of
steroids by mouth and also putting the steroids into the ears using a microwick
that I invented about 20 years ago that allows the patient to put drops in their
ear steroid drops in their ear and the drops go through the wick in the eardrum
and they can treat the deafness for a month with a steroid drops after a month
we remove the wick and the tube and patch the ear with a little piece of
paper and it usually heals with no problem
if we’re lucky and we treat the patient early we have the best chance of
restoring some hearing that has been lost I just wanted to show you a little
book that we’re putting out that will be available from the ear Research
Foundation website you can order this little book it talks about how you can
diagnose many of these problems in the ear by yourself and what the treatment
is at the Silverstein Institute we specialize in treating these infections
and if you’d like to make an appointment please call our office and one of our
specialists can see you as soon as possible

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