Chronic Otitis Media Home Remedies

Natures Amazing Ear Infection Cures By Naturopath Elizabeth Noble

Little Known Secrets To Cure An Ear Infection Fast! Here's A Taste Of What's Revealed In The Nature's Amazing Ear Infection Cures e-book: What type of ear infection do you or your loved one have? The 9 ear infection symptoms you can't afford to ignore. Danger at the drugstore what drugs you should never buy. Why antibiotics are useless and possibly dangerous for most ear infections. The problems with surgery. The causes and triggers of an ear infection everything from viruses, bacteria and fungi to allergies, biomechanical obstruction, environmental irritants, nutrient deficiencies, poor infant feeding practices and more. How to relieve even the most excruciating ear ache with a hot onion poultice. An ancient Ayurvedic recipe to control an ear infection. The herbal ear drops you can make in your own kitchen that are renowned for soothing ear pain. The wonderful essential oil ear rubs you can make to ease ear congestion and discomfort. The simplicity of homeopathy for treating an ear infection great for babies and young children. User-friendly acupressure, massage and chiropractic to relieve ear pain, enco. How to relieve problem ears with air travel.

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Otitis media with effusion

Otitis media with effusion (OME) is a condition with complex etiologies including anatomical variations, allergy, infections and inflammation. The interplay of these factors lead finally to structural and or functional abnormality of the Eustachian tube resulting in OME. The more horizontal lie of the Eustachian tube and frequent attacks of URTI contribute to the high prevalence of OME in infants and young children of any race. The reported cumulative incidence of first episode of OME reaches almost 100 by the age of 3 years. The incidence drops sharply after the age of 7 so much so that the condition is uncommon amongst teenagers and rare in adults. However, in places where nasopharyngeal carcinoma (NPC) is endemic, deafness associated with OME is a common presenting symptom of the disease. In these areas, NPC should be excluded in any adult with unilateral OME. Clinical diagnosis is straightforward when otological examination shows a fluid level (Fig. 20.2) or bubbles behind the...

Chronic suppurative otitis media

Chronic suppurative otitis media (CSOM) is the commonest form of chronic otitis media. Clinically it is characterized by otorrhoea and conduction hearing loss of variable severity. Otoscopy reveals a perforated eardrum. The condition is classified into the safe (tubotympanic) and unsafe (atti-coantral) variety depending on the likelihood of coexisting cholesteatoma. The unsafe variety is CSOM with cholesteatoma (Fig. 20.4). The presence of cholesteatoma is usually obvious on otoscopy. Occasionally, cholesteatoma may be more difficult to diagnose. If otoscopy reveals granulation tissue, aural polyps or middle ear infection that is resistant to conservative treatment, cholesteatoma should be excluded. Traditionally, in the presence of a marginal perforation or a deep retraction pocket, CSOM is considered potentially unsafe. However with modern endoscopic equipment and CT, assessment of the middle ear becomes much more accurate than before. Diagnostic uncertainty occurs only rarely. The...

Necrotizing otitis externa

Necrotizing otitis externa is also known as 'malignant otitis externa'. It is not that the condition may become malignant, but because of the occasional fatal outcome. This typically occurs in elderly patient who is diabetic or is immunocom-promised for other reasons. There is usually a long history of ear discharge and otalgia is frequently present and pronounced. The causative organism is Pseudomonas pyocyanea. The clinical features of 'necrotizing otitis externa' are often misleading and deceptive in the early phase of the disease. However, the response to standard treatment is poor and the condition may suddenly deteriorate. Ear examination often shows exuberant granulation tissue. A biopsy should be taken for microbiological work-up and for histological examination to exclude malignancy. Infection and the necrotizing process may spread to involved the temporal bone causing osteomyelitis. The first indication is often facial nerve palsy. In advanced disease, the jugular foramen...

Otitis externa

Otitis externa is a very common ear condition. It usually occurs following minor trauma, often self-inflicted, to the external auditory canal (EAC). Treatment is usually straightforward with local toilet and topical medications. In severe cases, the external canal should be packed with an otowick or ribbon gauze impregnated with a steroid-containing antibiotic cream. The dressing should be changed daily or as required by the condition. When the condition becomes recurrent or is resistant to treatment, an underlying cause should be excluded. Conditions like diabetes mellitus and a chronic dermatosis may need to be treated simultaneously. Otomycosis may sometimes complicate chronic otitis externa especially when prolonged or recurrent courses of topical antibiotics had been used. Rigorous aural toilet and topical antifungal eardrops should be used. Repeated local toilets and antifungal therapy are often needed as the fungal spores are very resistant to treatment. Occasionally, stenosis...

Acute otitis media

Acute otitis media most commonly occurs in young paedi-atric patients less than 6-7-year old. It typically occurs, following an upper respiratory tract infection (URTI), as ascending infection through the Eustachian tube. The natural course of acute otitis media is best described in four stages hyperaemic, inflammatory, suppurative and resolution phases. In the hyperaemic phase, the patient has otalgia without hearing loss and otoscopy reveals a hyperaemic eardrum. The inflammatory phase that follows is characterized by increasing otalgia and hearing loss. Fever is usually present at this phase. Otoscopy reveals a hyperaemic eardrum and middle ear effusion. The disease reaches a climax at the suppurative phase. The patient often becomes irritable because of intense otalgia and hyperpyrexia is frequently present. Otoscopy reveals pus collecting behind a bulging and intensely hyperaemic eardrum. The eardrum is now under severe tension and may rupture spontaneously. Once the eardrum...

Benefits of breastfeeding in the general population

One of the most beneficial attributes of breast milk is that it protects against common childhood infections such as diarrhoea, pneumonia, neonatal sepsis and acute otitis media (Habicht et al., 1986 and 1988 Victora et al., 1987 WHO Collaborative Study Team, 2000). Whether it confers similar protection in areas of high HIV-prevalence is less clear, however. Results from a recently published pooled analysis of six studies carried out from 1983 to 1991 with data on all-cause death for 1123 children under the age of two years, in Brazil, Ghana, Gambia, Senegal, Pakistan, and the Philippines, confirm that breastfed infants are at lower risk of mortality than those who are not breastfed (WHO Collaborative Study Team, 2000). In the three non-African studies, in which outcomes for breastfed infants could be compared with those for infants who had not been breastfed, mortality rates were significantly higher for the non-breastfed through the first eight months of life. This was particularly...

Head and Neck Manifestations

Tuberculous otitis media is rare and usually represents hematogenous spread. Roughly one-half of the cases have no other evidence of present or past TB. The classic clinical picture is painless otorrhea with multiple tympanic perforations, exuberant granulation tissue, early severe hearing loss, and mastoid bone necrosis (see Chapter 25 for further discussion of otorrhea). The finding of multiple tympanic membrane perforations is most likely TB, possibly pathognomonic. Nonetheless, the diagnosis is difficult, even when tissue is available. Tuberculous otitis may be complicated by facial nerve paralysis, which is discussed in detail in Chapter 29. Response to drug therapy is excellent, and surgery usually is not required. Tuberculous Laryngitis. The pathogenesis of TB laryngitis has changed with the implementation of active chemotherapy. In the preantibiotic era, TB laryngitis was often encountered in advanced disease, along with oral and epiglottic lesions,...

Primary HHV6 infection and the respiratory tract

While early descriptions of exanthem subitum specifically stress the absence of respiratory symptoms (Levy, 1921 Westcott, 1921 Beaven, 1924 Zahorsky, 1925), Glanzmann writes in the German Handbuch der Inneren Medizin that rhinopha-ryngitis, katarrhalic otitis and occasional bronchitis do occur. Pulmonary complications are usually not present (Glanzmann, 1952). Only after HHV-6 was identified as a causative agent for ES (Eberle et al., 1988 Takahashi et al., 1988 Yamanishi et al., 1988), and the disease was thus better classified, an occasional respiratory pathology became overt even in primary HHV-6 infections (Wiersbitzky et al., 1989a,b, 1991a,b).

Radiation Oncology Nurse

Radiation therapy provides an important role in the management of HGG. Nursing care provided by the radiation oncology nurse begins at the initial consult visit and continues into the early post-radiation phase. Patients and families must be educated regarding treatment schedules and expected effects and side effects. Options available to patients include conventional regional radiation, whole brain radiation, stereotactic radiosurgery such as gamma knife or photon beam, brachytherapy, and hyperthermia (31). It is often difficult to assess if symptoms are being caused by the radiation therapy itself, tumor growth, or other concurrent therapies. Acute symptoms occur within the first few weeks to months and are usually self-limiting. These include nausea but rarely vomiting, anorexia, impaired taste, fatigue, increased seizures, increased neurologic deficits, skin changes, hair loss, and impaired wound healing. Some patients whose radiation fields lie near the ear can experience hearing...

Host Factors in Measles and Its Pathogenesis

The clinical manifestations of measles virus infection are greatly influenced by host factors. Healthy, well-nourished children usually have a self-limited illness which may be accompanied by complications (otitis media, pneumonia, gastroenteritis), but carries a low mortality rate (1 per 500). In contrast, malnourished children, particularly those with protein deficiencies, are subject to severe illness with mortality rate that may reach 20 or higher 14 .

Clinical Manifestations

Otologic manifestations are particularly relevant to the otolaryngologist. Patients may present at any time during childhood. Mastoid disease may present in unifocal, multifocal, or systemic LCH. Patients typically present with otorrhea. The incidence of LCH ear disease (all types) is from 15 to 61 . It is usually unilateral, but bilateral disease may occur. The presence of polyps and granulation tissue in the external canal is highly suggestive of LCH. The middle ear is usually spared. Otitis externa can also be present. LCH can mimic cholesteatoma and should be kept in mind as a part of the differential of otorrhea, especially if bloody. A computed tomography (CT) scan typically shows aggressive lytic lesions similar to osteomyelitis, bone lymphoma, or sarcoma (4,5).

Nasopharyngeal cancer

The first sign of NPC is often an enlarged metastatic cervical node in the posterior triangle. Common local signs and symptoms include nasal (blood-stained discharge, obstruction), aural (serous otitis media, tinnitis, conductive hearing loss) and neurological symptoms (diplopia due to abducen nerve paralysis). Diagnosis is by flexible fibreoptic nasopharyn-goscopy and biopsy. Elevated blood levels of antibodies to Epstein-Barr virus capsid antigen (IgA-VCA) and early antigen (IgA-EA) are often seen. CT and MRI are useful in staging the disease and in detection of recurrence. Radiation is the firstline treatment for NPC of all stages because of the radiosensi-tivity of undifferentiated carcinoma. For recurrent disease after radiotherapy, surgical resection of the nasopharynx by the transoropalatal approach, mandibular swing or maxilla swing approach are recently established surgical salvage procedures that are preferred over re-irradiation which is associated with complications...

Wegeners Granulomatosis

Wegener's granulomatosis is an idiopathic vasculitis of small arteries, arterioles, and capillaries primarily affecting the upper aerodigestive tract, lungs, and kidneys. Typical presentation is in middle-aged patients with a slight male predominance. Otologic manifestations are common and range from 19 to 45 of cases (103). They include conductive hearing loss, sensorineural hearing loss, otalgia, otorrhea, and serous otitis media. Neurologic involvement is frequent with nearly half of patients demonstrating either peripheral or central neuropathy (104). Cranial nerve involvement was reported in 6.5 of patients (105). When the ear is affected by the disorder, facial nerve involvement has been estimated at 5 (103,106). Injury to the facial nerve may be from destructive granulomatous lesions involving the skull base, necrotizing vasculitis, or compressive effect due to granuloma in the middle ear (107). Pathologically, the disorder is characterized by noncaseating granulomas with...

Severe Chronic Neutropenia Patients

In patients with SCN, severe bacterial infections frequently occur during the first year of life. Postnatal omphalitis may be the first symptom, but later otitis media, pneu-monitis, infections of the upper respiratory tract, and abscesses of the skin or liver are also common infections, which often lead to the diagnosis of SCN. Blood cultures are positive for staphylococci or streptococci, but other bacteria, e.g., Pseudomonas and Peptostreptococcus, and fungi were reported. In addition, rare infections like a clostridial gas gangrene infection may occur in these patients. The outcome of these fulminant infections is often lethal owing to lack of neutrophil defense. Most patients have frequent aphthous stomatitis and gingival hyperplasia, leading to an early loss of permanent teeth.

Mycobacterial Infections

Tuberculosis (TB, from Mycobacterium tuberculosis and or Mycobacterium bovis) is a major cause of morbidity and mortality in HIV disease. It usually presents as reactivation of a pulmonary primary focus, with a risk of 7 to 10 per year for HIV-infected persons regardless of CD4 lymphocyte count, versus 10 per lifetime for HIV-negative persons. There can be involvement of the lungs, central nervous system (CNS), or other organs, with rhinosinusitis, diffuse or localized (scrofula) lymphadenopathy, skin and mucosal ulcers, chronic otitis, and laryngeal involvement. Fever, chills, night sweats, and weight loss may be the presenting symptoms of any form of tuberculosis. Hemoptysis may be a symptom of laryngeal, tracheobronchial, or pulmonary disease. The clinical presentation becomes more atypical as the immunosuppression worsens pulmonary TB presenting with essentially normal chest X ray is not uncommon in CD4 counts of less than 50 cells mm3. TB can also coexist with other...

Conjugate Technology for Other Pathogens Whose Surface Polysaccharides Are Protective Antigens

Clinical trials established the value of multivalent PS vaccines for the prevention of Neisseria meningitidis and Streptococcus pneumoniae and protective levels of anti-CP for these two pathogenic species have been proposed. Vaccine-induced PS antibodies initiate complement-dependent killing (lysis for meningococci and opsonophagocytosis for pneumococci) as well as inhibition of colonization. Moreover, the extensive experience with passive immunization of patients with hypogammaglobulinemia and of native American infants, shown to be at high risk for Hib and pneumococcal infections, provides evidence that a critical level of CP-specific IgG antibodies is sufficient to prevent systemic (including pneumonia) and local infections (otitis media) with these pathogens 23, 24 . Conjugates of these capsular PS have similar properties to those of Hib PS conjugate vaccines. Accordingly, it seems logical and reasonable to use these data for licensure of new conjugates without extensive clinical...

Diagnosis And Treatment The Infectious Etiologies

Both the external ear and the middle ear are susceptible to infection and both can present with otorrhea. External-ear infections (acute otitis externa) are most often caused by irritation to the ear, either from manipulation (fingers, Q-tips, etc.) or from environmental factors (water, debris, etc.). External-ear infections will present with ear pain and drainage. In bacterial otitis externa, the discharge is typically purulent. The main pathogens are Pseudomonas and Staphylococcal species, with a variable amount of anaerobes, as well (3). Typically, the ear will appear red and inflamed and be extremely sensitive to touch. In some cases, the ear can swell to the point where the tympanic membrane cannot be seen through the ear canal. Less commonly, the ear will demonstrate vesicles and pustules. Generally, this appearance is driven by pathology, since the vesicular lesions that tend to drain a clear, watery fluid, are usually viral in origin. In most...

Allergic rhinosinusitis

The sinuses and in uncomplicated allergic rhinosinusitis, sinus radiographs may demonstrate mucosal thickening. Some patients may appreciate nasal congestion as headache rather than as facial pressure pain. Abnormal mobility of the tympanic membrane and the presence of otitis media commonly are noted. Fatigue, perhaps due to sleep disturbances caused by nasal airflow obstruction, commonly accompanies allergic rhinosinusitis (6). Otitis Although the direct contribution of allergic mechanisms to otitis media remain controversial, it is clear that obstruction to Eustachian tube drainage and resultant dysfunction can result in symptoms of ear fullness and diminished hearing and may contribute to the severity and persistence of otitis media. Allergic rhinosinusitis is an extremely common disorder. It is generally easily treated but may be complicated by sinusitis (acute or chronic) and otitis. Additionally, as for all allergic diseases, patients must be evaluated for non-head-and-neck...

Allergy and Dermatitis

There is clear evidence that otitis media with effusion is highly related to an allergic diathesis. When this converts to chronic draining otitis media, the allergic component would seem to still be relevant, although direct evidence is scant (17-19). Therefore, the surgeon must consider allergy evaluation, based on a patient history of other allergic diatheses, especially of the unified respiratory epithelium. Patients with chronic draining ear and allergic rhinitis, chronic rhinosinusitis, and asthma are strong candidates for allergy workup before contemplating surgical treatment. Contact allergy to chemicals used in ear drops is the most common type of dermatologic otitis externa. Hairsprays, dyes, and cosmetics can also result in an eczematoid and draining otorrhea. If the source of external canal weeping is not obvious, routine patch testing is strongly suggested (20). The autoeczematization (ID) reaction, which is an autoimmune reaction that may involve only the external...

The Maternal UPD14 Syndrome

With the exception of one case of no apparent phenotype (Papenhausen et al., 1995), which was insufficiently documented at the molecular level (Robinson and Langlois, 1996), all other cases further illustrated this emerging syndrome (Coviello et al., 1996 Tomkins et al., 1996 Sirchia et al., 1994 Barton et al., 1996 Linck et al., 1996 Walgenbach et al., 1997 Splitt and Goodship, 1997 Robinson et al., 1994 Desilets et al., 1997 Miyoshi et al., 1998 Ralph et al., 1999 Harrison et al., 1998 Fokstuen et al., 1999 Martin et al., 1999). The birth is often premature and the birthweight low for gestational age. In about 30 of cases, the head grows rapidly in the postnatal period, owing to a hydrocephalic condition that, however, arrests spontaneously A suggestive facies with prominent forehead (in association with arrested hydrocephalus) and supraorbital ridges, a short philtrum, and downturned mouth corners are present (Figure 2). There is hypotonia, hyperextensible joints, mild to moderate...


Damage to the tympanic membrane or middle-ear ossicles produces conduction deafness. This impairment can result from a variety of causes, including otitis media and otosclerosis. In otitis media, which sometimes follows allergic reactions or respiratory disease, inflammation produces an excessive accumulation of fluid within the middle ear. This, in turn, can result in the excessive growth of epithelial tissue and damage to the eardrum. In otosclerosis, bone is resorbed and replaced by sclerotic bone that grows over the oval window and immobilizes the footplate of the stapes. In conduction deafness, these pathological changes hinder the transmission of sound waves from the air to the cochlea of the inner ear.

Hearing Impairments

There are two major categories of deafness (1) conduction deafness, in which the transmission of sound waves through the middle ear to the oval window is impaired, and (2) sensorineural, or perceptive, deafness, in which the transmission of nerve impulses anywhere from the cochlea to the auditory cortex is impaired. Conduction deafness can be caused by middle-ear damage from otitis media or otosclerosis (discussed in the previous clinical applications box, p. 257). Sensorineural deafness may result from a wide variety of pathological processes and from exposure to extremely loud sounds. Unfortunately, the hair cells in the inner ears of mammals cannot regenerate once they are destroyed. Experiments have shown, however, that the hair cells of reptiles and birds can regenerate by cell division when they are damaged. Scientists are currently trying to determine if mammalian sensory hair cells might be made to respond in a similar fashion.

Clinical Overview

Physical manifestations of WBS usually include involvement of the cardiovascular system, most often as a narrowing of the ascending aorta (SVAS) although a generalized arteriopathy can lead to vascular stenoses in other vessels, and hypertension is common in later life. Stellate irides, flat nasal bridge, short, up-turned nose with anteverted nostrils, long philtrum, full lips and lower cheeks, and a small chin are the recognizable facial features. Other symptoms include hernias, visual impairment, hypersensitivity to sound, chronic otitis media, malocclusion, small or missing teeth, renal anomalies, constipation, vomiting, growth deficiency, infantile hypercalcemia, musculoskeletal abnormalities, and a hoarse voice (11,12). As WBS individuals grow older they may also present with premature graying of the hair, diabetes and impaired glucose tolerance, decreased bone mineral density, sensorineural hearing loss, and a high frequency of psychiatric symptoms (13).

Other Etiologies

Tuberculosis (TB), although technically infectious in etiology, can often be associated with an aural form. Although the classic description of TB otitis media is a single central perforation with profuse, painless discharge (26,27), the disorder can cause a host of otologic complications, many of which will also present with otorrhea. A more detailed discussion of TB can be found in Chapter 12.


Tuberculosis is caused by an infection with the bacterium Mycobacterium tuberculae. In 2004, 14,517 cases of tuberculosis were reported in the United States (17). The infection is spread via respiratory droplets. Pulmonary symptoms predominate, but any organ system can be affected. Spread to the ear can be via direct extension through the nasopharynx, from hematogenous spread, or on rare occasions, via direct implantation through a preexisting tympanic perforation. Tubercular otitis media occurs in 1 of all tuberculosis cases and currently accounts for roughly 0.1 of all cases of otitis media (18-20). Presentation of tubercular otitis is variable but classically is a painless, copious otorrhea with multiple or total tympanic membrane perforations and granulation tissue. Tubercular otitis media has a higher incidence of postauricular fistulae, preauricular lymphadenopathy, and facial nerve involvement when compared to other bacterial causes of otitis media. It is important to note that...

Otic Diseases

Acute otitis media is a suppurative infection of the middle-ear cavity. Facial nerve involvement is considered a complication of the infection and often occurs from direct pathogen invasion of a dehiscent portion of the facial nerve course, most commonly in the horizontal segment of the facial nerve. Treatment consists of systemic antibiotic therapy against the most common pathogens Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae. Drainage of the infected fluid from the middle-ear space with a wide myringotomy is mandatory. If mastoiditis is present, a cortical mastoidectomy for drainage is indicated. Any sequestrum must be removed. Most physicians do not advocate facial nerve decompression in this setting. Chronic Otitis Media. Chronic otitis media is an infection lasting more than six weeks with persistent otorrhea. Facial nerve involvement in this setting requires decompression of the facial nerve in addition to long-term antibiotics....


Phenoxymethylpenicillin has been shown to induce minor variations in numbers of aerobic and anaerobic gastrointestinal microorganisms in healthy adults (5,6) and in infants treated for upper or lower respiratory tract infections or otitis media (7). Penicillin that reaches the gastrointestinal tract is destroyed by beta-lactamase produced by the microorganisms. Despite the low concentration of the agent in feces, generally under the detection level, occasional new colonization with Gram-negative aerobic rods has been observed during administration.

Data Collection

Beitel and colleagues at Children's Hospital in Boston compared the sensitivity and specificity of ED chief complaints and ICD-9 codes. Both chief complaints and ICD-9 codes demonstrated excellent specificity and moderate specificity for all respiratory infections. They were also able to demonstrate that adding the chief complaint codes of fever and earache could raise the sensitivity but lower the specificity. Although ICD-9 codes are superior to chief complaints, the timeliness of chief complaints and the possibility of improving the accuracy and or sensitivity of chief complaint codes make them an attractive alternative.


Ed is a 45-year-old man who goes to the doctor complaining of severe ear pain and reduced hearing immediately after disembarking from an international flight. It is apparent that Ed has a bad head cold, and the doctor recommends that he take a decon-gestant. He further recommends that Ed come back after the cold is better for an audiology test, if his hearing has not improved by then.While talking to the doctor, Ed complains that he can't see print very clearly anymore, even though he's never worn glasses. However, he tells the doctor that his distant vision, and ability to drive, are still fine. What may have caused Ed's ear pain and reduced hearing What may be responsible for his impaired ability to see print