Can’t Hear? Ear Hurts? You Might Have THIS Common Problem!

The term ‘swimmer’s ear’ describes ear discomfort such as pain, redness and swelling. It commonly attributed to water finding itself into the ear, but the actual cause is infection. The medical term for swimmer’s ear is otitis externa, and it can happen to anyone, not just swimmers.

WORDS LIM TECK CHOON

FEATURED EXPERT PROFESSOR DATO’ DR BALWANT SINGH GENDEH Senior Consultant Ear, Nose, and Throat (ENT) Surgeon Pantai Hospital Kuala Lumpur

WHEN OUR EAR CANAL HAS UNINVITED GUESTS

Professor Dato’ Dr Balwant Singh Gendeh shares that:

• Otitis externa is an infection in the ear canal.
• Bacteria such as Staphylococcus aureus are the most common unwanted guests that trigger this infection.
• However, it is also possible for fungi (such as Candida albicans) to trigger an infection.

Why Is It Common Among Swimmers?

Such infection commonly affects swimmers and other people whose ears are in contact with water.

This is because water that gets into the ear creates a moist environment that encourages the growth of bacteria and fungi in large enough numbers to cause an infection.

However, Otitis Media Can Affect Anyone

Professor Dr Balwant points out that otitis externa can affect anyone as long as certain conditions are present for the unwanted guests to thrive in the ear canal:

A suitable environment

• Our ear canal is dark and warm, which makes it a great place for many bacteria and fungi to move in and live.
• These guests feed on the dead skin, secretions and various other substances trapped among the fine hairs in the ear canal.

Moisture

• Even if we don’t swim regularly, our unwanted guests rarely worry about being deprived of moisture.
• This is because we live in a tropical climate, where it is humid all year long!

ARE OUR EARS ALWAYS VULNERABLE THEN?

Not Always!

Professor Dr Balwant points out that our ear has its own defense mechanism – our earwax.

• Earwax, or cerumen, is secreted in the ear canal.
• It is an acidic substance containing enzymes that inhibit the growth of bacteria and fungi.
• It also traps and removes debris and other substances that nourish these unwanted guests.

However, This Defense Mechanism Can be Disrupted

• Excessive moisture spilling into the ear canal can dislodge the cerumen coating the ear canal.
• If we make it a habit to remove earwax too often, such as by using cotton buds to clean our ears, we are also making our ear canal more vulnerable to these unwanted guests.

Therefore, Professor Dr Balwant recommends the following:

• Always dry our ears as much as possible after a bath or swim as well as during a hot sweaty day.
• Only clean our ear canal once in about every 3 weeks.
• Avoid inserting our fingers or foreign objects into our ear canals.

YOU MAY HAVE OTITIS EXTERNA IF YOU EXPERIENCE…

• Ear pain, which can radiate to the face, neck, and side of the head
• Ear itchiness
• A sense of ‘fullness’ inside the ear due to swelling
• Ear discharge (otorrhoea)
• Some hearing loss, usually temporary)

Professor Dr Balwant recommends seeing a doctor if we have any of the above symptoms.

• This is because, without proper treatment, the infection can eventually spread into surrounding tissues and even nearby bones.
• Increasingly severe hearing loss may also result.
• These complications will require more complex treatments, possibly even surgery.

HOW IS OTITIS EXTERNA TREATED?

Professor Dr Balwant explains that most mild cases can be successfully treated using appropriate topical medications (such as eardrops, ointments, or creams).

If still no improvements are seen, or if the symptoms are severe, it may be time to visit an ENT specialist.

HOW CAN THE ENT SPECIALIST HELP?

To Properly Clean the Ear Canal

• The ear canal of someone with otitis externa is often clogged with earwax, debris, and various secretions.
• The ENT specialist will perform a procedure called ‘ear toilet’.
• Guided by direct visualization from a device called the otoscope, the specialist will use a medical device to create a gentle suction in order to clean the ear canal.
• If the debris and secretions are thick and hard to dislodge through suction alone, the ENT specialist can use antibiotics or hydrogen peroxide droplets to soften them first.

To Inspect the Eardrum

• Our eardrum allows us to hear. It is also a thin piece of tissue. During an infection, the weakened eardrum is especially vulnerable to damage.
• The ENT specialist will inspect the eardrum to ensure that it is in good shape.
• If the eardrum is damaged, the use of water and other fluids such as eardrops will be avoided, as doing so may cause damage to the ear structures normally protected behind an intact eardrum.
• Damaged eardrum can usually heal on its own after a few months, although sometimes surgery may be necessary.

To Determine the Nature of the Infection

• Oral or topical antibiotics can help with getting rid of bacteria, but they do not work on fungi and viruses.
• Therefore, determining the type of the microorganisms that are giving us so much problem will allow the ENT specialist to prescribe the best treatment option.

WHAT IF OTITIS MEDIA KEEPS COMING BACK?

Some people may experience long-term infection called chronic otitis externa.

This more common among people with existing chronic skin- related diseases, such as eczema and psoriasis, as well as people with diabetes or conditions that affect the ability of their immune system to fight infections properly.

People with chronic otitis externa should consult an ENT specialist for a proper treatment plan tailored for their conditions.