Meet OtoSight Middle Ear Scope

Eight out of 10 children will have a middle ear infection, and as a parent or caregiver, you know how ear infections can not only be tough for you to manage, but painful and uncomfortable for your child. 

PhotoniCare’s missions is to make a real impact on the health of children. We started with middle ear infections because of our personal experience with this disease, as both parents and patients.

Why OtoSight Middle Ear Scope?

Ear infections are the leading cause of surgery and hearing loss in children, and responsible for $10 billion in related healthcare costs and 30 million office visits each year in the United States alone. What is interesting to note is that the tool most used in the diagnosis of middle ear infections hasn’t changed in over 100 years!  Yes, you read that correctly — the technology in otoscope that is used to visualize the surface of the eardrum, has fundamentally remained unchanged for 100+ years. Although now a bit sleeker and more lightweight, the design and the technology has not changed appreciably, while the need to diagnose acute otitis media (AOM) more accurately has increased dramatically in the age of antibiotic resistance and super-bugs. With a published misdiagnosis rate approaching 50% among primary care healthcare providers*, there is a real need for the OtoSight Middle Ear Scope.

AN ADVANCED OCT IMAGER IN MINIATURE

Our easy-to-use OtoSight Middle Ear Scope is designed to look, and handle, just like the familiar otoscope. However, unlike the otoscope, the OtoSight Middle Ear Scope uses an advanced light-based technology called optical coherence tomography (OCT) to see through the eardrum. Now, healthcare providers can view a high-resolution depth image on-screen to learn what’s going on in the middle ear. OtoSight is capable of helping clinicians make better decisions leading to improved outcomes and quicker time to restored ear health.

OBJECTIVE TREATMENT DECISIONS

Ear infections are the leading cause of antibiotic over-prescription and antibiotic resistance development. middle ear scan provide objective data for healthcare providers to increase confidence in their treatment plan. The

The OtoSight Middle Ear Scope has the potential to fundamentally transform the management of middle ear infections. Our long-awaited, non-invasive solution adds objective data to the diagnostic equation, giving hope to improved quality of care for children worldwide. 

_{*Arch Pediatr Adolesc Med. 2001;155(10):1137-1142.}

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How Do Antibiotics Work?

Your local pharmacist just filled the prescription for antibiotics to treat your child’s Acute Otitis Media (AOM) infection…ever wonder how those antibiotics work?

First, a little background. Antibiotics are used to treat bacterial infections. Some antibiotics are highly specialized and are only effective against certain bacteria. Others, known as broad-spectrum antibiotics, attack a wide range of bacteria. Unfortunately, they may also attack some of the native, good bacteria too – so as we learned in a previous post, it’s imperative to be a good Antibiotic Steward.

How Antibiotics Target Bacteria

There are two main ways in which antibiotics target bacteria. They either prevent the reproduction of bacteria (bacteriostatic), or they kill the bacteria (bactericidal), for example, by stopping the bacteria from building their cell walls.

3 Common Bacterial Pathogens in AOM

The most common bacterial pathogens in AOM infections are Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella (Branhamella) catarrhalis. These three organisms are responsible for more than 95% of all bacterial AOM cases. Each one of these bacteria have a cell wall and are commonly treated with Amoxicillin.

Amoxicillin is a penicillin-type antibiotic in the beta-lactam class, and it works by preventing the formation of the bacterial cell wall. However, to kill Strep. pneumoniae, a high dose of amoxicillin is required and even at a high dose, both H. influenzae, and M.catarrhalis are often resistant due to production of an enzyme called beta lactamase that inactivates amoxicillin.  Therefore, healthcare providers may prescribe amoxicillin combined with a second ingredient to neutralize the beta lactamase enzyme, such as amoxicillin/clavulanate (Augmentin), or a cephalosporin-type antibiotic, such as Cefdinir.

So now you know how the antibiotics chosen to fight the infection in your child’s middle ear work – by preventing the formation of the bacterial cell wall (amoxicillin) and by neutralizing bacteria resistance mechanisms (augmentin and cefdinir)! Good to know the next time you’re discussing AOM treatment plans with your child’s healthcare provider.

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History of the Otoscope

When you go to the doctor, how often do you think about the tools used by your healthcare provider? Typically, when a person is looking around the doctor’s office, he or she spends most of his or her time hoping that none of those tools will be used. But, how often does one think of the history of these items? Many medical tools have a rich history and one of those tools, the otoscope, happens to be incredibly important to ear health. 

What is an otoscope?

Before going into the history, first we should learn a bit more about how the Otoscope is used. An Otoscope, or an ear speculum, is a device that assists doctors in examining the nasal and aural (ear) passages of the patient. Everyone that has ever been in a doctor’s office has seen one of these hanging on the wall, or even in the doctor’s pocket. It consists of a long handle, and on the head is a magnifier that the doctor peers through, and a light to better see the area he or she is inspecting. The end of the Otoscope is used to examine the patient without damaging the ear or nasal canal. Whenever a patient comes into an office complaining of blockage or pain within the ear or nose, the Otoscope is the first thing the doctor reaches for. While most patients are pretty familiar with what the Otoscope does, few likely know the history of the tool. 

History of the otoscope

The beginning of the Otoscope’s history can be traced all the way back to France in 1363. At that time, French physician and surgeon Guy de Chauliac envisioned a tool that could help diagnose patients complaining of ear or nose pain. The actual device was not created until a German surgeon and a medical device salesman – Wilhelm Fabry and J.J. Perret – created the first prototypes in the 1600s and 1700s, respectively. The first Otoscope was shaped more like a pair of tongs than the device you are accustomed to seeing today. 

In the middle of the 19th century, in Germany, the modern Otoscope really began to take shape. Wilhelm Kramer, a German Otologist, developed a steel ear speculum with a funnel on the end. Kramer’s speculum, as it became to be known, was the primary device used by physicians until 1881, when A. Hartmann created a design that mostly resembles today’s look. 

What is interesting to note is that while most medical devices have evolved over last 100+ years, the Otoscope has pretty much remained the same over that same period. Although now  a bit sleeker and more lightweight, the design, as well as the technology, have not changed appreciably, while the need to diagnose acute otitis media (AOM) more accurately has increased dramatically in the age of microbial resistance. 

Taking the guesswork out of ear health

Being that it is essentially a penlight and magnifying glass, the otoscope can only see the surface of the eardrum, not what’s going on behind it, in the middle ear, where the diseases such as AOM reside. That’s where the OtoSight™ Middle Ear Scope comes in!

OtoSight helps to determine the presence or absence of fluid in the middle ear, characterize the type of fluid, visualize the fluid’s density, and can do all of this even in the presence of significant wax.

• Middle ear scan provides an objective assessment of middle ear health.
• OtoSight™ results are not minimally affected by user or patient variability.
• OtoSight™ Middle Ear Scope technology is 90.6% accurate when assessing middle ear effusion (fluid).

If you’re looking for answers, you’re looking for OtoSight™. Find an OtoSight™ Middle Ear Scope near you by clicking here.

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2 Types of Ear Infections

Everyone remembers having ear infections. As a child, it was probably one of the more frustrating things to endure. Your ear hurt and your hearing was muffled. Thankfully, as we grow older, ear infections become less common (although they do happen) but they are frequently present during childhood. 

Something most people don’t know is that there are actually two different types of ear infections. Most just assume that there is just one type and it’s the painful kind you remember; however, there is Acute Otitis Media and Otitis Media with Effusion. Don’t know how each one affects you? You’re not alone, and we’re here to help.

Acute Otitis Media
Acute Otitis Media (or AOM) is an ear infection where the middle ear (area behind the eardrum) becomes inflamed and infected. The eustachian tube that runs from the middle of the ear to the back of the throat becomes swollen, trapping infected fluid in the middle ear. This occurs due to a variety of reasons including the flu and common cold. Because the eustachian tube is much shorter and more horizontal in children, it can become blocked much easier than in adults, and is more susceptible to middle ear infection. Since this happens to young children, sometimes it can be tough for them to explain exactly how they are feeling, so parents have to be extra vigilant when it comes to looking for symptoms. Some things parents can look for are the following:

• Fussiness and intense crying in infants
• Tugging on ear and grimacing
• Complaining about a sharp pain in the ear

When one of these symptoms is present, it may be time to get the child to their healthcare provider. When a provider checks you or your child for an ear infection, they will typically use an instrument called an otoscope. An otoscope is basically a pen light attached to a magnifying glass, and this simple device has been used in medicine for the past 150 years. The otoscope comes with several cone-like tips called specula. The healthcare provider will gently insert the speculum into the ear canal to try to get a view of the surface of the eardrum. While the otoscope view of the eardrum may provide some relevant information, such as an inflamed and/or bulging eardrum, it cannot view the middle ear where the infection actually resides. 

Future technologies, such as the OtoSight Middle Ear Scope, will allow clinicians to view the middle ear by seeing through the eardrum. If the healthcare provider does suspect an ear infection, antibiotics may or may not  be recommended. Generally speaking, an ear infection has the potential to resolve itself without antibiotic treatment. In the case of a severe middle ear infection with infected fluid in the middle ear, the American Academy of Pediatrics recommends the healthcare provider prescribe antibiotics. And in cases where multiple ear infections have occurred, called Recurrent AOM (RAOM), a referral to an ear specialist (otolaryngologist) may be necessary, to evaluate whether surgical intervention may be warranted. However, the guidelines recommend a “watchful waiting” approach for non-severe middle ear infections in children over the age of two. The overall goal is to reduce over-prescription of antibiotics.

Otitis Media with Effusion
Otitis Media with Effusion (OME) occurs when the eustachian tube clogs and fluid cannot drain from your ears to the back of your throat. It is incredibly common and, according to the Agency of Healthcare Research and Quality, around 90% of children will have OME by the time they turn ten. Just like with AOM, children are much more likely to get OME because of their shorter and more horizontal eustachian tubes. Also, children contract more colds and other viral upper respiratory illnesses with more regularity than adults. While OME is not actually an ear infection, they are closely related. By developing OME, the middle ear fluid  serves as a breeding ground for bacteria to grow, which may lead to AOM.

One of the major symptoms of OME is hearing problems. You may notice your child turning the television up louder, having to ask you to repeat yourself more or saying things sound muffled. He or she may also be continuously tugging at the ear. If you have a suspicion that your child has OME, you can take him or her to the doctor where further testing can be done. Similar to AOM diagnosis, a doctor can use an otoscope or conduct a tympanometry test to see if the child does in fact have OME. However, current tools used to diagnose fluid in the middle ear can be difficult to use reliably in squirming or crying children, and rely heavily on user expertise to interpret a simple image or measurement of the eardrum, especially in primary care settings where otoscopic accuracy has been reported to be as low as 50%.  If your child is diagnosed with OME, it can usually be cleared up by just giving it time.

A complication that can arise when fluid stays in the ear for an extended period of time (3 months or more) or comes back time and again is Chronic OME (COME). When a person develops COME, he or she can find it harder to fight off future ear infections and his or her hearing may be permanently affected. If it happens in children it may have an impact on speech development. Referral to an otolarygologist for suspected COME may require surgical intervention to drain the fluid and air out the middle ear. 

Again, OME is incredibly common and may not have any long-term effect on a child’s health as long as it does not become a chronic issue. Washing hands regularly, avoiding allergens, utilizing air filters and avoiding cigarette smoke and air pollution are just a few ways to avoid contracting OME.

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Why are my ears ringing?

It’s the middle of the night, all is silent in the house except for what’s going on in your ear(s). It’s constant. It’s irritating. It’s that ringing that no matter what you try to do is always there when everything is so quiet, leaving you with so many questions. Why is it there? What could you have done to prevent it? Is there any way to cure it?

Although our technology is focused on imaging the middle ear, we often meet patients that struggle with issues affecting the inner ear. One such issue is when a patient is experiencing the ringing in his or her ears. In this blog post, we discuss what causes the annoying, and sometimes painful, reasons why you might have ringing in your ears.

What is ringing in the ear?

The sensation of hearing ringing, buzzing, hissing, whistling or any other sounds is called Tinnitus. Interesting to note, the word Tinnitus is pronounced two different ways. One pronunciation tends to sound like “TIN-ni-tus”. While the general American pronunciation often sounds like “ti-night-tus” or “tin-NYE-tus.” 

Tinnitus can be intermittently heard or a continuous noise and varies in volume. While the noise is constantly occurring, many times a person who has Tinnitus will be more aware of it when the background noise is lower, hence why most people are bothered by it when trying to fall asleep. Tinnitus is incredibly common and has affected around 50 million adults in the US. For most individuals, Tinnitus is simply an annoying sound heard in the quiet, and causes little to no ear pain; however, there are severe cases that can cause individuals to experience difficulty sleeping or even concentrating and, in the more extreme cases, cause psychological distress. So, now that you have some background into what Tinnitus is, let’s look into some of the causes of that ringing in your ears.

What Causes Tinnitus

The most common cause of Tinnitus is prolonged exposure to loud noises. When a person is exposed to loud noises over a long period of time (think construction workers, pilots, musicians etc.), it causes permanent damage to the sound-sensitive cells within the cochlea. Along with prolonged exposure, a single exposure to an extremely loud and jarring noise can also cause Tinnitus. 

While noise plays a key role, other factors can also cause Tinnitus, including the following:

• Blockages due to wax buildup or ear infections
• A potential side effect of multiple drugs including aspirin, sedatives and others
• The natural aging process, which causes the cochlea to deteriorate
• High blood pressure and/or cardiovascular disease
• Neck or jaw problems
• Injuries to the head or neck

Tinnitus symptoms can often worsen from use of alcohol, smoking cigarettes, eating certain foods, and even experiencing stress and fatigue. 

Tinnitus Treatment

Now that you know what it is and what causes it, let’s talk about some ways to treat Tinnitus. The first step in treatment – and most important – is figuring out what is causing the ringing sound. If you find that the cause of your Tinnitus is an underlying health or medical condition, your first step should be to address that condition. If, instead of an underlying health issue, the problem is simply excessive earwax, you will need your healthcare provider to clean out your ears. Once that is completed, the noise may go away completely, or at least be considerably toned down.

There are certain medications that can also treat Tinnitus. Anti-anxiety drugs – Valium or antidepressants like Elavil – have been known to help reduce the effects of Tinnitus. Also, the use of steroids placed in the middle ear can also help reduce the effects of Tinnitus.

For most people, Tinnitus is caused by noise exposure, so a natural remedy is to use masking devices. The use of hearing aids or Tinnitus Maskers – devices that play a sound more soothing and pleasant than the internal ringing – help deaden the noise made by Tinnitus and can help the affected person cope easier.

Tinnitus is a common condition that most people live with every day. You can try to avoid this condition by avoiding loud noise exposure altogether; however, your ear health may not be horribly altered by Tinnitus. By making changes to your daily life, you can learn to live and cope with Tinnitus without experiencing any detrimental side effects or further ear pain. Some of these changes may be minor, like adding soothing sounds to silence to avoid hearing the ringing, while other changes may be more drastic, like quitting smoking or drinking alcohol; however, when it comes to maintaining ear health, any measure is worth it.

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What Are Ear Tubes?

As a parent, you always want to have the answers. You have a tiny human being that has to depend on you for all of his or her needs. You helped create this smiling bundle of joy and you want to put him or her on the best possible track for success; however, some things happen that are outside of your control and expertise. One of those things that commonly affect infants and small children is an ear infection. 

Eight out of 10 children will have a middle ear infection, but what if your child seems to have them more than what you think is normal? What if your child seems to have difficulty hearing and complains about “water in the ear” when there doesn’t seem to be a reason for it? When this happens, it may be time to seek help by calling your primary care doctor or ENT specialist for the best next steps for your child’s ear health.

WHAT ARE EAR TUBES? 

Ear tubes go by many names – myringotomy tubes, tympanostomy tubes, ventilation tubes – but they’re all the same thing. They are small, hollow tubes made of plastic or metal that are surgically inserted into an incision in your child’s eardrum. This procedure creates an opening that allows air ventilation of the middle ear, drains any fluid present, and stops the buildup of fluid behind the eardrum. By doing this, the risk of ear infections is mitigated and, as long as the tube stays in place without clogging, the child should not experience any further ear infection-related issues. But even knowing what ear tubes accomplish can still leave some unanswered questions, such as; “How do I even know if my child needs them or not?”

WHEN A CHILD MAY NEED EAR TUBES

Ear tubes are most commonly used in children because their eustachian tubes – the natural ventilation structure of the middle ear – are narrower and more horizontal than in a grown adult. When children develop an upper respiratory infection, the resulting mucus can more easily block the eustachian tubes, which causes an accumulation of fluid in the middle ear. When this problem persists for more than three or four months following an ear infection, it may be time for tubes to be placed in your child’s ears. 

Other symptoms that may precede the need for ear tubes are the following:

• Repeated ear infections that do not improve with medications over several months
•  Fluid in the ears and more than 3 months hearing loss
• Speech and language development delays

RISKS ASSOCIATED WITH EAR TUBES

Before making the commitment to getting this surgery for your child, do not be afraid to ask about the risks and benefits of the procedure. 

While all types of surgeries in which general anesthesia is used carry a risk, the procedure for placing ear tubes in the eardrum is a relatively quick, safe and effective procedure. However, outcomes may vary. Just because a child receives tubes does not mean he or she can never contract an infection again. There is also the potential risk of scarring or weakening of the eardrum or the tubes staying in too long or falling out early; however, the benefits of receiving tubes generally outweigh the risks.

By receiving the ear tube placement procedure, the child’s risk of future ear infections are lowered and hearing can be restored if one of the symptoms prior to the surgery was hearing loss. Also, speech development can continue on as normal and even the child’s sleep, behavior and communication may be improved if previous ear infections affected one or all of those areas. Finally, the ear tubes will allow time for the child to mature and will help his or her eustachian tube to work more efficiently as it becomes wider and longer.

Finally, after surgery has been completed and the tubes are safely inside your child’s ear, the next step is simply to care for your little one. Antibiotic ear drops and/or pain killers may be prescribed, and your healthcare provider will provide any special post-surgery care instructions. If you notice any drainage, ear pain, or fever after the procedure, you should call your child’s healthcare provider. If all things go according to plan, the tubes should fall out on their own after approximately six to nine months.

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Talking About Ear Tubes with Dr. Michael Novak

Eight out of 10 children will have a middle ear infection, but what if your child seems to have them more than what you think is normal? What if your child seems to have difficulty hearing, and complains about “water in the ear” when there doesn’t seem to be a reason for it? When this happens, it may be time to seek help by calling your primary care doctor, who may refer you to an ENT specialist, for the best next steps for your child’s ear health. 

For some children, the next best step in managing your child’s ear health is the placement of tubes within the eardrum, also known as tympanostomy tubes. About 700,000 children each year have ear tubes surgically placed t, according to the American Academy of Otolaryngology-Head and Neck Surgery. Ear tubes typically cost around $2-5,000, most of which is usually covered by insurance. The surgery does carry some risk, partly because the child will be put under general anesthesia. 

We sat down with Dr. Michael Novak, an Ear, Nose and Throat doctor from Carle Foundation Hospital in Urbana, Illinois, to chat more about ear tubes and specifically why the fall and winter months are a common time for placement of ear tubes.

What are the common reasons for tube placement in children?
Tubes are generally placed in children to treat frequent infections (4 or more over a 6 month period) or persistent fluid in the middle ear (fluid that stays in the ear for at least 3 months).

If a child is a candidate for this type of surgery, why are the fall and winter months the most common time for tube placement?
The most common times for tube placement are late fall and early winter since the infections and fluid typically are caused by colds and flu. It may take 3 months or more to determine that a child is prone to ear infections and would benefit from tubes. The pattern of frequent infections tends to start in the late summer or early fall when kids get back into school and start sharing viruses, and we are indoors where colds can be communicated more easily. 

Is there immediate relief for the child after the tubes are placed?
Yes, the relief of the infection and removal of fluid gives immediate relief from pain and hearing loss. The improvement continues over 2-3 days as the ear returns to normal.

What are the general instructions and follow-up care for ear tubes?
I tell my patients to where ear plugs when they are swimming in lakes and rivers where   the water is not as clean as the swimming pool or shower. Otherwise, there are no special precautions necessary for the great majority of children. If drainage from the ear develops, it is treated with topical antibiotic and corticosteroid drops, and usually clears up quickly.

Thank you Dr. Mike for the fantastic insight regarding ear tubes – paying attention to the frequency and time of year of ear problems are key to a successful outcome!  

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The Real Cost of Ear Infections

Middle ear infections, or otitis media, are very common. So common, in fact, that 90% of children will suffer from an ear infection in their childhood. You may notice your child being more fussy than usual, tugging on their ear and grimacing, or complaining about a sharp pain in the ear. These are all common ear infection systems which often lead a parent to take their child to a healthcare provider. 

Because ear infections are the most common ailment among kids it can cost a significant amount to the consumer and the health care system. With healthcare expenses on scrutiny now more than ever, we break down the real cost for ear infections, and how our technology will empower healthcare providers to make better decisions, and reduce costs exponentially. 

By the Numbers
If a parent brings their child into the office to see a healthcare provider, hits to the pocketbook begin to escalate:

• A typical visit to a healthcare provider’s office costs between $25 and $250.
• Copays for office visits range from $5 and $75, depending on the insurance company.

In addition to an office visit, there are many parents who take their child for ear pain treatment to urgent care or the emergency room. Debt.org reported on an Annals of Internal Medicine study that found the average cost of an urgent care visit for three common illnesses — middle ear infection, pharyngitis and urinary tract infection — was $155. Other estimates place the average urgent care visit at anywhere from $71 to $125. There are also instances where a parent may take their child to the emergency room for ear pain. Debt.org reports that an average emergency room visit for ear pain can cost an average of $400. 

Antibiotics
Besides being so prevalent among children, ear infections are also the leading cause of antibiotic over-prescription and antibiotic resistance development. Antibiotics play an important role in fighting infection, but when prescribed inappropriately, such as for viral infections or a non-bacteria related middle ear problem, the correct course of treatment is delayed, and the potential for unrelated bacteria to develop resistance to the prescribed antibiotic(s) can become a problem. 

Antibiotics also come with a price tag for parents:

• Antibiotics typically prescribed for a bacterial ear infection, such as Amoxicillin, cost between $20 and $110 for a week’s treatment. 
• Copays for the prescription ranges from $5 to $50.

Devices like OtoSight Middle Ear Scope will allow your healthcare provider to image the contents of the middle ear– providing key access to the information needed for a correct diagnosis and the first step in being a good Antibiotic Steward and reducing costs, both to you and the healthcare environment! 

Surgery
For some children, the next best step in managing your child’s ear health is the placement of tubes within the eardrum. About 700,000 children each year have ear tubes surgically placed, according to the American Academy of Otolaryngology-Head and Neck Surgery. Ear tubes typically cost around $2,000-5,000 for people with insurance.  

Diagnosing Ear Infections
The American Academy of Pediatrics AOM guidelines state that fluid must be present in the middle ear to definitively diagnose Acute Otitis Media (AOM). This buildup of fluid and pressure in the middle ear is the direct result of a microbial infection that would, in many cases, be treated with antibiotics. However, determining if there is fluid in the middle ear is difficult today because the tools currently available measure or view the eardrum only, rather than measuring the potential fluid directly. In the current paradigm of care, the eardrum is observed as a proxy for middle ear health.

Current tools used to diagnose fluid in the middle ear can be difficult to use reliably in squirming or crying children, and rely heavily on user expertise to interpret a simple image or measurement of the eardrum. In the primary care setting, otoscopic accuracy has been reported to be as low as 50%. By the numbers, half of all children are not given an accurate diagnosis. The result? Increased costs for payers and over prescription of antibiotics for the patient. 

• Ear infections, in general, are responsible for $10 billion in related healthcare costs
• AOM  infections are the cause of 30 million office visits each year in the United States alone. 

PhotoniCare’s mission is to make a real impact on the health of children – that’s why we started with middle ear infections. Our goal with our first product, the OtoSight Middle Ear Scope, is to revolutionize the diagnosis, treatment, and monitoring of middle ear infections. 

The Future of Diagnosing Ear Infections
The technology harnessed by the OtoSight Middle Ear Scope is a quantum leap over the current standard, in that OtoSight Middle Ear Scope can actually see evidence of disease in the middle ear. All other technologies on the market are using the eardrum as a proxy to diagnose middle ear disease – this methodology is inherently problematic as it does not reflect accurately enough the actual condition of the middle ear. In other words, you get what you see – OtoSight Middle Ear Scope technology allows healthcare providers to actually see the contents of the middle ear, such as fluid, and this is the first step in diagnosing middle ear disease accurately. No proxies, no guessing. 

The OtoSight Middle Ear Scope has the potential to fundamentally transform the diagnosis and treatment of middle ear infection. It could improve the quality of care for one billion children worldwide, empower healthcare providers to make better decisions, and reduce costs exponentially. We are so excited to get this technology out to patients as soon as possible. Thanks, as always, for being part of our journey.

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Is it dangerous to swim with an ear infection?

Summer is here, temperatures are rising, and kids want to get outside and cool off. It can be crushing for your little ones if they have to miss out on the chance to go swimming because of an ear infection. But do they have to stay out of the water? In this month’s blog, we explore the differences between swimmer’s ear and a middle ear infection and discuss whether it is safe to go back into the water.

Swimmer’s Ear
Also known as otitis externa, swimmer’s ear is an infection of the outer ear, commonly caused by excess moisture remaining in the ear, which enables bacteria to grow. The bacteria that causes this type of infection can also grow in scratches to the ear canal lining (such as an abrasion caused by inserting something into the ear, like a cotton swab).

Symptoms range from itching in the ear canal, discharge, and mild discomfort that can be felt when the outer ear is touched, to muffled hearing in more moderate cases or even severe pain, blockage of the ear canal, and fever in advanced cases. Typically, swimmer’s ear is treated first with a thorough cleaning. The Mayo Clinic notes that “cleaning your outer ear canal is necessary to help ear drops flow to all infected areas. Your doctor will use a suction device or ear curette to clean away discharge, clumps of earwax, flaky skin and other debris.” Then, ear drops are used to clear up the infection, plus over-the-counter pain relievers, as needed.

In order to prevent swimmer’s ear, healthcare providers recommend keeping as much moisture out of the ear canal as possible. Dry your children’s ears thoroughly after bathing and swimming by wiping the outer ear gently with a soft washcloth. We’ve all probably detected that sloshy feeling in the ears after (or during) a swim. You can help drain water from the ear canal by tipping your head to the side to let it run out. You can also use a blow dryer on its lowest setting – but be sure to hold it at least a foot away from the ear. For those who swim regularly, it is also recommended to wear a tight-fitting swim cap that covers the ears, to keep as much water out as possible.

Swimmer’s ear is easily treatable and should be addressed quickly when symptoms emerge. If left untreated, complications include temporary hearing loss or more chronic, widespread infection. Because swimming is the most prominent risk factor – especially swimming in water prone to high bacteria levels – anyone diagnosed with swimmer’s ear should stay out of the water until the infection clears up. This means no swimming or scuba diving, and even protecting your ear from water in the bath or shower is recommended.

Middle Ear Infection
One of the most common health problems children will face in their lifetime, middle ear infection (acute otitis media or AOM) affects the ear further down the canal, behind the eardrum. At PhotoniCare, our focus is on visualization of the middle ear space. AOM is an ear infection where the middle ear (area behind the eardrum) becomes inflamed and infected. The eustachian tube that runs from the middle of the ear to the back of the throat becomes swollen, trapping infected fluid in the middle ear. This occurs due to a variety of reasons including the flu and common cold. Because the eustachian tube is much shorter and more horizontal in children, it can become blocked much easier than in adults, and is more susceptible to middle ear infection. In contrast to swimmer’s ear, however, water in the ear canal does not cause middle ear infections.

Symptoms of a middle ear infection usually appear rapidly, and include fever, fluid draining from the ear, headache, and even loss of appetite. Behaviors that indicate your child might have an ear infection include tugging at the ear, out-of-the-ordinary crying or fussiness, trouble sleeping, or not reacting to sounds.

While most middle ear infections clear up on their own, it is important to contact your pediatrician if symptoms persist more than 24 hours, to monitor progression and determine if antibiotics are needed.

The good news for parents and kids eager to get to the pool is that even with a middle ear infection, swimming is not out of the question. You do still want to dry the ears thoroughly to avoid the risk of an additional infection on top of otitis media, but water from the pool will not typically exacerbate an infection in the middle ear.

Recap:
Swimmer’s ear and middle ear infections are two different beasts. The CDC notes that an easy way to tell them apart is the presence of pain in the outer ear: “If you can wiggle the outer ear without pain or discomfort then your ear condition is probably not swimmer’s ear.”

Once diagnosed, can we go swimming?

• with swimmer’s ear = NO (not until the infection clears)
• with a middle ear infection = YES

So give that ear a tug, and if it wiggles without pain, you can enjoy a refreshing dip in the pool!

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How dangerous are untreated ear infections in adults?

Itchiness or pain. Trouble hearing. Fluid leaking out of the ears. These symptoms may have been all too common when we were kids, but as an adult, the signs of an ear infection are probably something you have not felt in quite some time. While ear infections—middle ear infections in particular—are more common in children, they are not unheard of in adults. In this blog post we explore the risks and complications of leaving an ear infection untreated in adults.

In our last blog, we talked about the difference between middle ear infections (otitis media), and outer ear infections (otitis externa), more commonly known as swimmer’s ear. Otitis media is caused by either bacteria or viruses. A common cold, the flu, or allergy symptoms that cause congestion and swelling of the nasal passages, throat, and eustachian tubes can sometimes lead to an infection. Anything that makes the nose stuffy has a tendency to cause swelling and blockage of the eustachian tubes. Swelling from colds or allergies can keep the eustachian tubes from opening and this leads to pressure changes and the accumulation of fluid in the middle ear. This pressure and fluid will cause pain and sometimes persistent fluid can lead to an infection.

Swimmer’s ear, on the other hand, is an outer ear infection, typically caused by bacteria growing due to the presence of excess moisture in the ear or an abrasion to the lining of the ear canal. This type of infection is much more common in adults, whether they regularly hit the pool or not. The excess moisture that causes otitis externa can also come from baths and showers, or the infection can grow out of an aggressive cotton swab or even irritation from beauty products or jewelry.

Potential Complications

The Mayo Clinic notes that although the majority of ear infections do not cause lasting problems, recurring infections left untreated can lead to serious complications. Due to swelling and/or fluid buildup, ear infections often cause mild hearing loss, however it usually clears up along with the infection. Extensive fluid in the middle ear due to chronic ear infections, however, can lead to more severe damage to the eardrum, resulting in a more permanent hearing impairment.

Untreated chronic ear infections can also cause tears in the eardrum. These tears will typically heal within a few days, though in more extreme cases, surgical repair might be required.

The other primary risk of leaving an ear infection untreated is that the infection could spread beyond the ear. An untreated infection can spread to other nearby tissue in and around the ear, and in rare cases even into the skull, resulting in meningitis. Infections will more commonly spread to the mastoid, just behind the ear, which can damage the bone and form pus-filled cysts.

These complications highlight the critical need to monitor symptoms in the case of an ear infection and to seek treatment if they continue or even worsen after a day or two. While you may not need treatment right away, it is important to consult with your physician to know what to look out for and when to seek further testing in order to avoid more extensive damage. Initial diagnosis usually involves an examination, but lab testing may be needed if the infection does not clear up.

Ear Infection Treatments

The good news is, most ear infections clear up on their own, and when treatment is needed, it is usually relatively minor. Swimmer’s ear is typically treated with a thorough cleaning, ear drops, and over-the-counter pain medication as needed. A middle ear infection will more often than not be treated first by monitoring symptoms and possibly adding anesthetic drops if there are no signs of a tear in the eardrum. While antibiotics can also be used to treat middle ear infections, they are generally reserved for more extreme cases, so as not to build up unnecessary antibiotic resistance.

Ear Infection Prevention

The best ways to prevent ear infections involve the steps we take as adults to prevent the common cold and boost our immune systems. Wash your hands frequently, don’t sneeze or cough out into the air, and be careful when interacting with those who show symptoms of a virus (something we have become even more keenly aware of in the age of COVID-19). Avoid smoking and secondhand smoke and eat plenty of fruits and vegetables to keep your resistance up.

When it comes to an outer ear infection, make sure you dry your ears thoroughly after a bath, shower, or swim. Be extremely careful with cotton swabs and avoid strong movements that could scratch your ear canal.

And above all, pay attention to how you feel. If you notice out-of-the ordinary pain or itches, keep an eye on your symptoms and consult with your doctor so that you don’t risk letting a little ear infection get out of control. The risk of an infection may be low as an adult, but the consequences are not if left untreated.

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