What you need to know about ear infections: outer, middle and inner ear

Posted Sep 12th, 2019

There are three types of ear infections: outer, middle and inner. Each infection type is associated with a specific region of the ear, and the symptoms and treatment of each is distinct.

A person can have a combination of these infections at the same time. An infection in one ear region has the potential to migrate to an adjacent ear region and can even migrate between the left and right ears.
The eardrum is the division between the outer and the middle ear. The outer ear includes the eardrum, going outward along the ear canal, the earlobe and auricle.

The middle ear begins at the inward, or medial, portion of the eardrum and includes the middle ear space, Eustachian tube, the three little bones called the ossicles, up to the oval window of the cochlea.
The inner ear includes the cochlea, the vestibule, the semicircular canals, and the balance and hearing nerves. Each region plays a specific role in our sense of hearing and balance.

In my next two columns, I will discuss middle ear infections and inner ear infections. in this column I will focus primarily on outer ear infections.

You will likely have an outer ear infection, or otitis externa, at some point in your life. It can cause feelings of ear or aural fullness, redness, sudden hearing loss, and can be painful or itchy; it can also cause swelling or ear discharge. If the infection is advanced, it may cause fever and severe pain in the neck and head. If an outer ear infection is attributed to exposure to water, it is sometimes referred to as swimmer’s ear, because it is commonly associated with exposure to pools, lakes, ocean water, or improperly chlorinated pools. This condition is more common in children than in adults.

Outer ear infections can be caused by bacteria, fungus, eczema, or even by a scrape of the ear canal from a Q-Tip or fingernail. Cerumen, or earwax, reduces outer ear infections because it is a neutralizing agent and reduces the likelihood of bacteria.

An outer ear infection, if not treated, can lead to a perforated eardrum. This is significant because the eardrum plays an integral role in moving dead skin cells out of the outer ear. If the eardrum is perforated, the dead skin cells can collect in pockets near the eardrum and lead to a cholesteatoma, a buildup of skin cells, a very serious condition that requires immediate attention.

Untreated outer ear infections can also lead to a condition known as malignant otitis externa. However, this is a less common condition and mostly occurs with diabetics or immunocompromised persons. This condition is typically not cancerous or malignant. It can be caused by bacteria such as Staphylococcus aureus. The classical symptoms are foul-smelling discharge, ear pain that worsens with head movement, loss of voice, facial weakness on the affected side, and even difficulty swallowing.

The treatment for outer ear infections vary, from over-the-counter eardrops, prescription drops and oral antibiotics, to more aggressive approaches, such as surgery. In some cases, a CT scan, an MRI, or a culture of ear discharge may be indicated. The
diagnosis and management of outer ear infections is entirely the purview of a physician. If you have any questions or concerns regarding your ears, consult your audiologist or physician.

To conclude, if you have any questions or would like me to address any topics, please feel free to email me at mike@creditvalleyaudiology.ca. If you have been following my column, you are aware that, in my previous column I discussed noise and restaurants. Thank you for your replies regarding your experiences. There's some good news: Google is
teaming up with SoundPrint and is going to be detailing restaurant noise levels in Google Maps. This is exciting news, indeed. I will keep you updated.

Hutchinson Hearing Centre

From Our Team

  • It is important to address hearing loss. Researchers at the Mayo Clinic have found that if hearing loss is left untreated it can affect cognitive processing, auditory memory, and can lead to social isolation. Please call us at 905-820-1688 to book an appointment.
    Michael Schamber | Audiologist