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Earache

Intro

Any severe earache that lasts more than a few hours, or even a mild earache that persists for more than a day should receive medical attention. An infection responds much better to treatment if therapy is started early, rather than waiting until it is severe.

Ear infections rarely need to be treated in the hospital. A doctor can safely handle most ear infections in an office setting.

Exceptions that would require hospital treatment are as follows:
  • Illness in an infant under 3 months
  • Illness in an infant who is becoming lethargic or running a very highb fever (104ºF or higher)
  • Severe headache , stiffness of the neck, or swelling in the neck may represent a complication of an ear infection and may require immediate attention.
Self-Care at Home

Any severe earache requires medical attention. Only a doctor can make the proper diagnosis of otitis externa, otitis media, or other less common causes of earache including problems that are not infectious. These diseases have similar symptoms making self-diagnosis unwise and potentially dangerous.

Follow-up

People with earache caused by ear infection should have follow-up care with their doctors to insure that the infection has completely gone away.

  • A follow-up appointment is scheduled 1-3 weeks after starting treatment, depending on the severity of the condition and other factors.
  • Take all medications, as prescribed, and finish the prescription, as directed.

NOTE: Ear infections often will return if only partially treated. Do not stop the course of treatment even though symptoms are relieved.

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Prevention

Preventive measures can be very useful to decrease the frequency of otitis externa. On the other hand, otitis media is difficult to prevent. Avoid the risk factors outlined under Causes, if possible.

Otitis externa prevention—preventing moisture in the ear
  • Careful drying of the ear after swimming or bathing
  • Shaking out excess water
  • Holding a hair drier on low heat setting at least 12 inches from the ear
  • Wearing earplugs while swimming

Homemade solution of 1/2 rubbing alcohol, 1/4 white vinegar, and 1/4 distilled water may be used for tougher cases.

  • Place 3-4 drops in each ear after swimming or bathing.
  • Do not use drops if there is a hole (perforation) in the eardrum or if there is a ventilation tube in the ear.
  • Immediately discontinue drops if any pain occurs.
Otitis externa prevention—preventing scrapes to ear canal

Careful cleaning of ears to avoid scraping the ear canal. Do not use objects (for example, paper clips, bobby pins, or fingernails) that may tear the skin. Most people have ears that are self-cleansing, and cleaning with a cotton-tipped swab is unnecessary and potentially harmful.

Otitis media prevention

Avoid risk factors (for example, secondhand smoke, daycare), if possible.
Treat severe allergies.
Avoid contact with others who have a cold or respiratory infection.
In severe cases, a prolonged course of an antibiotic can be used as a preventive measure.

Outlook

Both of these earache conditions (otitis externa and otitis media) usually respond quickly to proper medical treatment. Pain relief should occur within the first few days of treatment.
Other symptoms, such as hearing loss or ear fullness, may take longer to improve.
An otolaryngologist (ear, nose, and throat specialist) should evaluate people with continuing infection, or those who get frequent, recurring infections.

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