Growing Care PDX“Oh no, not another ear infection! How is this possible? We JUST got her better and must have killed off the bacteria with that last round of antibiotics. Do we just do more- again?”

This is such a classic scenario for parents of little ones. In order to make the most well informed choices, a little understanding of the anatomy and physiology of ear infections is crucial.

  • Outer Ear: Going from the outside, starting with the ear, there is a short, visible canal (outer ear) that leads to the “ear drum” (tympanic membrane).
  • Middle Ear: Behind the ear drum is a pea-sized cavity, normally filled with air (the middle ear), that houses three tiny bones (ossicles), that send sound vibrations from the ear drum to the inner ear.
  • Inner Ear: The inner ear houses nerves that translate the vibrations into what we hear as sounds.
  • Eustachian tube: Finally, there is a tube that connects the middle ear to the back of the throat called the eustachian tube. This is how pressure inside the ear is regulated. It opens every time you swallow, yawn, or quickly change altitude. When you use the trick to “pop your ears”, you are forcing air through this tube. The openings to the tube are behind the nose and can be accessed behind the skin folds that dangle the punching bag (uvula) seen in the back of the throat. The eustachian tube allows the middle ear to “circulate” air, and to drain in case fluid builds up.

But why would fluid build up in a space that should be filled with air? When something causes the eustachian tube opening to not open freely, it disrupts the ability to equalize pressure within the ear. Many factors can be responsible. An infection elsewhere can create inflammation and a fluid shift. A strain to the head or neck can shift tissues that surround the openings. Allergies to foods, environmental factors and toxins (second-hand smoke is a big culprit) also create inflammation.

An important note with the anatomy of the eustachian tube is that prior to the age of two years, it sits in more of a parallel axis from the ear to the throat, where build-up and back-up is much more likely.  As heads and bodies grow, this becomes more tilted at a downward angle, hence making ear infections in older children much less likely.

Whatever the cause, the effect is the same. When fluid builds up in the middle ear and is unable to drain, bacteria start the phone tree and settle into their warm undisturbed home in droves. And though you may kill them with drugs, as long as the home still stands, they will return.

Though antibiotics hold a very important place in our treatment options for a variety of conditions, healthcare providers and parents alike are becoming increasingly aware of the detriments of its repeated use. Antibiotics are intended to kill bacteria, though they are unable to exterminate only the “bad guys”. The body holds many healthy bacteria to regulate functions, and end up suffering the loss of the “good guys”, too. Many children have allergic side-effects to antibiotics, and overuse has been allowing the environment to create drug-resistant strains. And in the case of ear infections, one can see how the positive effects may only be short-term, considering the anatomy. What was once considered a first line of defense, is fortunately becoming more of a last resort in many minds.

In most cases of suspected, or confirmed, ear infections- children are able to heal on their own, and as a parent the best you thing you can do is give them TLC and help reduce the pain. You can find a far more conclusive list of home-remedies with a quick internet seach, but here’s a few goodies for pain relief:

Use warm compresses over the ear. Drip warmed oil (olive oil is fine) in ear canal. Some find that adding things like onion, garlic, lemon, tea tree, vinegar, and alcohol can all have an anti-microbial effect. Avoid smoke and environmental pollutants as much as possible. And cut the dairy and sugar, as dairy promotes mucous production and sugar just feeds the little beasties (no, not your kids- the bacteria!).

If these practices do the trick- great! If you are still wanting more support and perhaps a more speedy recovery, come on in to see us. We will make sure that the factors in the skull and neck are not impeding drainage. We may also manually open the eustachian tubes to allow the middle ear to circulate and remove the bacteria bathing grounds…to keep the little buggers from returning again and again.