“Oh no, not another ear infection! How is this possible?”

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.

If you want support and 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.