The difference between Otitis Media and Otitis Externa

Otitis Media is an infection that affects the middle ear and arises in the tympanic cavity (the hollow space between the tympanic membrane or ear drum and inner ear), whereas Otitis Externa is an infection in the external ear and the ear canal, and is popularly called swimmer’s ear or external Otitis. Both these classes of inflammation cause what is popularly known as “Earaches”. Although both conditions are different from each other, they could still at times coexist.

Causes of Otitis Media and Otitis Externa

Otitis Media: The middle ear is connected to the pharynx with the help of the Eustachian tube. The Eustachian tube is responsible for maintaining air pressure within the tympanic cavity. The condition of Otitis Media often begins with an infection that cause a sore throat, cold or respiratory problem and eventually spread to the middle ear. Pathogens like viruses, bacteria or fungi that cause throat infections, common colds and respiratory problems get into the middle ear via the Eustachian tube. Generally the condition resolves itself in 2-6 weeks, but more severe cases may lead to loss of hearing especially in young children. A child’s Eustachian tube is much smaller than an adult's and pathogens have easy access to the ear. The difference in their resistance to pathogens is another factor. Allergies or exposure to other children’s colds in day care centers further increases the risk of Otitis Media.

Otitis Externa: Otitis Externa may or may not be caused by pathogenic infections. Swimming in contaminated water is one of the reasons of contracting swimmer’s ear. People using swimming pools are at greater risk of this inflammation as the combination of water and chlorine changes the “pH” balance of the ear from acidic to alkaline. This results in an ideal breeding environment for bacteria and fungus to culture. Also, as pool water gets trapped inside the ear canal, chlorine may damage the skin inside the ear, causing inflammation and leaving it exposed to pathogens. The use of ear buds is the top cause of external Otitis, as it causes irritation and inflammation to the skin inside the ear canal. Constantly removing cerumen (ear wax) may also leave the ear exposed to pathogens.

Symptoms of Otitis Media and Otitis Externa

Otitis Media: The following are some of the most commonly observed symptoms of Otitis Media, especially in children:

• Intense earache
• Headache
• Fever
• Sense of fullness in the ear
• Leaking of fluid from the ear
• Nausea
• Difficulty in speaking or hearing
• Sense of buzzing in the ears
• Irritability

Otitis Externa: The following are some of the most commonly observed symptoms of Otitis Externa:

• Itchy ear canal in the beginning
• Earache that is aggravated when pulling on the ear lobe
• Release of fluids from the ear canal
• Temporary diminished hearing due to puss accumulating in the ear canal
• Fever
• Inflammation of ear canal’s skin

Treatment for Otitis Media and Otitis Externa

Otitis Media:

The course of the treatment is usually based on a few main points; keeping in mind the patient’s age, risk factors for having resistant bacteria, status of immunization, and current auditory status. Depending on the patient’s risk factor, the doctor may prescribe antibiotics for 24 hours with a follow up the next day. Alternatively analgesic ear drops without antibiotics may also be prescribed. For children at high risk, doctors may prescribe ear drops with an antibiotic too. In case the infections do not respond to antibiotics, or the infection is chronic, or there is a loss of hearing, the patient may have to undergo surgery, as well.

Otitis Externa:

Strict and safe ear hygiene is to be maintained. In case of severe infections, antibiotics are prescribed. Usually ear drops for the affected skin in the ear are given, and a cotton wick maybe employed to reach deeper into the canal to deliver the antibiotics or anti-inflammatory.