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Examiner
  • Lori A. Boyajian-O'Neill: Swimmer's ear can affect even nonswimmers

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  • On those hot summer days there is not much more fun than passing the time in a swimming pool. Kids live for summers spent frolicking at community or backyard pools. Swimmer's ear is a condition that can make that summer fun not so fun.
    Swimmer's ear, what do you know? T or F?
    1. It is usually caused by fungus.
    2. Ear tubes are placed for treatment.
    3. It can cause long-term hearing loss.
    The ear canal is an engineering marvel into which we commonly place beads, peas, corn and cotton swabs. Water gets trapped there, which can lead to infection of the canal, commonly seen in swimmers, hence the term, swimmer's ear.
    Swimmer's ear can occur in anyone exposed to water from daily showers to water sports. Another name for swimmer's ear is external otitis, and it leads to over 2.4 million visits to physician's offices each year. Bacteria cause 85-90 percent of cases.
    Lined by protective cerumen (wax) producing cells, the canal leads directly to the tympanic membrane – the eardrum. The drum transmits the beat of sound waves through a series of tiny bones to deep nerves then to the brain where the information is processed and interpreted – heard, if you will. When there is occlusion of the canal (wax, beads, etc.) or swelling from swimmer's ear, hearing can be impaired. Swimmer's ear causes ferocious pain and muffled hearing.
    The canal is self-cleaning. Swabs should only be used to clean the outside of the ear, the auricle. Pile driving a cotton swab into the canal will tamp down a wad of wax deep into the space. This can injure the protective lining; obstruct sound waves; cause pain and even trap water against the eardrum. When water is trapped, bacteria and fungus can grow causing painful inflammation and infection of the skin that lines the canal. This is swimmer's ear. The dark, moist canal is a perfect environment for the growth of bacteria or fungi. Skin abrasions of the canal, from cotton swabs, for example, are an invitation for infection.
    Treatment begins with cleansing the ear canal of excess wax, dead skin and foreign debris. This allows antibiotic and other drops to directly bathe the canal. The tympanic membrane must be evaluated to determine if there is any perforation. Antibiotic, antiseptic, acidifying solutions and steroid drops are often used to kill bacteria or fungus and to decrease inflammation and pain. At times swelling may block the canal. In such cases, a small wick is placed which acts as a conduit to drip medicine deep into the canal. Gradually the swelling will decrease and the wick is no longer necessary.
    Preventing water from entering or staying in the canal decreases risk for swimmer's ear. Tilting and shaking the head to allow water to flow out is a first step. Your physician may recommend solutions to help dry the canal after swimming or bathing. A blow dryer on low setting placed about 12 inches from the ear can help dry the canal. Swimmers' earplugs are designed to block water from entering the canal, with varying success. Applying petroleum jelly to a cotton ball and placing at the opening of the canal can provide a good seal and is inexpensive.
    Page 2 of 2 - Swimmer's ear can sideline even the most enthusiastic water babies. Some simple steps for prevention and quick recognition of symptoms and treatment can help keep them water-logged all summer.
    Answers: 1. F; 2. F; 3. F.
    Dr. Lori Boyajian-O’Neill can be contacted at lori.boyajian-oneill@hcahealthcare.com.

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