Dizziness, a sign of ear infection

Ear infection is more common than many people think. Sometimes, its first sign is dizziness, reports Sade Oguntola.

Little Tosin sat quietly in the corner of the room and from her face you could see that something was wrong with her. This is a girl that ordinarily would be all over you the moment you enter their house. Surprisingly, what was wrong with her had to do with her ear. This is one organ of the body that you hardly hear people complain about.

Ear infections are commoner than many people think. They are one of the most worrisome illnesses for parents and children to go through, especially if they frequently occur. In fact, it is one of the commonly diagnosed childhood illnesses and some of these infections are traceable to infections like cold or an allergy.

Dr. Diran Olabisi, an Ear, Nose and Throat expert and medical director of Highland Specialist Hospital, Yemetu, Ibadan, however said many things could be responsible for a child having an ear infection that the child simply complain of as pain or fluid that is discharged out of the ear.

According to him, some pains may be as a result of a problem in another part of the body that affects the nerves commonly shared by such organs of the body as the nose, mouth and head. In some instances, when the tonsil is irritated or there is arthritis of the neck, the effect may manifest as pain in the ear. In these cases, the problem is far away from the ear itself.

In some instances, it may be related to common cold. In a person with cold, the nasal passage become swollen and mucus collects in the back of the nose. This environment is a breeding ground for the bacteria that normally live in the nose and throat and so they begin to overgrow. Mucus is also secreted within the middle ear space just as it is in the sinuses.

Some pains may also be related to fluid that drains out from the ear this is different from the earwax. “The ear has a self cleansing mechanism. There is the production of little wax to lubricate the external canal so that it does not get dry and it eventually falls off,” he said.

A case of a child with ear ache also having fluid draining out of the ear, the expert said, may have occurred as a result of the Eustachian tube getting blocked. This blockage would allow fluid to build up within the normally air-filled middle ear. Bacteria or viruses that have entered the middle ear through the Eustachian tube can also get trapped in this way. These germs can breed in the trapped fluid, eventually leading to an ear infection.

The Eustachian tubes are muscular/cartilaginous tubes that extend from each middle ear space to the top of the throat (nasopharynx). The tubes are normally closed, but can “pop” open as needed to ventilate your middle ear spaces. That is what the tubes are for, to allow air up into the middle ear spaces.

Dr. Olabisi said many people in the community might not be familiar with a doctor diagnosing them to have “fluid in the ears”. They usually wonder what it could mean. It is characterised by a “dullness” of hearing or a “stuffed-up” sensation in the ears, and may be accompanied by earache. This type of “fluid in the ears” is not the normal state, and represents a disease of the middle ear, which should be treated by a physician.

He said that this is a medical condition in which there could have been an infection of the external ear, the middle ear or even the inner ear. The case of an infection affecting the middle ear is called middle ear infection (Otitis Media) and aside the presence of fluid, typically pus, in the middle ear, the individual may have symptoms such as earache, blocked nose, redness of the eardrum, dizziness, itchy ears and possible fever.

Dr. Olabisi added that in a number of cases where fluids accumulate in the middle ear space, it affects hearing by reducing the mobility of the eardrum, so that sounds are not collected as efficiently. The fluid may also affect the function of the inner ear, by disturbing the normal chemical composition of the inner ear fluids.

Meanwhile, the colour of the fluid that accumulates in the ear is dependent on the micro-organism responsible for the problem and it could be a sign of something more serious. For example, any ear discharge that is white, yellow or clear or bloody is a danger sign of a problem. Similarly, any ear discharge that persists for more than five days, that is accompanied by severe pain, fever or headache or results in hearing loss requires urgent attention.

Dr Olabisi said some “fluid in the ears” that are also dangerous occurs when the cerebrospinal fluid covering the brain finds its way into the ear. This could occur in an individual that was involved in a road accident and now has a clear, colourless liquid or fluid coming out of his or her ear. This, he said, is dangerous because if care is not taken, an infection could easily spread to give meningitis and tonsillitis.

Meningitis can progress to develop into brain abscess, which subsequently leads to death.

In some cases, the fluid in the ear could be an indication of such bacterial infections like tuberculosis affecting the middle ear, allergy and viruses like HIV.

“HIV has many ways of manifesting apart from the person losing weight. They could have rashes and so on. From the nose, as an ENT surgeon, there are certain ways people with HIV present with ear, nose and throat problems. For example, they could have ear discharge, nasal discharge and they do also bleed from their nose,” he said.

“Mere looking at the ear drums and assessing the type of perforations that may have occurred in this essential part of the hearing organ, one may be able to detect those fluid in the ear cases that are related to TB, for instance.

Assuring that it is not normal to have any watery ear discharge coming out from ones’ ear, he said if the discharge was as a result of an infection, it would be accompanied with earache, high body temperature and when left untreated, could result to hearing loss and other serious complications, such as mastoiditis (a rare inflammation of bone adjacent to the ear). The hearing loss is as a result of the eardrum getting torn due to the initial infection. Repeated ear infections may slow down speech acquisition in children younger than three years old.

Dr. Olabisi cautioned that ear infections should not be overlooked as a simple thing. He said it is something to worry about because it is an indication that the individual need to seek medical care.