Ear disorders can affect anyone at any age. While many of the common ear disorders involve infections, others include structural or sensory damage. Common ear disorders include barotitis media, Ménière’s disease, labyrinthitis, otitis externa, acute otitis media, and chronic otitis media, among others. Hearing loss, vertigo (a sense of spinning and/or dizziness), earache, and discharge from the ear are some of the common symptoms. When ear problems arise, other areas may be affected such as the nose, sinuses, teeth, tongue, tonsils, pharynx (throat), larynx (voice box), salivary glands, and facial joints.
Acute otitis media (AOM), or middle ear infection, is a bacterial or viral infection, usually secondary to a respiratory infection. Although this infection can occur at any age, it is most common in young children, particularly in infant and toddlers. Microorganisms may migrate from the throat to the middle ear through passages that connect to the ear. Secondhand smoke has been designated a risk factor in AOM. Symptoms include persistent severe earache, hearing loss, fever (up to 105°F), nausea, vomiting, and diarrhea. Fluid with blood or pus may also drain from the ear, and the eardrum can appear red and swollen.
Commonly Prescribed (On-Label) Drugs: Cefdinir, Cefprozil, Erythromycin/Sulfasoxazole, Loracarbef, Trimethoprim
Off-Label Prescription Drugs Breakthrough Options: Ampicillin - sulbactam, Clindamycin, Gatifloxacin
Chronic otitis media (COM) is recurrent or persistent otitis media, a bacterial or viral infection in the middle ear, usually secondary to a respiratory infection. A chronic ear infection may be more destructive than an acute ear infection because its effects are prolonged or repeated, and it may cause permanent damage to the ear. A chronic, long-term ear infection may show less severe symptoms; therefore, the infection may remain unnoticed and untreated for a long time. COM symptoms include ear ache or fullness in the ear, hearing loss, fever, nausea, vomiting, and diarrhea. Fluid with blood or pus may also drain from the ear, and the eardrum can appear red and swollen.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Ampicillin-sulbactam, Budesonide Nasal, Ciprofloxacin-hydrocortisone otic
Labyrinthitis, or inner ear infection, is an infection of the inner ear that affects hearing and causes motion disturbance. Medical experts think that labyrinthitis is caused by viral infections. In this ear disorder, hearing may be reduced or distorted, and patients may experience vertigo (a sense of spinning and/or dizziness). Nausea and vomiting may also accompany it and be quite difficult to control. Another complication of labyrinthitis is middle ear infection (otitis media). Recovery from infection may take three weeks since the body has to fight off the infection, and the brain needs to recover from the imbalances. Persistent vertigo and nausea may endure for more than three weeks in some people.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Diazepam, Lorazepam
Meniere's Disease, a disorder of the inner ear causing vertigo, which is a sense of spinning/dizziness and ringing in the ears, fluctuating hearing loss, and pressure or pain in the ear. Usually it affects only one ear and is a common cause of hearing loss. Causes of the disease remain unknown. The symptoms of Meniere's Disease are associated with a change in fluid volume in a portion of the inner ear. Some experts think a rupture of the inner ear area allows certain lymphatic substances to mix, causing the symptoms of Meniere's Disease. Researchers believe that a low-salt diet and a water pill may reduce the frequency of Meniere's disease attacks.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Acetazolamide, Dexamethasone, Diazepam, Droperidol, Gentamicin, Glycopyrrolate, Meclizine, Methazolamide, Propantheline, Streptomycin, Triamterene - hydrochlorothiazide
Otitis externa, also known as swimmer’s ear, is a common disorder that is usually represented by an acute bacterial infection of the skin inside the ear canal. This ear disorder also can be caused by a fungal infection contracted through swimming or bathing in contaminated water. Otitis externa is more common in hot and humid weather, in instances of local injury, for example with cotton swabs or hearing aids, and in the absence of earwax. Edema, redness, fluid, and pus often appear in the ear canal. Symptoms of otitis externa include ear pain and pressure, temporary hearing loss, fever, and tinnitus (ringing or roaring in the ears).
Commonly Prescribed (On-Label) Drugs: Boric Acid, Ciprofloxacin, Ciprofloxacin/Dexamethasone, Desonide, Neomycin/Polymyxin/Hydrocortisone, Ofloxacin
Off-Label Prescription Drugs Breakthrough Options: Betamethasone, Clotrimazole, Gentamicin
To prevent recurrent otitis media, medical treatment should follow soon after awareness of symptoms and diagnosis. Prompt treatment of acute ear infections may reduce the risk of developing recurrent or chronic otitis media. Follow-up examinations after treatment can ensure resolution. Some goals to successful prevention of otitis media include decreasing exposure to common ear pathogens, boosting immunity, and improving the ear function. To decrease exposure in children, smaller day care and class sizes, especially in the winter months, can reduce the number of outbreaks.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Sulfasoxazole
Sudden hearing loss (SHL) is greater than 30 decibel hearing reduction, over at least three consecutive frequencies, and occurring during 72 hours or less. In general, SHL most often affects persons in the 30- to 60-year-old age range. Although this hearing loss is termed “sudden,” it usually occurs during a few hours. Hearing loss is generally limited to one ear, and is accompanied with vertigo (problems with balance) and/or tinnitus (ringing in the ears). SHL may be severe, and involve different parts of the hearing frequency range. Causes of SHL include viral diseases and unknown causes. Steroids have been the drugs of choice for moderate to profound hearing loss.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Dexamethasone, Low - Molecular - Weight Heparin, Methylprednisolone, Prednisone
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