Hey, sorry to be late..! Let me see if I can help...
Not sure what this means... I know that it sounds pedantic, but here's a cut and paste from my response to another thread... a lot of these discussions tend to get confusing since all ear symptoms are lumped together.
Otitis externa (OE, outer ear infection, "swimmer's ear") and Otitis media (OM, middle ear infection, from barotrauma or infection), are two completely different things with different causes, physiology and risks.
OE is a skin inflammation of the canal of the ear that starts in the side of your head and travels down to the eardrum. It can be caused by aggressive instrumentation, diving, sweating or some types of ear drops. In severe cases, with swelling of the canal, it can cause some hearing loss but this is uncommon. Sometimes, accumulated earwax makes it worse, especially if you are packing it in with a q-tip in an attempt to remove it..!
OM is caused by bacterial infection in children (AOM, or acute otitis media), or by pressure injury in divers (OME, or otitis media with effusion). It causes a significant (but usually temporary) hearing loss. The problem in both cases is poor equalization/ventilation of the middle ear cleft (the space behind the eardrum) due to diving or (in children) due to poor function of the Eustachian tube. Diving when you can't equalize make you at risk for an eardrum perforation, or worse.
There are also INNER ear problems (DCI, perilymph fistulas, etc..) that can cause permanent deafness, but these are extremely rare, and when diving related, usually involve some pre-existing defect in the skull base or significant dive accident. They often involve severe hearing loss and/or vertigo that persists after exiting the water.
There is a small amount of overlap: OM can cause OE if the eardrum perforates and that infected fluid drains into the ear canal. OE can't really cause OM (although I suppose it is remotely possible to cause some barotrauma if your outer ear was sealed shut from inflammation and that affected the air pressure in the ear canal during descent).
Again, the devil is in the details. If someone sees fluid behind the drum (not yellow pus, but just liquid, or OME), that would be middle ear effusion, a common dive issue. Sometimes the fluid has blood in it, especially if it is from barotrauma. But adults (even divers) rarely get true middle ear infections with pus that require antibiotics.
There is no evidence that antibiotics have any effect on middle ear fluid. However, these things typically improve on their own with time, so antibiotics are often credited with the cure...
It can take weeks or even months for fluid to resolve, especially in children.
This is one of those things -and I know that this sounds like a dodge - that just needs to be seen to give an intelligent opinion. Unfortunately, a hundred pages of description of symptoms, onset, history, etc.. is not as good as two seconds of someone with experience looking in your ear.
Again, two different things - you could certainly have some transient dysfunction of your Eustachian tube due to a cold, allergies, etc.. but exposure to contaminated water would mainly put you at risk for outer ear infections, which as I mentioned are very different things.
You have answered your own question! Obviously, I like commenting here, and I always try to help as best as I can, but the devil really is in the details. In this forum, people are quick to offer their own experience and cures. However, until you have an accurate diagnosis, there is no point in trying remedies...
If you want, PM me and tell me where you are, and I may be able to give you a local referral...
Mike
Not sure what this means... I know that it sounds pedantic, but here's a cut and paste from my response to another thread... a lot of these discussions tend to get confusing since all ear symptoms are lumped together.
Otitis externa (OE, outer ear infection, "swimmer's ear") and Otitis media (OM, middle ear infection, from barotrauma or infection), are two completely different things with different causes, physiology and risks.
OE is a skin inflammation of the canal of the ear that starts in the side of your head and travels down to the eardrum. It can be caused by aggressive instrumentation, diving, sweating or some types of ear drops. In severe cases, with swelling of the canal, it can cause some hearing loss but this is uncommon. Sometimes, accumulated earwax makes it worse, especially if you are packing it in with a q-tip in an attempt to remove it..!
OM is caused by bacterial infection in children (AOM, or acute otitis media), or by pressure injury in divers (OME, or otitis media with effusion). It causes a significant (but usually temporary) hearing loss. The problem in both cases is poor equalization/ventilation of the middle ear cleft (the space behind the eardrum) due to diving or (in children) due to poor function of the Eustachian tube. Diving when you can't equalize make you at risk for an eardrum perforation, or worse.
There are also INNER ear problems (DCI, perilymph fistulas, etc..) that can cause permanent deafness, but these are extremely rare, and when diving related, usually involve some pre-existing defect in the skull base or significant dive accident. They often involve severe hearing loss and/or vertigo that persists after exiting the water.
There is a small amount of overlap: OM can cause OE if the eardrum perforates and that infected fluid drains into the ear canal. OE can't really cause OM (although I suppose it is remotely possible to cause some barotrauma if your outer ear was sealed shut from inflammation and that affected the air pressure in the ear canal during descent).
Again, the devil is in the details. If someone sees fluid behind the drum (not yellow pus, but just liquid, or OME), that would be middle ear effusion, a common dive issue. Sometimes the fluid has blood in it, especially if it is from barotrauma. But adults (even divers) rarely get true middle ear infections with pus that require antibiotics.
There is no evidence that antibiotics have any effect on middle ear fluid. However, these things typically improve on their own with time, so antibiotics are often credited with the cure...
It can take weeks or even months for fluid to resolve, especially in children.This is one of those things -and I know that this sounds like a dodge - that just needs to be seen to give an intelligent opinion. Unfortunately, a hundred pages of description of symptoms, onset, history, etc.. is not as good as two seconds of someone with experience looking in your ear.
Again, two different things - you could certainly have some transient dysfunction of your Eustachian tube due to a cold, allergies, etc.. but exposure to contaminated water would mainly put you at risk for outer ear infections, which as I mentioned are very different things.
You have answered your own question! Obviously, I like commenting here, and I always try to help as best as I can, but the devil really is in the details. In this forum, people are quick to offer their own experience and cures. However, until you have an accurate diagnosis, there is no point in trying remedies...
If you want, PM me and tell me where you are, and I may be able to give you a local referral...
Mike
