ERNEST CAMILLERI - MaltaRightNow.com

| HEALTH |SWIMMER’SEARJohn CutajarMD MRCSEd DO-HNS(doctor of medicine and surgery)Part 2 of 2When the canal contains discharge or debris, thiscan be cleaned to allow the applied medication towork more effectively. Such cleaning may need tobe repeated regularly. Additionally, if the canal issignificantly swollen, your doctor may choose to inserta special wick into the ear canal that absorbs applieddrops and expands, so as to allow them to reach allparts of the canal despite the swelling. These wicksshould be removed and/or changed after 24 to 48hours. These ear canal procedures, be it cleaning orwick insertion/changing, should only be carried out bya trained doctor who can see what he’s doing, usingspecialised equipment. Fiddling blindly with your ownears is much more likely to make things worse!These measures are usually sufficient for symptomsto resolve within a few days. Pain-relieving medicationssuch as paracetamol or anti-inflammatory drugs canbe taken as dictated by the duration and severity ofthe earache, and can thus be stopped as symptomssubside. However, other medications such as eardrops or oral antibiotics are prescribed as a full courseof predetermined duration. Stopping these prematurelymay lead to recurrence of infection, which may turnout to be more difficult to treat the second time round.During treatment, one should avoid wetting the earsas this could worsen, prolong and complicate theinfection. Swimming, especially diving, should beavoided at all costs. Cotton wool balls impregnatedwith lubricating jelly can be used to occlude the earcanal opening, protecting the canal from water whileshowering.Complying with prescribed treatment, maintainingmedical follow-up and adhering to the above adviceusually result in a satisfactory outcome. However,some cases tend to persist, worsen or recur, andthese should be referred for specialist assessment.Worsening of symptoms on starting ear drops shouldalso be reported to the prescribingdoctor, as this may signify allergy tothese medications.Swimmer’s ear is a conditionthat can affect anyone. However,some people are more at risk thanothers. An important predisposingfactor associated with increasedrisk of infection is cotton bud use. This causes waximpaction, with subsequent increased risk of trappingof water in the ear canal. Additionally, cotton buds(and anything else used to scratch the ears, includingfingers!) may irritate and traumatize the sensitive earcanal, causing small cuts which provide bacteria andfungi with the opportunity to penetrate the skin andcause infection. The inside of the ears should thus onlybe cleaned if wax is causing problems (such as hearingloss or recurrent infections), and this should only bedone by trained doctors or nurses using specialisedequipment.Other risk factors for swimmer’s ear are abnormallynarrow ear canals, medical conditions such as diabetesor eczema, swimming in contaminated water andthe use of hair sprays/dyes, some of which containsubstances that irritate the ears. Those who getrecurrent infections can sometimes be helped by useof ear plugs designedto prevent waterentering the ear canalduring swimming,and prescription ofear drops containingalcohol; these canbe applied afterswimming, aiding the ear canal to dry rapidly.Unfortunately, despite good ear care and preventivemeasures, some of us won’t have an infection-freesummer, and will still develop swimmer’s ear. It isimperative to remember that there are endless causesof earache, and that different types of ear infectionsrequire different forms of treatment. One shouldtherefore never take any medications of one’s ownaccord, except for over-the-counter pain relief. The firststep should always be a proper medical assessment atyour doctor’s clinic or health centre, to ensure accuratediagnosis and initiation of appropriate treatment.L&s | august ’08 25