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Is Your Earache Just a Cold or an Ear Infection?

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How Is an Ear Infection Diagnosed?

When your doctor suspects an ear infection, he or she will examine the ear using an instrument called an otoscope. A healthy eardrum is pinkish gray in color and transparent. If an ear infection is present, the eardrum may be inflamed, swollen, or red. The doctor may also check the pressure caused by fluid in the middle ear using a pneumatic otoscope. This instrument blows a small amount of air at the eardrum, causing the eardrum to move back and forth. The eardrum will not move as readily if fluid is present inside the ear.

Another useful diagnostic tool for ear infections is tympanometry. This is a test that uses sound and air pressure to check for fluid in the middle ear (it cannot test hearing).

How Are Earaches From a Cold or Ear Infection Treated?

An ear infection is usually treatable, and permanent damage to the ear or to the hearing is much less common today with proper treatment. Treatment may include medications for pain and fever, antibiotics for bacterial ear infections, and/or observation of symptoms.

  • Pain relief for an earache. Acetaminophen or ibuprofen can help relieve an earache with a cold or a fever over 102 degrees F. These medications usually control the ear pain within one to two hours. (Earaches tend to hurt more at bedtime.)
  • Antibiotics for an ear infection. Prescribed antibiotics will kill the bacteria causing the ear infection. They are not needed to treat an earache due to a cold or a virus. Antibiotics may cause nausea, diarrhea, rashes, or yeast infections and may interact with other drugs.
  • Myringotomy (ear tubes) to relieve ear fluid. If fluid remains in the ear for more than three months or if your child has repeated ear infections, your doctor may insert small metal or plastic tubes through the eardrum to help keep the ear free of fluid and infection. This outpatient procedure is usually performed on children and is done under general anesthesia. The tubes usually remain in from eight to 18 months and normally fall out on their own. In some instances, the doctor may choose to leave the tubes in longer.
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