Ears
If matter accumulates in the corners of the eyes, wipe with a clean cloth or cotton balls dipped in water. You may gently clean the nose and ear canal openings with a moist Q-tip™. Do not stick the Q-tip™ into the ear or nose. This can cause impacted ear wax which can be uncomfortable and is difficult to see past when by a doctor tries to view the ear canal and tympanic membrane.
Treatment of hardened wax (cerumen) in the ear will require more than one application of glycerin in the ear canal. You can find glycerin in most pharmacies or use BabyLax (used for constipation) in single dose plastic pipettes. Fill ear canal with glycerin and let set for 5-10 minutes. Then rinse with warm water (test on your inner wrist to ensure water isn't too hot). If you get no wax after 5-10 rinses, then dry the ear and repeat once a day for up to three days. Stop if there is any pain. If you have been unsuccessful after three tries, contact our office so I can check the ear or we are happy to check the ear any time if you worried about the plugged ear.
Ear pain sometimes accompanies a cold. Earaches can go away in thirty minutes or up to a couple of hours without treatment. Using a portable hair dryer, try blowing warm air into the ear to relieve the pain. Propping your child up may also help reduce ear pain. Ear drops cannot cure common middle ear infections. Ear pain can successfully be treated with Tylenol or Motrin (Click on Tylenol or Motrin to learn about dosing). You should call the office to make an appointment if pain lasts more than 10 minutes, if fever persists, or drainage from the ear or hearing loss occurs. Although it has been estimated that 80% of ear infections should be resolved without medications, most pediatricians will treat children under two years with antibiotics.
During the summer months, each day I see several infections of the ear canal called swimmer’s ear. “All that swimming, my kids are in the water all day”, according to many parents. Children and adolescents don’t have many cold-like symptoms, but it really hurts to touch their ear(s). On the exam, I noticed a pain in the ear during the exam. It is hard to investigate the ear canal without the child jumping off the table. The ear canal itself is swollen and red.
The normal child’s ear canal is protected with flaky skin and wax. After exposure to high humidity or moisture the canal can easily be invaded by opportunistic bacteria or fungi. The natural lining of the canal is acidic and will prohibit growth of bacteria, but this becomes neutralized with constant water in the canal. After my exam, treatment consisted of topical antibiotics and steroids to reduce the swelling and growth of the bacteria. Treatment lasts about five days but could last longer depending on the severity of the infection and the consistency of treatment.
With the warm Fresno and Clovis weather, some families have their children in at least once each summer. It doesn’t have to be so. After swimming, get the water out of the ear. I recommend a hair dryer on the lowest setting for several minutes in each ear. This usually works. Avoid touching or scratching the ear. Scratching increases the chances of introducing bacteria into the inflamed and swollen canal. Children with a history of wax build up or foreign material build up in the ears should be irrigated with warm water periodically. 20 cc syringes can be found at all pharmacies. Use silicon type ear plugs to reduce the amount of water entering the canal. For those kids who lose the ear plugs, consider using a tight-fitting swim cap or wet suit hoods. Most over the counter ear drops for swimmers’ ear don’t work well. You should look for drying agents for the ear. You can ask your pharmacist. These drying agents should not be used if there is any pain or tenderness in the ear at the time.
I don’t treat swimmers ear infections over the phone. A surprising number of children have infections of the middle ear (otitis media) along with the canal (otitis externa). By treating over the phone, I might under treat a more serious infection or miss fluid which can later interfere with hearing. The treatment is not the same. An oral antibiotic is used with common ear infection whereas a topical antibiotic is used with ear canal infections.
Reviewed 5/1/2024