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Do you suddenly feel a sharp pain in the ear? Is there a fever too? Then you could suffer from eardrum inflammation - especially if your middle ear was already inflamed. Such inflammation not only hurts a lot, it can also be very dangerous and lead to numbness.
What is the eardrum?
The eardrum sits at the end of the inner ear canal in front of the middle ear and thus separates the outer ear canal from the tympanic cavity, where the ossicles lie. It is a fine membrane just one tenth of a millimeter thick that stretches across the ear canal like a funnel.
The eardrum protects the middle and inner ear from dirt. But not only that: when sound arrives in the ear, the membrane vibrates, converting sound waves into mechanical vibrations that travel through the ossicles into the inner ear. In short, the eardrum allows us to hear.
Such an inflammation manifests itself with blistering on the membrane itself - but you cannot see it from the outside. On the other hand, the purulent discharge that drips from the ear is very visible. You feel throbbing, stinging and intense pain in the ear and hear "noises" due to the impaired hearing function. You get a fever, can hardly concentrate and lose your orientation. You become deaf. Many sufferers also feel sick and have to vomit.
Where does the pain come from?
The eardrum is highly sensitive. Numerous nerve branches run through the membrane and transmit signals to the fifth. or tenth. Cranial nerve continues. If these nerves are irritated, the pain is almost unbearable.
The most common cause is an unhealed otitis media, caused by viruses, bacteria or fungi. Not treated, inadequately or incorrectly, this now affects the eardrum. Various other triggers are possible, including:
- Facial paralysis,
- Inner ear infection,
- Mastoid inflammation,
- and tinnitus.
Infants most often develop otitis media. It usually begins with a runny nose, cough or flu, in which the pathogens spread to the ear. Viruses and bacteria use the ear trumpet, i.e. the connection between the nasopharynx and the ear, as a highway and settle in the middle ear. The inside of the ear is poorly ventilated due to the swollen mucous membranes. Now the eardrum can ignite firstly and secondly tear open.
Hole in the eardrum?
A hole in the eardrum is not myringitis, but it can easily be mistaken for it, since some symptoms are similar. The eardrum is extremely tough for its thickness of a tenth of a millimeter. However, it does not tolerate sharp objects that pierce the ear - so please do not try to remove wax with a needle, nail scissors or fine tweezers. A hole quickly arises here.
Excessive pressure differences also cause the eardrum to tear, as does the tympanic effusion, in which the tympanic cavity fills with so much outflow from the middle ear that the membrane perforates.
In contrast to myringitis, the violent pain occurs only briefly and then subsides. You can hear poorly on the affected ear. A torn eardrum is usually not a reason to panic, it usually heals itself. If not, an otolaryngologist can close the tear in a simple operation.
Inflammation of the ear canal
Myringitis can also be triggered by an inflamed external auditory canal, in specialist terminology Ottis externa. In addition to the skin and subcutaneous tissue, it can also extend to the eardrum. In the healthy state, the ear canal cleans itself. Its epithelium grows outwards and transports skin fat like dander from the ear canal. If this protective skin fat is missing, the skin easily ignites. Bacteria nest particularly often, more rarely fungi.
An inflamed external ear canal only manifests with itching and redness. The ear canal and pinna swell. Ear pain occurs especially when pulling the earlobe. If the ear canal swells, hearing loss is also possible. Such inflammation often arises after bathing in chlorinated public swimming pools. Other causes include poking around with cotton swabs, earplugs, headphones or hearing aids that damage the protective layer of the ear canal wall.
Most important pathogen of a myringite
Various pathogens can lead to eardrum inflammation, the most important of which are briefly explained here.
1) Haemohilus influenze
These Pfeiffer influenza bacteria are highly infectious and trigger bronchitis, pneumonia or otitis media. If you reach over the eardrum, myringitis develops.
These bacteria often trigger myringitis. They spread in the bronchi, middle ear and pharynx and penetrate to the eardrum via the pharynx and nose area.
Pneumococci as well as Moraxella cocci trigger myringitis. Moraxella catarrhalis is notorious primarily as a trigger for chronic lung disease, but also migrates to the middle ear and eardrum. A Moraxella infection is an ugly affair because some of the strains are now resistant to common antibiotics.
When to the doctor?
If there is inflammation in the ear area, you should immediately go to the doctor for treatment. The rule of thumb is: early-treated ear infections heal easily, late-treated infections in this sensitive area of the body can have dangerous consequences - from paralysis to numbness.
Ask your doctor first about the specific pain. Here there is only the possibility of confusing myringitis with other ear infections, especially with an otitis media or an inflammation of the external ear canal. Experts recognize the differences particularly in the location and the form of the pain - an inflammation of the external ear canal hurts more than pulling pain. Hearing disorders rarely occur in the middle ear.
Then the pathogens are identified using laboratory equipment. This is particularly important with Moraxella cocci, with the other triggering bacteria common antibiotics help. By the way, a little all-clear applies: even if, for example, an otitis media is incorrectly identified, but the eardrum is affected instead, the antibiotic fights the same pathogen.
An X-ray can be used to determine whether the tympanic cavity is filled and possibly pressing on the eardrum.
Once a bacterial pathogen has been identified, antibiotics must be administered. Please do not trust “self-healing”. Infection with bacteria shows that the body's defense system has already failed. If the pathogen is resistant to penicillin, macrolide antibiotics, for example azithromycin or clarithromycin, help.
Nasal sprays and ibuprofen help against the pain.
Medicinal plants against myringitis
In the case of myringitis, infusion dripped into the ear from plants that have an antibiotic or pain-relieving effect ideally does both.
In addition to anise and savory, houseleek, chamomile, coltsfoot, lavender, nasturtium, garlic and onions, yarrow, hyssop and ribwort and sage. To clean the infected area, you can also add the herbal brew to the bath water and take a warm herbal bath.
In case of extreme pain, the ENT doctor sometimes recommends piercing the infectious vesicles on the membrane. Never come up with the idea of doing this yourself. Stopping next to it can lead to lifelong deafness.
How long does myringitis last?
The sooner you go to the doctor, the faster the inflammation subsides. A cure always takes at least two weeks. If myringitis is already advanced, healing can take up to six weeks.
With myringitis, complications only arise when the inflammation spreads and also attacks the meninges or temporal bone. If the nerves of the eardrum are damaged, facial or even brain paralysis can result. Because it is purulent inflammation, sepsis or an abscess can form. Thrombosis is also possible and ultimately means permanent hearing loss if scars have formed in the eardrum.
It is difficult to absolutely prevent myringitis, since it is just as inflammatory as a flu infection. If you are particularly easily infected in the ear area, you could be vaccinated against pneumococci and also against Haemophilus influenzae. With this you already checkmate two skin pathogens. You can also wash your hands regularly and put on a swimming cap in the swimming pool.
Myringitis is usually a complication. Since the eardrum is not located at the ear entrance, it is usually preceded by an inflammation of the outer ear, then the middle ear, throat or nose. The best way to prevent this is to immediately make sure that an ear, nose and throat infection heals. Especially if otitis media has already formed, make sure that it completely heals. (Dr. Utz Anhalt)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Merck and Co., Inc .: Myringitis (accessed: July 6, 2019), msdmanuals.com
- Federal Center for Health Education: Ear infections (accessed: July 6, 2019), infektionsschutz.de
- Amboss GmbH: Otitis externa (accessed: July 6, 2019), amboss.com
- Mayo Clinic: Ear infection (middle ear) (accessed: July 6, 2019), mayoclinic.org
- Devaraja, K .: Myringitis: An update, Journal of Otology Volume 14, Issue 1, March 2019, sciencedirect.com
- The University of Texas Health Science Center at Houston (UTHealth): Bullous Myringitis (accessed: July 6, 2019), med.uth.edu
ICD codes for this disease: H73ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.