Ear Infection: Fluid and Noise Distortion

Hello Dr. Nagler,

I recently acquired tinnitus in January of 2020 from a concert and I’m assuming years of loud noise. Since then the tinnitus has remained fairly the same.

Last Sunday I developed an ear infection while battling a, what I perceived as a mild cold. So mild, I wasn’t using any OTC treatments. Well. I developed a left ear infection (bad) as well as pink eye in both eyes. I’ve been on Augmentin for 5 of the ten day course. Today I visited my GP and was informed I have infected ear and both have fluid behind ear drum. I am instructed to finish my antibiotics.

I noticed that sounds, especially female singing and certain parts of songs sound distorted. I noticed this distortion earlier in my infection but only out of my infected ear. I’m assuming that now fluid has accumulated in my right (non infected) ear as well that this is my general hearing now.

I’m hoping that this sound distortion is not permanent and is a part of the fluid build up? Does that seem possible? Is there a way to speed up the fluid drainage?

Thank you for your time.

Kind regards,
Shelby

 

Hello @Shelbylynn -

Thank you for your question.

You may know this already, but in order for my response to make sense I want to review some basic anatomy. The ear is divided into three regions: outer, middle, and inner. The tympanic membrane (eardrum) separates the outer ear from the middle ear, which contains the three tiny bones (the "ossicles") that transmit sound waves through the oval window to the inner ear. The inner ear contains the cochlea and (within the cochlea) the hair cells, which convert the sound waves into an electrochemical signal that is then transmitted via the auditory nerve into the brain, where it eventually reaches the auditory cortex, at which point it is perceived as a sound.



I know that's a mouthful (an earful?), but if you look at the diagram above, you will see that without the Eustachian tube, the middle ear would be a closed space. The Eustachian tube drains the middle ear to the upper throat and the back of the nasal cavity.

In your post, you refer to fluid behind your eardrum. It is this buildup of fluid that is affecting the functioning of your ossicles, thereby causing the distortion. From what you say above, I suspect that the fluid is thick because it is infected, and the thickened fluid cannot easily drain down your Eustachian tube.

Your doctor prescribed antibiotics to control the infection, and decongestants can help improve drainage down your Eustachian tube. A room humidifier can sometimes help as well.

In some cases a doctor will prescribe steroids to help decrease swelling, and in occasional chronic cases an ENT will put a small hole in the eardrum and insert a tube to keep the hole open for a while. (The hole typically closes on its own when the tube falls out.) Most folks do not require either of those steps.

Once the fluid has cleared, your distorted hearing should return to baseline.

As to what you can do to improve the fluid drainage, the answer is complete your antibiotics, take the decongestants recommended by your doctor, and use a room humidifier. If you are still symptomatic after a few more days, return to your doctor for further instructions.

Hope this helps.

Stephen M. Nagler, M.D.