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Monday, August 22, 2005

Ear infections and swimmer's ear

So far, my children's list of summer holiday souvenirs includes one embroidered silk shirt from Toronto's Chinatown, two bags of 'gem stones' from Collingwood, and three raging ear infections from Lake Simcoe.

But they aren't alone. This season's hot, humid weather has meant more time spent cooling off in area pools and lakes, which, in turn, means more residents and cottagers are turning up at Royal Victoria Hospital's emergency department with painful 'swimmer's ear.'

"Our cottage country location means we treat a large number of people with otitis externa infection, and some are quite severe. We admit at least two people a month so they can be put on intravenous antibiotics," says RVH ear, nose and throat surgeon, Dr. Rob Ballagh. "And swimmer's ear is a very painful infection. In fact, I've had several women tell me it was worse than childbirth!"


I've never suffered swimmer's ear, but based on the number of sleepless, summer nights I've spent cradling my crying children, I can only imagine how much it hurts.

So what causes outer ear infections? Well, according to Dr. Ballagh there are a few reasons.

Some people are just naturally more susceptible to outer ear infections. They may produce a lot of ear wax, have a skin condition in their ear, such as eczema, or their ear canal is smaller than normal, trapping wax and water - conditions perfect for breeding bacteria.

The skin of the ear canal is extremely thin and therefore becomes wrinkled and 'pruney' - just like our fingertips - after a long swim, breaking down the skin's natural resistance to bacterial invasion.

That skin also sits directly on bone, making it especially prone to injury from anything that touches it, including cotton swabs. Ballagh warns that cleaning your ears with one of these seemingly harmless tools, not only shoves wax deeper inside your ear, but can result in tiny scratches that allow bacteria to enter.

"My grandmother always told me not to put anything into my ear that is bigger than my elbow and that's what I tell my patients," he says.

"Wipe the outer ear with a tissue or a damp washcloth to remove any unsightly or visible wax, but leave some behind. Wax is your body's way of naturally protecting the ear."

Outer ear infections can usually be cleared up quickly with antibiotic drops, although in my daughter's case, swelling of the ear canal required a matchstick-sized 'wick' to be painfully inserted to ensure the medication got past the blockage.

In the meantime, we'll be spending some time on dry land and picking up two pairs of ear plugs for future dips. This is one summer souvenir we can do without.

- Suzanne Legue is Royal Victoria Hospital's director of development and public affairs.

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