Water affects the ear nerve
Water in the ear
But prolonged stays in the water macerate the skin in the external auditory canal, as a result of which the natural fat protection is dissolved. Chlorine, which is used for disinfection in swimming pools, speeds up this process. Sea water as well. In addition, many pathogenic germs lurk in pools. In a large American study with more than 2000 patients, the most common pathogens were Pseudomonas aeruginosa, Staphylococcus epidermidis and S. aureus. And these bacteria even defy chlorinated water. "Germs are everywhere, but they are particularly common and concentrated in swimming pools," informs Dr. Michael Deeg from the professional association of ENT doctors in conversation with the PZ.
Once the skin protection in the ear has dissolved, germs effortlessly penetrate the skin, multiply and cause inflammation. The most common form of external ear inflammation, otitis externa diffusa, in which the inflammation spreads over the entire ear canal, is therefore particularly common for tourists on beach holidays, swimmers, surfers and divers. This explains the terms "swimmer's ear", "swimming pool otitis" or "diving ear".
Although bacterial pathogens are by far the most common cause of otitis externa, other pathogens such as viruses and fungi have also been documented. The smallest injuries in the ear canal also have a positive effect on inflammation in the ear. This can happen when cleaning the ear with cotton swabs or wearing earplugs or hearing aids. Basic diseases such as diabetes, acne or psoriasis also affect the texture of the skin in the ear. Special anatomical or physiological conditions such as a narrow ear canal or a reduced cerumen layer can also be predisposing.
Symptoms begin no later than two days after infection with the germs. "What starts with a certain itchiness and sensitivity to touch quickly culminates in severe pain," explains the ENT doctor from Freiburg. "Clear indication of otitis externa: Pulling the auricle or pressure on the cartilage in front of the ear canal, the tragus, increases the pain." The skin in the ear canal is red and swollen, and a cloudy secretion covers the surface of the skin. Sometimes secretion also flows out of the ear.
Even if bathing otitis is considered a mundane infection, the patients often feel very bad. As a first measure, analgesic substances such as ibuprofen or paracetamol are recommended. In addition, the ear can be cooled from the outside.
"The basis of any further therapy is the thorough cleaning of the ear canal with the help of a suction device," says the expert. It is therefore advisable to consult a specialist immediately. During the consultation, it should be pointed out that the ear canal must never be cleaned yourself, for example with a cotton swab. That would only intensify the inflammation.
As long as the ear canal is swollen, the doctor inserts a drug-soaked gauze strip into the ear canal. This is renewed regularly. If the swelling has receded, therapy is continued with ear drops. If the eardrum is otoscopically intact, the gauze strip is soaked with ointment containing antibiotics. Among the antibiotics is ciprofloxacin (like Ciloxan®) most widely used, along with bacitracin and polymyxin-B (such as polyspectran®) are used, some with the addition of corticosteroids. This should allow the ear canal to swell more quickly. If there is any uncertainty as to whether the eardrum has been damaged, gauze strips soaked with alcoholic solution are the means of choice. At the same time, analgesia should continue to be practiced. Deeg advises against ear drops containing local anesthetics. "In most cases, targeted local treatment improves the symptoms within a few days." Even problematic germs can usually be eliminated with this local therapy within a week. Deeg advises that you take proper care of your ears so that you don't catch an infection the next time you go to the swimming pool. It is important to ensure that the ears are thoroughly freed of fluid after being in the water. Perhaps rinse beforehand with clear fresh or drinking water.
Some divers swear by the so-called "diving droplets" as a preventive measure: They contain 70% ethanol and 85% glycerol in a ratio of 1: 1. Not only do they have a disinfectant effect, they also have a dehydrating component in the form of glycerol. Some ENT doctors even use glycerol mono drops (Otodolor soft®). Due to the high water binding capacity of glycerol and the resulting osmosis, water is withdrawn from the swollen tissue and the pain is reduced. Two to three droplets, brought to body heat, are trickled into the ear canal.
Ear drops containing acetic acid 0.7% (NRF 16.2) are also simple and practical for the onset of slight inflammation. Applied directly after contact with water, the acetic acid has a de-swelling, drying and antimicrobial effect.
Advice for the consultation: Patients who are prone to bathing otitis should discuss with the ear doctor in advance of their bathing holiday which aids and medicines they can use in an emergency. The good old swimming cap is also a tried and tested means of keeping germs away from the ear. /
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