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Inner Ear Infection Symptoms

Key Takeaways

  • There are two types of inner ear infections: vestibular neuritis and labyrinthitis.

  • Vestibular neuritis occurs due to the infection of the vestibular nerve, which helps in maintaining balance. 

  • Labyrinthitis occurs due to a bacterial or viral infection of the inner ear, often following more common infections, such as the flu or a common cold. 

  • Ear infection symptoms in adults include pain and discomfort in the ear, pressure in the ear, hearing loss, and pus-like discharge from the ear.

  • Children with an inner ear infection experience the same symptoms as well as fever, rubbing and pulling the ears, not reacting to some sounds, problems with hearing and balance, headaches, dizziness, restlessness, and loss of appetite.

  • Some common causes of inner ear infections include an upper respiratory infection, such as the common cold, allergies, excess mucus, sinus infections, changes in air pressure, and smoking.

  • Ear infections can go away on their own. However, if they are chronic, doctors may prescribe antibiotics.

Infections in the inner ear can occur when a person has flu or a cold or if the infection in the middle ear spreads to the inner ear. It can cause some parts of the inner ear to become swollen and inflamed. This can affect the patient's hearing and the ability to maintain balance.

This article discusses the symptoms, causes, and risk factors of inner ear infections and the effective ways to treat them.

What is an inner ear infection?

Infections in the inner ears can occur due to bacteria or viruses. These infections usually affect the middle ear, which is a part of the ear behind the tympanic membrane, and later spread to the inner ear.

Sometimes, ear infection clears up on its own. However, in some cases, ear infections can cause symptoms that persist, causing severe pain, inflammation, and fluid buildup. The inflammation of the inner is called otitis interna.

This can result in symptoms such as dizziness, nausea, a sensation of imbalance, or hearing impairments.

Ear infection may be chronic or acute, depending on the duration of symptoms. Acute ear infection is often painful, although it lasts a short duration. Chronic ear infections recur several times and do not clear up completely. Chronic infections can sometimes cause permanent damage to the inner and middle ear.

What are the types of ear infections?

There are two types of inner ear infections: vestibular neuritis and labyrinthitis.

Vestibular neuritis

Vestibular neuritis occurs due to the infection of the vestibular nerve, which sits in the inner ear and helps in maintaining balance by sending signals to the brain

Vestibular neuritis causes the vestibular nerve to become inflamed, due to which a person may experience symptoms such as loss of balance, dizziness, vertigo, or nausea.

This infection typically comes alongside or before a viral infection. The reactivation of the herpes simplex virus is a common cause of this condition. 

Vestibular neuritis is considered a benign condition as it lasts for a short period and resolves spontaneously without treatment.

Labyrinthitis

Labyrinthitis occurs due to a bacterial or viral infection of the inner ear. It results in the inflammation of the labyrinth, which is made of a maze of canals in the ear. 

The labyrinth inflammation can disrupt the transmission of signals from the inner ear to the brain, resulting in some symptoms, such as pain in the ear, headaches, ringing sounds in the ear, and the sensation of pressure in the ear.

Labyrinthitis often occurs following more common infections, such as the flu or a common cold. Viral labyrinthitis is more common in adults between 30 and 60 years of age. It is also more common in women than in men.

What are the symptoms of inner ear infection?

Ear infections can cause symptoms such as:

  • Pain and discomfort in the ear

  • The sensation of pressure in their ear

  • Hearing loss

  • Pus-like discharge from the ear

These symptoms tend to be more severe in patients with an acute inner ear infection. These symptoms may come and go or persist. In some cases, the symptoms may occur in both ears. Pain is usually more intense when a patient has an infection in both ears. This condition is called a double inner ear infection.

The symptoms of a chronic ear infection are less intense and often not as noticeable as those of an acute ear infection.

Symptoms of inner ear infection in children

The symptoms of inner ear infection in children are similar to those in adults. However, other than ear pain and pus-like discharge, young babies and children may show additional signs such as:

  • Fever

  • Rubbing and pulling the ear without any apparent reason

  • Not reacting to some sounds

  • Problems with hearing and balance 

  • Headaches

  • Dizziness

  • Restlessness

  • Loss of appetite

Symptoms of mild inner ear infection usually last 3 to 7 days in children.

Babies younger than 6 months who have the symptoms of inner ear infections need proper medical treatments. Parents should seek medical attention if their child complains of severe ear pain or has a fever higher than 39°C (102°F).

What causes an ear infection?

Infections in the inner ear are usually caused by bacteria and viruses. These infections often result from an obstruction in the eustachian tubes, leading to the build-up of fluid in the middle ear. A eustachian tube is a narrow tube that arises from each ear, connecting it to the back of the throat. The infection in the ear tubes can easily spread to the inner ear, resulting in the development of otitis interna.

Some common causes of blockage in the eustachian tube include:

  • An upper respiratory infection, such as the common cold

  • Allergies 

  • Excess mucus

  • Sinus infections

  • Changes in air pressure

  • Smoking

Ear infections can sometimes develop from infected adenoids. The adenoids are small glands located on the roof of the mouth behind the nose. Infections from these glands can spread to nearby structures, such as the eustachian tubes, thus increasing the risk of inner ear infections.

What are the risk factors for ear infections?

Inner ear infections are more common in young kids as their eustachian tubes are short and narrow. Nearly 80% percent of children develop an acute infection in the ear at some point.

The incidence of this condition is higher in bottle-fed infants compared to their breastfed counterparts.

Some other factors that can increase the risk of inner ear infections include:

  • Low birth weight

  • Changes in external temperature or humidity

  • Altitude changes

  • Exposure to cigarette smoke

  • Recent ear infection

  • Pacifier use

  • Being in daycare

Potential complications of inner ear infections

Ear infections often clear up without any active medical intervention. However, in some cases, they may recur, putting the patient at risk of serious complications. Some adverse symptoms associated with inner ear infections include:

  • Hearing loss

  • Delayed speech or language skills in children

  • Meningitis (infection of the membranes called meninges covering the brain and spinal cord)

  • Mastoiditis (infection of the mastoid bone)

  • Ruptured eardrum

Diagnosis of ear infections

Your healthcare professional will make the diagnosis of ear infections based on your symptoms and the examination of the ears using an instrument called an otoscope. An otoscope has a lens and a source of light that allows the doctors to see the inner parts of your ear clearly.

The examination can help to reveal:

  • Redness, pus-like fluid, or air bubbles inside the middle ear

  • Collapse or bulging of the eardrum

  • Perforation in the eardrum

In addition, the testing of the fluid sample from your ear in a laboratory may be needed to determine the types of antibiotics you need.

Your doctor may also recommend a computed tomography (CT) scan to determine the extent of damage and check if the infection has spread. Tympanometry, acoustic reflectometry, and hearing tests are recommended based on the specific symptoms of patients and their response to the treatment.

Treatment of inner ear infections

Simple home remedies and the use of over-the-counter medications can often help to relieve the symptoms of inner ear infections. If symptoms persist, medical treatment may be needed.

Home remedies for ear infections

  • Avoid sleeping on the affected ear

  • Apply a warm cloth

  • Use over-the-counter pain-relieving medication or ear drops

Medical treatments

If the symptoms do not improve or become worse, you must see your physician. Your doctor might prescribe antibiotics if the infection is bacterial, chronic, and does not appear to be improving.

However, it is important to note that antibiotics can be used to treat viral infections.

Surgery

Surgical interventions may be needed when the ear infection is not cleared with medical treatments or if the patient develops several episodes of ear infections over a short period of time.

The surgery involves placing small tubes in the ears to facilitate the drainage of fluid. These tubes are inserted into the eardrums through a minimally invasive procedure. The tubes eventually fall out, leaving small holes that heal over time. In some cases, these holes need to be closed surgically.

Inner Ear Infections: Frequently Asked Questions

How do you get rid of an inner ear infection?

The use of home remedies and over-the-counter medication, such as pain relievers, can often help to clear inner ear infections. Drinking ginger tea is an effective remedy for managing vertigo caused by ear infections. 

Can an inner ear infection go away on its own?

Yes, inner ear infections often go away on their own without the need for active medical intervention.

What is the difference between a middle ear infection and an inner ear infection?

A middle ear infection affects the middle ear located just behind the eardrum, while an inner ear infection affects the vestibule.

Problems affecting the hearing are more likely to be due to an infection in the inner ear than in the middle ear infections.

Is it safe to use earplugs?

Moisture in the ear canal is a common cause of fungal and bacterial infection. Water can find many ways to enter your ears, such as while bathing or swimming.

Moisture can create a perfect environment for the growth of bacteria, allowing the infection to persist and become worse. Hence, patients who suffer from repeat ear infections need to take extra precautions to protect their ears by keeping the ear canals dry.

This can be achieved by using earplugs while swimming or bathing. In addition, they should wipe the outer ear properly using a clean towel after bathing or swimming to keep them dry.

How to prevent ear infections?

  • Wash your hands often.

  • Avoid exposure to secondhand smoke.

  • Avoid overly crowded areas.

  • Forgo pacifiers with infants.

  • Take immunizations as recommended.

 

References:

1. https://www.ncbi.nlm.nih.gov/books/NBK560506/

2. https://www.nidcd.nih.gov/glossary/vestibular-neuronitis

3. https://www.ncbi.nlm.nih.gov/books/NBK549866/

4. https://www.nidcd.nih.gov/glossary/labyrinthitis

5. https://www.ncbi.nlm.nih.gov/books/NBK470332/

6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818021/