Drain Ear Fluid

Fluid in the ear is one of the main effects of middle ear infections, or acute otitis media (OM). Ear infections result when fluid (usually pus) is in the inner ear and causes pain, redness of the eardrum, and potentially also a fever. Fluid in the ear, however, can also persist after an infection has dissipated; this is called otitis media with effusion (OME). Ear infections and fluid are more common in small children than adults. Though there are some home remedies for draining ear fluid, in most cases, ear fluid will clear on its own. Moreover, treatment of the underlying cause of the problem is the most important step.

Steps

Diagnosing the Problem

1. Take note of visible symptoms related to the ear. The most common symptoms of OM and OME include ear pain or ear tugging (if the child can't yet verbalize pain), fussiness, fever, and even vomiting. In addition, a child may eat or have trouble sleeping normally because lying down, chewing, and sucking can alter the pressure in the ear and cause pain.
   • Given that the age group most commonly affected from ear infections and fluid ranges from three months to two years old, parents or primary caregivers will be required to give as much information and history as possible to the doctor on their children's behalf. Thus, it's important to keep track and careful record of any noted symptoms.
   • Be aware that OME often has no symptoms. Some people may experience a feeling of fullness in their ear or a "popping" sensation.
   • If you notice any discharge of fluid, pus or bloody discharge, see a doctor immediately.
2. Keep track of symptoms related to the "common cold." Ear infections are considered secondary infections that follow the "common cold," or the primary infection. You should expect to see a few days of nasal discharge or congestion, cough, sore throat, and a low fever, all typical symptoms that accompany colds.
   • Most colds are due to viral infections and, given that there is no treatment for viral infections, there is usually no reason to seek medical attention. Only seek medical attention if the fever cannot be controlled through appropriate doses of Tylenol or Motrin (and reaches temperatures higher than 102°F or 38.9°C). Keep track of all symptoms of the cold, as your doctor will want to know about the primary infection. The cold should last for a week. If you don't see improvement after a week, visit your doctor.
3. Look for signs of hearing problems. OM and OME can block sounds, which can lead to hearing issues. Signs that proper hearing may be impacted include:
   • Failure to respond to soft sounds or other noises
   • The need to turn up the TV or radio to a louder volume
   • Talking in an unusually loud voice
   • General inattentiveness
4. Understand the potential complications. Most ear infections don't cause long-term complications and often go away on their own within 2-3 days. However, frequent infections or fluid build-up post-infection can result in some serious complications, including:
   • Impaired hearing — Although slight difficulties in hearing are common with ear infections, more severe hearing loss can be a result of ear persistent infections or fluid, which can in some cases cause damage to the eardrum and middle ear.
   • Speech or developmental delays — In young children, hearing loss could result in developmental delays in speech, particularly if they are not yet verbal.
   • Spread of infection — Infections that remain untreated or that do not respond to treatment can spread to other tissues and should be addressed immediately. Mastoiditis is one possible infection that can result in the bony protrusion behind the ear. Not only can this bone become damaged but pus-filled cysts can also develop. In a few rare cases, severe middle ear infections can spread into the skull and affect the brain.
   • Tearing of the eardrum — Infections can sometimes result in a tearing or rupturing of the eardrum. Most tears usually heal within three or so days, but in a few exceptional incidences, surgery may be required.
5. Make an appointment with your doctor. If you suspect an ear infection or OME may be at work, see a doctor to confirm the diagnosis. The physician will examine the ear using an otoscope, a small instrument that looks like a flashlight. This helps the doctor see into the eardrum. Usually this is the only instrument they need to determine a diagnosis.
   • Be prepared to answer questions about the onset and nature of the symptoms. If it is your child who is affected, you will need to answer on his behalf.
   • You may be referred to a specialist in ear, nose and throat (ENT) disorders (otolaryngologist) if the problem is persistent, frequent or unresponsive to treatment.

Draining Ear Fluid

1. Use a nasal steroid spray. These are available by prescription and can help open up the Eustachian tube. It works by reducing inflammation in the nose, which in turn helps the Eustachian tube to clear out. Note, however, that it takes a few days for the steroid to build up to its full effect; this means that you will not experience immediate relief.
2. Use decongestants. Using an over-the-counter decongestant or medication can unblock your ear help drain the fluid. You can get them in the form of nasal sprays or as oral medication and they can be purchased at most pharmacies. Be sure to follow any instructions on the label.
   • Nasal decongestant sprays should not be used for more than three days at a time. Longer term use has been linked to "rebound" swelling of the nasal passages.
   • While the "rebound" swelling is less common with oral decongestants, some people experience palpitations or a rise in blood pressure.
   • Children may experience other side effects, such as hyperactivity, restlessness, and insomnia.
   • Avoid nasal sprays containing zinc. These have been linked to permanent loss of the sense of smell (rare).
   • Consult your doctor before using any nasal decongestant spray or oral decongestants.
3. Take antihistamine tablets. Some people find antihistamines useful, particularly in longer-lasting occurrences of sinus infections, because they can ease nasal congestion.
   • However, antihistamines can have serious side effects for the sinuses, including the drying up of the mucous membranes of the nasal tissue and thickening the secretions.
   • Antihistamines are not recommended for the treatment of uncomplicated sinusitis or ear infections.
   • Other side effects include drowsiness, confusion, blurred vision or, in some children, moodiness and overstimulation.
4. Do a steam treatment. A home steam treatment can help to open the Eustachian tube and release the fluid. Basically all you need is a warm towel and a bowl of hot water.
   • Fill a large bowl with boiling water; you can also add anti-inflammatory herbs to the water, such as chamomile or tea tree oil. Cover your head with the towel and hold your ear over the steam bath. Try not to crane your neck, and only stay under the towel for 10-15 minutes.
   • You can also try having a very hot shower and seeing if the steam from that can help loosen and drain the ear fluid. Do not try this with children, as they are not as tolerant of extreme temperature changes.
5. Use a blow dryer. Though this technique is highly debated, controversial, and scientifically unsupported, some people have had anecdotal success with it. In essence, you run your hair dryer on the lowest heat and blow setting available as you hold the mouth of the dryer a foot or so away from your ear. The idea is that the warm and dry air will turn the fluid in your ear to steam and help draw it out.
   • Take caution not to burn your ear or the side of your face. If you feel any pain or overly hot, stop using the dryer.
6. Use a humidifier. To help clear out your ear when you have an infection and improve the health of your sinuses, place a humidifier in your bedroom on a side table so it’s close to your affected ear. This will encourage the production of steam and help ease and alleviate the buildup of fluid in your ear. Humidifiers are good during the wintertime because the air in most homes is very dry due to central heating.
   • Even placing a hot water bottle near the ear may have a similar effect and help to draw out ear fluid.
   • For children, a cool mist humidifier is recommended — it decreases the risk of getting burned or injured.
7. Note that all of these methods have not been supported with reliable scientific data. Most studies suggest that these methods have little to no effect. Ultimately, in most cases the fluid that collects in the inner ear almost always fixes itself, unless it is the result of a chronic condition or persistent ear infections.
   • Most of these treatments, after all, really only treat the symptoms (e.g., ear fluid, congestion, etc.) and not the main problem itself (e.g., OM, OME, a blockage or other problem in the Eustachian tube).

Treating Ear Infections and Persistent Fluid

1. Be aware that there is no single best approach for treatment. When deciding on a course of treatment your doctor will consider a number of factors, including age, the type, severity, and duration of the infection, the frequency of ear infections in the medical history, and whether the infection has resulted in hearing impairment.
2. Follow the "wait-and-see" approach. Most of the time, the human immune system can fight off and heal ear infections with a bit of time (usually two to three days). The fact that most ear infections can actually clear up on their own has led a number of physician associations to support the "wait-and-see" approach, which essentially means administering pain relief but not treating the infection with antibiotics.
   • The American Academy of Pediatrics and the American Academy of Family Physicians recommends the "wait-and-see" approach for children from six months old to two years old who experience ear pain in one ear and for children over two years who have pain in one or both ears for less than two days and have a temperature of less than 102.2°F (39°C).
   • Many doctors support this approach because of the inherent limitations of antibiotics, including the fact that they are often overused and have lead to the proliferation of antibiotic-resistant bacteria. In addition, antibiotics can't treat an infection caused by a virus.
3. Take antibiotics. If the infection does not go away on its own, your doctor will likely prescribe a 10-day course of antibiotics, which can treat the infection and potentially shorten some symptoms. Commonly prescribed antibiotics include Amoxicillin as well as Zithromax (the latter case if you are allergic to penicillin). Antibiotics are often prescribed for individuals who suffer from frequent infections or for those with severe and extremely painful infections. In most cases, the antibiotics clear any fluid in the ear.
   • For children ages six and up who have a mild to moderate infection as determined by the doctor's assessment, a shorter course of antibiotic treatment (five to seven days instead of 10) may be prescribed.
   • Note that benzocaine has been linked to a rare but sometimes fatal condition that decreases oxygen in the blood, particularly in children under two years old. Do not administer benzocaine in children and if you are an adult, only use the recommended dose. Talk to your doctor about the potential risks.
4. Always complete the full course of antibiotics. Even if symptoms improve partway through the course of antibiotic treatment, make sure to finish the full prescription. If you are prescribed enough for 10 days, then you need to take the antibiotics for 10 days. However, you should notice improvement within 48 hours. A persistent high fever (of over 100°F or 37.8°C) suggests resistance to that particular antibiotic and you may need to acquire a different prescription.
   • Note that even after antibiotic treatment, fluid may remain in the ear for several months. You should consult your doctor after the course of antibiotic treatment has ended to check on on the infection and determine whether fluid is still present. Your doctor will usually want to see you about a week after the end of the antibiotic treatment.
5. Undergo a myringotomy. Ear surgery may be an option in cases of prolonged ear fluid (when fluid exists for more than three months after an infection has cleared up or in the absence of any infection), recurrent OME (three episodes in six months or four episodes in a year with at least one occurring in the past six months), or frequent ear infections that don't clear up through antibiotics. The surgery, called a myringotomy, involves draining the fluid from the middle ear and inserting a ventilation tube. Usually, you will need to be referred to an ENT to determine whether this surgery is appropriate.
   • In this outpatient surgery, an ENT specialist will surgically place the tympanostomy tube into the eardrum through a small incision. The process should help ventilate the ear, prevent the buildup of more fluid, and allow existing fluid to drain completely from the middle ear.
   • Some tubes are intended to stay in place for six months to two years and then fall out on their own. Other tubes are designed to stay in longer and may need to be surgically removed.
   • The eardrum usually closes up again after the tube falls out or is removed.
6. Undergo an adenoidectomy. In this surgery, the small glands in the throat at the back of the nose (the adenoids). This is sometimes an option in cases of recurrent or persistent problems with the ears. The Eustachian tube runs from the ear to the back of the throat and is met by the adenoids. When inflamed or swollen (due to a cold or sore throat) the adenoids can press on the entrance of the Eustachian tubes. Moreover, bacteria on the adenoids can sometimes spread up into the tubes, causing infection. In these cases, problems and blockages in the Eustachian tubes lead to ear infections and fluid buildup.
   • In this surgery, more common in children whose adenoids are larger and thus more likely to cause problems, an ENT specialist removes the adenoids through the mouth while the patient is under anesthetic. In some hospitals, the adenoidectomy is done as a day surgery, meaning that you can go home the say day. In other cases, surgeons like to keep the patient in hospital overnight for supervision.

Managing Pain

1. Use a warm compress. Place a warm, moist washcloth over the affected ear to lessen the pain and throbbing ache. You can use any warm compress, such as a hot towel wrung out in warm-to-hot water, against the ear for immediate relief. Make sure that the water isn't too hot, especially when using this method on children.
2. Administer pain medication. Your doctor may recommend the use of over-the-counter acetaminophen (Tylenol) or ibuprofen (Motrin IB, Advil) to relieve pain and ease any discomfort. Be sure to follow the dosage specified on the label.
   • Use caution when giving aspirin to children or teens. Aspirin is technically considered appropriate for ingestion by children over two years old. However, because aspirin has recently been linked with Reye's syndrome, a rare condition that can cause severe liver and brain damage in teenagers recovering from chickenpox or the flu, use caution when giving aspirin to adolescents. Consult your physician if you have concerns.
3. Administer ear drops. Your doctor may prescribe ear drops, such as antipyrine-benzocaine-glycerin (Aurodex) to relieve pain as long as the eardrum remains in tact and not torn or ruptured.
   • To administer drops to a child, warm the bottle by placing it in warm water. This will make the drops less of a shock to the ear since they won't be freezing cold. Have your child lie down on a flat surface with the infected ear facing you. Administer the drops as directed on the label. Follow the recommended dosage and do not use more. Follow the same procedure if you are administering drops to another adult or yourself.

Tips

• In some cases, OME may occur without prior presence of an ear infection; instead, there may be a problem with the Eustachian tube itself.

Warnings

• Do not attempt to remove fluid from the ears using a cotton swab. This can push debris in further and damage the eardrum.

Related Articles

• Remove Fluid in Ears
• Unclog the Inner Ear or Eustachian Tube
• Tell if Your Ear Is Starting to Drain
• Unclog a Clogged Ear

Sources and Citations

See also

• Remove Ear Hair
• Clean Your Ears
• Get Rid of Ear Wax
• Use Ear Candles
• Remove Water from Ears
• Remove Fluid in Ears
• Unclog a Clogged Ear
• Clear up Ear Congestion With Olive Oil
• Remove Wet Wax from Infected Ears
• Make a Homemade Ear Cleaner