The human ear is divided into three parts, namely the outer, middle and inner ear. All these parts function in coherence with each other and help us in converting vibrations into sound and information. The middle ear consists of the air space between the inner ear and the outer ear and contains the bones that transmit the vibrations of the outer ear and translate them into information. This area is prone to infections, especially among children and thus may cause discomfort or pain. 

Symptoms of middle ear infections
Middle ear infections primarily tend to manifest themselves as inflammation of the tissues and buildup of fluids. Some of the symptoms are mentioned below.

1. Infections in children - middle ear infections primarily occur in children although it can occur in adults as well. Some of the common symptoms could be:
A. Ear pain either sitting or standing up and especially while lying down
B. Irritability and crying, which in infants could translate to more than usual crying 
C. Problems with sound and difficulties in hearing
D. Fluid buildup causing balance related problems
E. Discharge of fluid in certain cases
F. Unable to sleep and also loss of appetite
G. In some cases children may have high fever

Causes of middle ear infections 
The primary cause of middle ear infection is due to the presence of bacteria or virus in the area. The eustachian tube, which runs from the middle ear to the back of the throat, is connected to nasal passages as well. Any infection that affects the throat or the nose may also affect the middle ear through this tube. Primary causes for the infections could be
A. Cold or flu like symptoms, which then infect the middle ear as well
B. Otitis media, which is the buildup of fluid and inflammation either due to the presence of bacteria and viruses or even without it
C. Seasonal infections, which are common during late autumn or winters
D. Air pollution is also known to be a factor
E. Infection from others, especially in the case of children when they are part of a group care
F. Children from 6 months to 2 years are also susceptible to middle ear infections as their immune systems are much less developed.

Treatment of middle ear infections
Usually, middle ear infections resolve on their own within a day or so. You can try warm compress with a soft piece of cloth to ease the pain. However, if pain persists for too long then antibiotic medications may be required to fight the infection with pain relief medications to lessen the pain and discomfort.

All About Middle Ear Infections

The infection of the bone of the ear is Mastoiditis. This may be an acute infection needing hospitalisation and injectable drugs or may be in the form of slow bone eroding processes like cholesteatoma.

Let us learn more about this condition and its treatment

Understanding the mastoid bone: The mastoid bone is made up of air sacs and it looks a lot like a sponge. In this sense, it is different from the other bones that can be found in the human body. In order to function properly, this bone requires air from the other parts of the ear, including the Eustachain Tube which connects the middle part of the ear with the portion that lies at the back of the throat. If this tube gets infected due to any reason, the infection and bacteria can also travel to the Mastoid bone, leading to an infection in this area. Another form of the infection starts from the ear drum and a slowly progressive bone eroding process starts which spreads into the air sacs and can potentially spread to the brain.

Symptoms: Acute mastoiditis will present with earache, ear discharge and onset of fever and chills, as well as redness and inflammation behind the ear. Pain in the ear may be experienced along with headaches and swelling that may be experienced behind the eyes. At the very earliest sign, these symptoms must be reported to an ENT or ear throat nose specialist so that the treatment can happen at the earliest. Chronic mastoiditis may be due to repeated infections and bone eroding cholesteatoma which presents with repeated episodes of ear discharge which may be foul smelling and may even have blood.

Diagnosis: The diagnosis is mostly made on ear examination and may involve imaging tests like a CT scan as well as an MRI scan of the head and the ear. A simple X-ray of the mastoids can help in detecting the severity of the infection, and it spread.

Treatment: After diagnosing the problem with imaging tests as well as a detailed ear examination, the doctor will usually start the treatment by admitting the patient in the hospital. Antibiotic medication will be administered through intravenous methods, after which oral antibiotics will be prescribed for many days after the patient has been discharged from the hospital. Surgery may be required if the infection has not cleared up even after the use of antibiotics and is also done in cases of bone erosion. This surgery will be done to drain the infected fluid from the ear and remove a part of this Mastoid bone. Complications like facial paralysis and vertigo need to be discussed with the surgeon before the surgery.

Acute Mastoiditis - Symptoms, Diagonisis & Treatment

Swimmer's ear is an infection of the ear canal, the passage that carries sounds from the outside of the body to the eardrum. It can be caused by many different types of bacteria or fungi.

Swimmer s ear is a kind of infection which occurs in the outer ear canal and it results in an infected ear canal, long-term pain and irritation. Swimmer s ear, as you can understand by the name, is referred in such a way because it is caused by water which is left inside the ear after swimming. The stuck water inside the canal gets damp where bacteria and fungus grows and results in an infection. Now we will discuss what are the causes that can bring such a condition.

Causes of Swimmer s Ear - There are many reasons because of which people suffer from a swimmer s ear: The entry of too much water inside the ear canal, leaves a part of it inside the ear which eventually allows bacteria to infest. The overcleaning of the ear canal with cotton buds causes the ear wax to come out which allows water to enter. When cosmetic chemicals like hair spray, enter the ears, it causes a sensitive chemical reaction which can lead to infection. Careless scratching inside the ear can result in small cuts inside the sensitive canal, where bacteria can infest. Swimming in water without covering your ears can also cause this.

So next time when you are swimming or scratching your ear without safety, remember that it can cause a swimmer s ear. But you may have a question in mind, how will I know if I am suffering from this? We have thus listed the symptoms as well.

Symptoms of Swimmer s Ear-

Constant itching and irritation inside the ear. The pain or itching increases when you pull your year or chew something. There is an acute sensation of blockage inside the ear which is caused because of this condition and results in reduced levels of hearing. Someone suffering from swimmer's ear will have pus or ear fluids draining out from their ears.

Swimmer s ear condition can be easily prevented if you follow some simple but very effective steps like blocking your ear with buds while swimming, cleaning the ear softly so that no water remains stuck etc. If you neglect any of the symptoms, they can result in a very chronic disease which can even result in hearing loss. So read through our article and understand what Swimmer s ear is. 

Swimmer's Ear - What Causes It?

Vertigo is a feeling that your head or your surrounding is spinning. It is an illusion of movement. People with vertigo cannot bend down to pick up stuff, as they may feel the spinning sensation.
There are two types i.e. objective and subjective. Vertigo is said to objective when the surrounding seems to be spinning; subjective is when the person feels their head is spinning. Vertigo can be slightly mysterious to diagnose. There are, however, some causes which can help you understand it better. There are two main types of vertigo: Central and Peripheral. Central vertigo is when there is an issue in the brain that is causing vertigo. Middle ear problems leading to vertigo is known as peripheral vertigo.

Central vertigo:

Paroxysmal positional vertigo (BPPV): Also known as, Benign paroxysmal positional vertigo (BPPV). These episodes are benign and occur in paroxysms or spurts. The person will feel the attack with simple actions like turning over in bed. They do not last long, often about 20 to 30 seconds.
Migraine: Known for the severe headaches, migraine can also cause vertigo.
Head trauma: This type of vertigo usually subsides with time as the person recovers from trauma.
Neck injuries: Injury to nerves and blood vessels in the neck can also lead to vertigo.
Health conditions: General health issues like arteriosclerosis, multiple sclerosis, and diabetes lead to vertigo.
Stroke or blood flow blockage: When blood does not reach the base of the brain, it can result in vertigo.
Peripheral vertigo:

Middle ear infections: Labyrinthitis (either bacterial or viral) a middle ear infection can cause vertigo. Common viruses include herpes, influenza, measles, rubella, hepatitis, and EBV.
Meniere s disease: Another ear problem causing vertigo is Meniere s disease. This is known for its 3 symptoms   vertigo, ringing in the ears (tinnitus) and hearing loss. This can be caused by various factors, some of which can include ear infections, head injuries, or heredity. The exact cause of the condition is not established clearly.
Acoustic neuroma: A tumor of the nerve tissue in the inner ear may cause vertigo. The person can also have hearing loss and ringing sensation.
Other causes of vertigo include:

Pregnancy: During the first trimester, in particular, the various hormonal changes can cause vertigo. The expanding uterus puts pressure on the blood vessels, leading to reduced blood supply to the brain, which can also induce vertigo. As the baby continues to grow, lying on the back can put pressure on the blood vessels to the heart, causing vertigo.
Stress: It is known to worsen vertigo, which a person may already have. Anxiety and panic attacks are known to worsen vertigo.
Travelers: Be it ship, air, or train, some people experience a spinning sensation with any form of travel.


Vertigo In Adults - Why It Happens?

If you hear a constant ringing in your ears without any external stimulus, it is called tinnitus. The sound can also manifest as incessant roaring, hissing, buzzing or clicking. The sound can be loud or soft, low or high pitched. Tinnitus can occur in one ear, or both the ears.

Tinnitus is primarily of two types:
i. Subjective tinnitus: This type of tinnitus is very common. In this type, only you are able to hear the ringing, or buzzing. The main cause of subjective tinnitus is ear problems, especially in the inner, middle and outer ear. Problems in the auditory nerves (hearing) or auditory pathways (the part in your brain that changes nerve signals into sound) can also cause subjective tinnitus.
ii. Objective tinnitus: In this type of tinnitus, the doctor can also hear the sound when he/she performs an examination. This type of tinnitus is rare. Muscles contractions, problems in the blood vessels or conditions in the middle ear bone can cause objective tinnitus.

Causes
Tinnitus is not a condition; it is more of a symptom of some other underlying medical condition. Tinnitus can be caused by any of the following complications-
1. Hearing loss (This happens mostly among older people)
2. Loud noises
3. Sinus and ear infections
4. Blood vessel or heart problems
5. Meniere's disease (The inner ear is affected by unknown causes which lead to deafness)
6. Brain tumours
7. Hormonal changes (This happens mostly to women)
8. Thyroid problem
9. Certain medications (antibiotics, cancer medicines, diuretics, quinine medication, some types of antidepressants, aspirin)

Symptoms 
The symptoms of tinnitus include
1. You hear noises that no one else will be able to hear
2. The sound can be depicted as chirping, whistling, screeching, clicking, static, hissing, buzzing, roaring, pulsing, musical or whooshing.
3. The sounds can vary greatly in volume and it is most prominent at night or when your surroundings are quiet
4. Loss of hearing commonly follows tinnitus.

All About Tinnitus

Pilonidal Sinus/ Cyst is Characterized By 
   Small nodular swelling in the lower spinal region with occasional discharges that may stain undergarments. Sometimes mild pain may also be noticed. 
   It is usually seen in adults of college/ school going age & with hairy skin. 

Pilonidal Sinus/ Cyst seldom heal with medicinal treatment. Any medication whether allopathic, Ayurvedic or homeopathic may show some temporary relief but do not eradicate the problem. In most of the patients having pilonidal sinus/ cyst, surgeons usually recommend surgical procedures like Z-plasty etc. Even after surgery the chances of recurrences are always there. Post operative pain, hospitalization and chances of recurrence are the factors which suggest that surgery is not the appropriate method of treating pilonidal sinus/ cyst. 

TREATMENT OF CHOICE (AYURVEDA) - 
In Ayurveda, a parasurgical treatment known as Ksharsutra therapy is an effective treatment for pilonidal sinus/ cyst. Treatment method includes proper identification of sinus tract wrt. to its depth, direction and branching pattern. This could be achieved via sinogram or skilled probing. Once the sinus tract has been properly identified, a super specialized medicated thread i.e. Graded ksharsutra  is placed in the tract. The medicine from the medicated thread is gradually released which leads to debridement of the sinus tract which means unhealthy tissue, pus, hairs are expelled out from the tract. The proper and complete debridement of the tract induces healing of the sinus which subsequently heals. The medicine coated thread remains effective for 7-10 days after which it has to be replaced by a new thread. 

Usually, in a sinus of approx. 5 cm length, 6-8 sittings of medicated thread replacement are required at a weekly interval. Ksharsutra therapy being a non surgical opd procedure doesn't involve any hospitalization or bed rest and patients can resume their routine work immediately after treatment. Graded ksharsutra  treatment is the treatment of choice for Pilonidal Sinus as chances of recurrence are seldom seen. The facility of Graded ksharasutra  is available only at Sushruta Anorectal Institute. 

Pilonidal Sinus/ Cyst Treatment FAQs 

Question 1 - What is Pilonidal Sinus/ Cyst Disease? 

Answer - Pilonidal Sinus disease is seen as a small nodular swelling in the lower spinal region with occasional discharges of pus & blood. It is most commonly found in people with hairy skin. Some times mild pain may also be noticed. The main problem is that it keeps on developing again and again after short period of remission. As the problem aggravates, the size of the swelling & pus discharges also increase. It is usually not noticeable in the beginning till it keeps recurring again and again. It is advisable not to get it operated as the chances of recurrence after surgery are pretty high, where as in Ayurveda with the help of Graded ksharsutra , this problem can be completely cured without surgery. *(There is no guarantee of specific results and the results can vary.) 

Question 2 - What are the Causes of Pilonidal Sinus Disease? 

Answer -Pilonidal sinus is also known as the jeep riders back problem. The problem was first recorded on a large scale during world war II in the soldiers who rode jeeps and motorbikes on a frequent basis. Though, the reason behind the occurrence of the issue is really not known it is believed that in growing hairs and hairs penetrating the skin are main cause. The problem is more common in people who have hairy skin. Home remedies for Pilonidal Sinus? Answer - Pilonidal Sinus is an infective condition usually seen in hairy skin individuals. As such there is no home remedy for Pilonidal Sinus. So instead of wasting time in searching for home remedies; you should plan for complete treatment i.e. Ksharsutra Treatment for Pilonidal Sinus as soon as possible. 

Question 3 - What are the ways of identifying a Pilonidal Sinus and Recognizing Signs of Infection? 

Answer -The main problem with identifying Pilonidal Sinus Infection is; it cannot be done till it grows to a certain extent. At first, it appears like a normal boil on the skin. When it does not go away with time; pus starts discharging out of it. We have demarcated a few of the signs that may help you in detecting the problem. 

Sensation of pain while sitting or standing in the low back region. 
The cyst appears swollen 
Pus and blood mixed watery discharge from the cyst 
eddened skin near the cyst 
Cyst forming again and again

Pilonidal Sinus - Say No to Surgery!

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