Gabe Mirkin, M.D.
The inner ear is full of air and is connected to the outside
through the eustachian tube that opens into the back of your
mouth. Young children have narrow eustachian tubes that can
close and fill with fluid that causes ear pressure and pain. If your
doctor sees fluid causing the ear drum to bulge outward, he
knows that the eustachian tube is closed and often prescribes
antibiotics and a cortisone-type nasal spray. Antihistamines do
not open eustachian tubes. Doctors sometimes remove tonsils
and adenoids or give allergy injections, but these treatments
have an extraordinarily high failure rate.
Since the eustachian tube enlarges as a child grows, the
tube usually opens by itself in time and it is rarely necessary to
perform surgery. However, if the doctor feels that fluid in the
drum can interfere with a child's hearing or school work or that
permanent damage in possible, it is reasonable to relieve this
pressure by punching a hole in the ear drum and inserting a tube
to keep it open. Research shows that the buildup of fluid in the
inner ear is probably caused by inactive cilia, the small hairs that
line the eustachian tube and sweep fluid toward the mouth.
Erythromycin antibiotics can stimulate the cilia, remove fluid from
the inner ear and help to relieve the discomfort.
March 1, 2006