How to Clean Middle Ear

Video Transcript

"Hi, I'm Dr. David Hill and today we're going to be talking about how to clean the middle ear. Now I think people who are asking this question may want to look at the anatomy of the ear, because there are parts of the ear that you can clean, and there are parts you really can't, so let's look at our ear model. The ear model of course starts with the outer ear, and the outer ear has this ear canal we call the external auditory canal, that ends at the tympanic membrane. That's as far as any cleaning can really happen. And the good news is, this eternal auditory canal is really self-cleaning. When ear wax forms in the external auditory canal, it tends to form in the outer part, it doesn't really form deep in the canal. And this skin tends to grow outward, it almost forms a little conveyor belt. It moves wax and whatever dirt the wax accumulates out regularly, that's why you don't always have a blocked up ear full of wax, because the wax is always coming out of the ear. So really, other than using a wash cloth and soap in the bath or the shower, you don't need to do anything at all. The thing you really don't want to do is to introduce a Q-tip, or a cotton swab. This is guaranteed to pack wax down into the ear, especially right in the middle where there's a little narrowing or twist in the ear canal. The wax gets caught right there that's bad news, so you do not want to do that. Now if you feel like you've got some hard wax in your ear you may instill a little baby oil or mineral oil. You can use over the counter products like d? sodium, or Debrox. You can even use a mixture of acidic acid, which is white vinegar and alcohol, one to one, to try to help flush that out. But you never want to introduce fluid forcibly into the outer ear because if there's a hole in this ear drum, and more people have that hole than might think, you can introduce infected fluid into the middle ear and cause an infection. Now the middle ear is a sealed chamber. It starts on the other side of the ear drum here and holds the bones that carry sound signals from the ear drum to the nerves. The only way to drain it is through the Eustachian tube that goes down into the nose, and usually this tube does a great job of carrying fluid out of the ear and into the nose where it can drain. Sometimes when somebody gets a cold, or bad allergies, or sinus infection, this tube, the Eustachian tube, can get clogged up and fluid may collect in the middle ear, and even get infected, causing acute otitis media. In older children, often antibiotics are not needed for these infections unless they're severe or complicated. They're going to go away on their own in almost all cases. In younger children, younger than age two, sometimes antibiotics help with that. Medicines that treat allergies like nasal spray, such as Fluticasone or Betamethasone, may all be helpful there in terms of opening this up and helping it drain. Decongestants haven't really shown much utility here, and in fact we don't recommend them anymore for children under age six. Some doctors may use a nasal decongestant spray for a few days, like Afrin, but remember you want to stop it after the first few days because stopping it after that gets very hard. The nose gets used to having the Afrin and it swells right back up as soon as you take the medicine away. So, talking about how to clean out the middle ear, I'm Dr. David Hill."