From the Guidelines
The proper treatment for an ear injury depends on the type and severity of the injury, and prompt treatment is essential to prevent permanent damage and potential hearing loss or infection. For minor external ear injuries, such as those resulting from ear piercings, clean the area gently with mild soap and water, apply an antibiotic ointment like Bacitracin or Neosporin, and cover with a clean bandage 1.
Key Considerations
- For pain, take over-the-counter medications such as acetaminophen (Tylenol) at 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) at 200-400mg every 6-8 hours as needed.
- If there's bleeding from the ear canal, place a clean, loose cotton ball at the opening (don't insert it) and seek immediate medical attention.
- For a ruptured eardrum, keep the ear dry, avoid swimming, and use antibiotic ear drops if prescribed by a doctor, typically 3-4 drops 3-4 times daily for 7-10 days.
- Serious injuries like deep cuts requiring stitches, significant bleeding, hearing loss, severe pain, dizziness, or discharge require immediate professional medical care.
Additional Guidance
- Avoid inserting objects into the ear canal, including cotton-tipped swabs, as this can cause further injury or push wax and debris deeper into the ear canal 1.
- For acute otitis externa, pain relief is an essential component of management, and frequent use of appropriate analgesics at adequate doses is necessary to permit patients to achieve comfort, rest, and resume normal activities 1.
- Topical therapy, such as antibiotic ear drops, is the most effective treatment for acute otitis externa, and patients should be instructed to use the drops for at least 7 days, even if symptoms resolve sooner, to prevent relapse of infection 1.
From the Research
Ear Injury Treatment
The proper treatment for an ear injury depends on the type and severity of the injury.
- For acute otitis media, management should begin with adequate analgesia 2.
- Antibiotic therapy can be deferred in children two years or older with mild symptoms, but high-dose amoxicillin (80 to 90 mg per kg per day) is the antibiotic of choice for treating acute otitis media in patients who are not allergic to penicillin 2.
- Children with persistent symptoms despite 48 to 72 hours of antibiotic therapy should be reexamined, and a second-line agent, such as amoxicillin/clavulanate, should be used if appropriate 2.
Treatment of Ear Infections with Perforation
For patients with a discharging ear and a perforation or patent grommet:
- Topical aminoglycosides should only be used in the presence of obvious infection 3.
- Treatment with topical aminoglycosides should not exceed 2 weeks 3.
- The justification for using topical aminoglycosides should be explained to the patient, and baseline audiometry should be performed if possible or practical before treatment 3.
Special Considerations
- Children with evidence of anatomic damage, hearing loss, or language delay should be referred to an otolaryngologist 2.
- Otitis media with effusion is defined as middle ear effusion in the absence of acute symptoms, and antibiotics, decongestants, or nasal steroids do not hasten the clearance of middle ear fluid and are not recommended 2.