Treatment of ear inflammation

Ear inflammation can develop for several reasons, such as frequent infections, fluid retention, or weakened immunity. In some individuals, symptoms occur seasonally, while in others they may be more frequent and severe. Timely action and professional assessment prevent complications and support recovery. Although it may sometimes seem sufficient to wait for symptoms to pass, delayed intervention can prolong discomfort and affect hearing. It is therefore important to recognize early signs and consult a doctor in time. At Dr Prlja Medical in Belgrade, we give attention to every patient and provide reliable treatment of ear inflammation with modern diagnostics and a gentle approach. Scheduling an appointment is simple, and our support begins from the first contact. Contact us today and check your hearing health with a team you can trust.

Ear inflammation – when is it time to see a doctor?

If you feel uncomfortable pressure in the ear, ringing, or notice symptoms that may indicate hearing loss, these may be signs that it is time to visit a specialist. In addition, if fluid is coming from the ear, it may indicate an infection that requires careful medical evaluation. Fatigue often accompanies some of these symptoms, further highlighting the need for an examination.

• Acute ear inflammation usually lasts between 3 and 7 days. In most cases, symptoms develop quickly and are accompanied by pronounced discomfort. If the condition does not improve within seven days, there is a risk of complications or progression to a chronic form.
• Chronic ear inflammation lasts more than three months. Symptoms are usually milder but may persist for a long time and affect hearing and daily life.

It is also necessary to distinguish between viral and bacterial inflammation. Viral infections are more common, especially in children, and are usually treated symptomatically, without antibiotics. Bacterial inflammation may be recognized when there is a worsening effect after initial improvement, or when there is pronounced localized ear pain.

Ear inflammation in children: how to recognize it?

Parents should watch for the following in children:

• irritability
• refusal to eat
• frequent ear rubbing

Such behavior may indicate a hearing problem in your child. It is necessary to schedule an urgent ENT examination if the discomfort persists or symptoms worsen — this is a clear sign that prompt medical intervention is needed.

How ear inflammation is diagnosed at Dr Prlja Medical

To establish an accurate diagnosis, it is necessary to begin with a specialist ENT ear examination, which includes a detailed patient interview (anamnesis), physical examination of the ear using an otoscope, and, if needed, additional diagnostic procedures. The examination usually starts with a visual inspection of the external ear canal and the eardrum to detect possible changes, redness, discharge, or signs of perforation.

• If there is suspicion of fluid in the middle ear or dysfunction of the Eustachian tube, the doctor may perform tympanometry. This test objectively measures middle ear pressure and eardrum mobility, detecting the presence of fluid, negative pressure, or adhesions. It is completely painless and highly effective for diagnosing ear inflammation even in very young children.
• Audiometry — a hearing test used in adults and children over five years old — is applied to assess hearing function and identify possible hearing loss. The test measures hearing thresholds at different frequencies and helps distinguish between conductive and sensorineural hearing loss, which can further guide treatment.
• In certain cases, if there is a chronic infection, additional procedures may be recommended, such as taking an ear discharge swab for microbiological analysis, which helps in selecting a targeted antibiotic.

Possible diagnoses identified during this examination

When an ENT specialist examines the ear, several precise diagnoses may be made.

• Otitis externa is inflammation of the external ear canal, often caused by bacteria such as Pseudomonas aeruginosa or Staphylococcus aureus. It presents with swelling, itching, redness, and sometimes discharge.
• Otitis media, an acute inflammation of the middle ear, involves an inflammatory process behind the eardrum and can cause pain, fever, and exudate that may pass through if the eardrum becomes perforated.
• A longer-lasting form of the disease appears as secretory otitis, also known as “glue ear,” when fluid collects behind an intact eardrum without causing typical acute symptoms. This condition can persist for weeks or months and often affects hearing without significant pain.
• In some patients, the eardrum may be permanently damaged, leading to perforation — a lasting hole that may prevent spontaneous healing, especially if recurrences or complications occur.

Next steps after diagnosis

Once the diagnosis is confirmed, our team of ENT specialists will propose a personalized treatment plan, which may include various methods to relieve symptoms of ear inflammation.

When are antibiotics recommended and how do they work?

Antibiotics are recommended for acute bacterial middle ear inflammation (otitis media acuta), which most often occurs after a viral respiratory infection. Typical signs of bacterial infection include:

• high and persistent fever (above 38.5 °C)
• thick, purulent discharge from the ear
• pronounced local pain and pressure
• worsening of symptoms after initial improvement

The most commonly used antibiotic is amoxicillin (a penicillin antibiotic), which acts on gram-positive and some gram-negative bacteria by disrupting their cell walls. This eliminates pathogens such as Streptococcus pneumoniae and Haemophilus influenzae, the most common causes of otitis in children.

If resistance or allergy is present, amoxicillin–clavulanic acid, cefuroxime, or macrolides such as azithromycin are used.

When is symptomatic therapy sufficient?

In viral inflammation, symptoms are milder and last no longer than 3–5 days, the temperature is moderate, there is no purulent discharge, and pain is mild and fluctuates. In such cases, treatment of ear inflammation includes:

• paracetamol or ibuprofen to reduce fever and relieve pain
• ear drops with decongestants to improve Eustachian tube function and reduce middle ear pressure

When and why are follow-up examinations important?

A follow-up is scheduled 7 to 14 days after completing therapy. At that time, we check whether the eardrum has returned to its normal position, whether middle ear fluid has disappeared, and whether there is a persistent perforation (hole) in the eardrum. Warning signs may include:

• persistent symptoms such as tinnitus (ringing in the ear), a feeling of fullness, or discomfort when swallowing
• reduced hearing, indicating fluid retention
• recurrence of infection within a short period, which may suggest secretory otitis

If signs of complications are detected (e.g., persistent perforation), additional diagnostic tests or surgical options may be recommended.

Surgical treatment

If secretory otitis occurs or fluid does not resolve spontaneously and affects hearing, the doctor may recommend tympanostomy. Tympanostomy is advised when:

• there is reduced hearing, especially in children during speech development
• fluid in the middle ear persists for more than 3 months
• infections recur (more than 4 times a year)

The procedure involves making a small opening in the eardrum and inserting a ventilation tube (grommet) that allows aeration of the middle ear and drainage of fluid. The intervention enables ventilation of the middle ear, prevents fluid accumulation, and helps restore hearing.

Prevention of ear inflammation

Prevention of ear inflammation begins with proper care of the external ear canal. Excessive or rough use of cotton swabs can damage the natural protective layer of cerumen, which protects the skin from irritation and infection. Damaged ear skin more easily becomes an entry point for bacteria, increasing the risk of external ear infections, known as otitis externa.

Special attention should be given to ear contact with water, especially during swimming. Entry of contaminated or chlorinated water into the ear canal can disrupt the skin’s pH balance and create conditions for bacterial growth, leading to swimmer’s ear.

To prevent this, it is recommended to use silicone earplugs or headbands that protect the ear canal from moisture. After swimming, mild acidic solutions, such as boric acid solutions in alcohol, can be applied. These solutions lower the skin surface pH in the external ear canal, speed up drying of remaining moisture, and have an antiseptic effect, reducing the risk of infection.

In children and people with weakened immunity, additional immune support measures and preventive ENT check-ups are advised. This includes vitamin D and C supplements, as well as a diet rich in antioxidants. Regular time outdoors and moderate physical activity also positively influence the body’s resistance.

Take the first step – do not delay treatment of ear inflammation

If you experience hearing problems, ringing, pressure, or fluid from the ear, it is best to come in for an examination. Early diagnosis helps avoid more serious complications and ensures faster recovery. This is especially important in children and older adults, where timely action makes a big difference. At Dr Prlja Medical Clinic in Belgrade, every patient receives the care they need. Whether symptoms appear for the first time or occur repeatedly, our team of doctors will listen to you and choose the best treatment of ear inflammation. The examination is quick, safe, and without discomfort, and therapy is prescribed according to an accurate diagnosis. If you notice any sign of a problem, do not wait for it to worsen. Call us and book your appointment today. Our team is here to help you hear again and live without discomfort.