Middle Ear Infections Treatment in Singapore

An ear infection occurs when a bacterial or viral infection affects the middle ear, the air-filled space behind the eardrum containing tiny vibrating bones.

These infections often cause fluid build-up behind the eardrum, resulting in pain and discomfort. The condition can affect people of all ages but occurs most frequently in children.

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

Middle Ear Infection Treatment Singapore

Symptoms Causes Types Diagnosis Treatment Prevention FAQ

Symptoms of Middle Ear Infections

Ear infection symptoms can differ between adults and children, but common signs include:

Ear Pain: Sharp, sudden pain that often worsens when lying down. This is one of the most noticeable symptoms.
Drainage: Yellow or white fluid leaking from the ear may indicate a ruptured eardrum, often accompanied by relief from pain.
Hearing Difficulties: Fluid accumulation in the middle ear reduces sound transmission, leading to muffled or diminished hearing.
Balance Issues: The inner ear’s involvement in balance regulation can cause dizziness or unsteadiness.
Fever: A rise in body temperature, typically above 38°C, is common, particularly in children with middle ear infections.

Causes and Risk Factors

Several factors contribute to the development of middle ear infections, ranging from anatomical differences to environmental conditions.

Upper Respiratory Infections: Colds and flu often precede middle ear infections as the airways connecting the nose, throat, and ears allow the spread of infection.
Eustachian Tube Dysfunction: Impaired function of the Eustachian tube prevents proper drainage and ventilation of the middle ear, creating a favourable environment for infections.
Age: Children are more prone to middle ear infections due to their shorter and more horizontally positioned Eustachian tubes, which are less effective at draining fluid.
Allergies: Allergic reactions can cause nasal and ear inflammation, leading to fluid build-up in the middle ear and increasing infection risk.
Exposure to Smoke: Second-hand smoke irritates the respiratory tract and Eustachian tubes, raising the likelihood of middle ear infections.

Types of Middle Ear Infections

Middle ear infections manifest in different forms, each with distinct characteristics and treatment approaches:

Acute Otitis Media (AOM)

This infection affects the middle ear space behind the eardrum. Fluid and mucus become trapped, causing pressure and pain. The condition typically develops quickly and may cause fever.

Otitis Media with Effusion (OME)

This condition occurs when fluid remains in the middle ear after an infection has resolved. The fluid can persist for weeks or months, potentially affecting hearing. Children may not exhibit obvious symptoms besides mild discomfort.

Chronic Suppurative Otitis Media

This persistent middle ear infection causes recurring fluid drainage through a perforated eardrum. The condition can last several weeks and may lead to hearing loss if untreated.

Dr. Gan medical exam of patient's ear canal

Diagnostic Methods

Otoscope Examination: An ENT doctor uses an otoscope to inspect the eardrum and ear canal. Signs such as redness, bulging, or perforation of the eardrum, along with the presence of fluid, can confirm a middle ear infection.
Tympanometry: This test assesses eardrum movement by introducing changes in air pressure within the ear. A graph generated from the results helps detect fluid behind the eardrum and evaluate its functionality.
Acoustic Reflectometry: This technique uses sound waves to measure fluid levels in the middle ear. It is particularly useful for children who may not cooperate fully, as it requires minimal participation.

Treatment Options

The choice of treatment depends on the type and severity of the middle ear infection, as well as the patient’s age and overall health.

Non-Surgical Treatment

Observation: For mild middle ear infections, symptoms are closely monitored over 48–72 hours before initiating antibiotic treatment. This approach allows for natural resolution of the infection while minimising unnecessary antibiotic use and reducing the risk of resistance.
Antibiotics: These are recommended for severe infections or those that persist beyond the observation period. A typical course lasts 7–10 days, with noticeable improvement usually within 48–72 hours.
Pain Management: Over-the-counter pain relievers, such as ibuprofen or paracetamol, help alleviate pain and reduce fever. Applying a warm compress to the affected ear can provide additional comfort.

Surgical Treatment

Myringotomy: This procedure, usually performed at the clinic, involves creating small openings in the eardrum to drain accumulated fluid from the middle ear. Ventilation tubes are inserted into these openings to facilitate ongoing drainage and improve air circulation. The tubes typically remain in place and fall out naturally within 6–12 months.

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Prevention and Management

Reducing the risk of middle ear infections involves regular hand washing, avoiding exposure to tobacco smoke, and ensuring children are up to date with recommended vaccinations, including the pneumococcal vaccine. Breastfeeding for the first year strengthens infants’ immune systems, while feeding them in an upright position helps prevent fluid from entering the Eustachian tubes. During upper respiratory infections, frequent nose blowing and maintaining good nasal hygiene can further lower the risk.

For Singaporeans & Singapore Permanent Residents

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Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.

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Frequently Asked Questions (FAQ)

Are middle ear infections contagious?

The ear infection itself is not contagious, but the upper respiratory infections or colds that often cause them can spread from person to person.

Can allergies be mistaken for middle ear infections?

Allergies can cause similar symptoms, including ear pressure and fluid build-up. A medical examination helps differentiate between allergic reactions and actual infections.

Is there a connection between middle ear infections and sinus infections?

Yes, sinus infections can contribute to middle ear infections, as both conditions involve the upper respiratory tract. Blockages or infections in the sinuses may affect Eustachian tube function, leading to middle ear issues.

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.

Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.

2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
2016 – Best Educator Award (Eastern Health Alliance)
2016 – “Wow” Award (Patient Compliment)

2014 – Eastern Health Alliance Caring Award – Silver
2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
2012 – Human Manpower Development Award (Ministry of Health, Singapore)
2007 – Singhealth Best Doctor Award

Qualifications

MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
FAMS – Fellow of the Academy of Medicine Singapore

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