Hi I'm Dr. David Hill and today we're going to be talking about how to drain an inner ear infection. I think what we really mean here is how to drain a middle a middle ear infection or an acute otitis media and let's look at the anatomy of the ear for a second. The external auditory canal is the part you can see. This is the part you should never stick a Q-tip in and it ends right here at the ear drum. It is a closed system. You can get an infection of the outer ear that is usually called a swimmer's ear and that is not what we are concerned with today. The inner ear is here where the nerves are and that is not an infection that can be drained. You can get what is called labyrinthitis or inner ear infection but that's usually viral and usually goes away on its own. The middle ear is the area in between the outer ear and the inner ear. It contains the bones that carry sound signals from the ear drum to the nerves that detect them. This is the area where fluid can collect especially when there is a cold, allergies or sinusitis. That fluid once it is in there can become infected with bacteria. We call that a middle ear infection or acute otitis media. Now normally the way to treat this is with antibiotics. Sometimes antihistamines or allergy medicines like Flonase, a steroid that you can blow up into your nose can help relieve any drainage or clogging in this tube, the Eustachian tube that drains fluid out of the ear. However, occasionally ear infections fail to respond to those conservative measures with antibiotics. In those cases an ear, nose, and throat surgeon can look in and assess what needs to be done. Occasionally they may just put a needle through the ear drum and suck out the fluid culture that's called a tympanotomy and those holes heal up very quickly. For more chronic problems or recurrent problems they may choose to put a PE a pressure equalizer a tympanotomy tube in the ear drum temporarily. Usually those tubes sit there for months or a year or two and they allow fluid and air to get in and out of the middle ear and cut down the number of ear infections that somebody gets. They don't eliminate ear infections altogether and it is not clear that these tubes preserve hearing or speech function when they are used but they certainly can reduce the number of ear infections and therefore antibiotic exposure and office visits. So remember usually fluid in the middle ear goes away on its own. If it's infected usually you want to use antibiotics although I will add that in children over age two you don't necessarily need to use those and last if it's a chronic or severe problem an ear nose or throat surgeon may want to assist the drainage with a tympanotomy or a pressure equalizing tube. Talking about getting fluid out of the middle ear when it's infected I'm Dr. David Hill.