Hi I am Dr. David Hill, and today we are going to talk about how to drain an ear infection. Now the first thing we have to do is define ear infection. The ear has different parts, and different parts of the ear may become infected. A swimmers ear for example we call it an otitis external is an infection of the outer portions of the ear. The outer portions of the ear start here, enter the hole, and stop at the eardrum. That is the external auditory canal that is the tunnel from the hole down to the eardrum. That is where otitis externa occurs, and that doesn't usually require drainage. In severe cases of otitis externa however, the canal gets so swollen that there is no space. And sometimes an ear, nose, and throat specialist will actually need to insert a wick down into that space so that medicine can get in there. But that is not draining, that is the opposite of draining. That is putting something in. Now the other part of the ear that frequently gets infected is called the middle ear. That starts behind the eardrum inside the head. That is an air filled space that contains bones. The bones conduct sound waves from the eardrum into the cochlear, the nerve that actually generates the nerve signals that your brain interprets the sound. That space is infected is called an otitis media or middle ear infection. Those can be quite painful as pressure builds up against the back of the eardrum. Now normally it is not necessary to drain these, although sometimes they do drain own their own. Spontaneously a little hole forms in the eardrum, the pus comes out, and usually feels better after that. But there are some cases where drainage is required. Now a few pediatricians know how to accomplish this drainage. More often it is a ear, nose, and throat specialist who know how to do it. It requires numbing so there is some numbing that are put in for anesthetic, and then the child or adult has to be very still during procedure. In what is called an tympanostomy, or tympanotomy rather. In an tympanotomy you take a tiny little scalpel, and just cut a nick in just the right part of the eardrum, and usually we do that because we want a culture the fluid inside the ear to see what sorts of bacteria are causing the infection. This is not done very frequently any more, because we can usually guess what it is, and we have broad spectrum of antibiotics that are effective against a lot of different microbes. The more common reasons to do that drainage is to insert pressure equalizing tubes or tympanostomy tubes. These are the ear tubes that you hear about. These are used usually for children who have multiple, severe, or chronic ear infections, and they provide some relief from these ear infections, and some prevention of recurrence. So that is almost always done by an ear, nose, and throat specialist. Usually under anesthesia, often in a hospital, but occasionally in an office setting. Talking about how to drain fluid from an ear infection I am Dr. David Hill.