Chronic Ear Infection

[zimmer]

Can someone please help me? I am at my wits end!!

For over 3 years now I have had this ear problem (picked up initially, I think, from a swimming pool) Mostly the problem is a continual, foul-smelling brown/yellow liquid/pus that blocks my ear. It affects my hearing and itches and irritates the hell out of me, to the point of being painful. I sometimes (especially in my sleep) find myself pulling and rubbing the ear so vigorously that it can be quite embarrassing. It kind of goes in cycles, when the irritation diminishes the stuff hardens to a sort of crust and I begin to think its getting better but then it just starts all over again. Sorry to be so graphic but I'm desperate to find an answer.

I take great care not to get any water in the ear, I put a soft silicone wad in when showering (previously I've tried every kind of ear plug, with flange-type things etc) and its been over 2 years since I went swimming.

I have had it syringed dozens of times, been to doctors, ear specialists and hospitals. I've had enough drops and anti-biotics to have cured aids twice over and still I have it. The main diagnosis seems to be that the ear canal itself is virtually closed, hence why drops dont work, they just lay in the ear and compound the problem. Dont know if these last 2 points have any bearing but I thought I should include everything just in case. About 9 years ago I broke my cheek bone, whilst playing rugby, high up near the ear area and, up to about 4 years ago, I had a job for over 3 years that involved being on a plane every week and I always suffered with my ears.

The point I'm really getting to is that I have spent a lot of time trying to get this sorted and have come across, on the internet, a possible operation that widens the ear canal. Has anyone had this operation here in Thailand or know of someone who has? I'm seriously beginning to think that this is my last, MY ONLY, hope of clearing this up and getting back to a normal life.

Heres hoping theres someone who has an answer for me, thanks.

[JohnnyFeelIt]

You've been the the ENT department at a good international hospital? I pick this up every 4 or 5 years, usually from dirty swimming pools. I think they call it otis externa and it has several different variations, the recurrance can indiate serveral things though, an underlying skin condition, diabetes, or maybe just mis-treatment.

[FBN]

The underlying problem is the narrowing of the ear canal. The chronic infection has also caused some fibrosis and the chronic swelling also contributes. The infection will not clear as the occlusion prevents normal circulation of air that the ear canal needs.

The short time solution would be to have the ear canal cleaned under direct vision by an experienced ENT with the proper equipment every time there is a flare-up of the infection. This needs to be done as often as needed (daily to weekly) to prevent the canal from blocking up from secretions. Syringing the ear will probably just complicate the whole issue. The foul smelling discharge is probably a pseudomonas bacterium that thrives under these conditions and is highly resistant to most antibiotics. Likely to be a mixed infection with fungal elements in there as well. The effective cleaning of the canal to remove the debris is more important than antibiotics.

The long term solution would be to try and restore the ear canal so widening, if possible, may be the final solution. This, however, can only safely be done if there is no active infection. It also needs to be confirmed that the infection is confined to the outer ear and that the middle ear and ear drum is intact.

I am not aware of any medical center in Thailand that does this but it is likely that you may need to see a consultant at a university hospital or a hospital where one of these specialists work privately.

[zimmer]

The underlying problem is the narrowing of the ear canal. The chronic infection has also caused some fibrosis and the chronic swelling also contributes. The infection will not clear as the occlusion prevents normal circulation of air that the ear canal needs.

The short time solution would be to have the ear canal cleaned under direct vision by an experienced ENT with the proper equipment every time there is a flare-up of the infection. This needs to be done as often as needed (daily to weekly) to prevent the canal from blocking up from secretions. Syringing the ear will probably just complicate the whole issue. The foul smelling discharge is probably a pseudomonas bacterium that thrives under these conditions and is highly resistant to most antibiotics. Likely to be a mixed infection with fungal elements in there as well. The effective cleaning of the canal to remove the debris is more important than antibiotics.

The long term solution would be to try and restore the ear canal so widening, if possible, may be the final solution. This, however, can only safely be done if there is no active infection. It also needs to be confirmed that the infection is confined to the outer ear and that the middle ear and ear drum is intact.

I am not aware of any medical center in Thailand that does this but it is likely that you may need to see a consultant at a university hospital or a hospital where one of these specialists work privately.

Thanks for the responses guys. Yes its my understanding that the real cause is the narrowed ear canal (I'm actually in great discomfort with it again right now) and I have been to both Bangkok/Pattaya and the hospital in Sri Racha and I dont know how many times to the supposed ear 'specialist' on Sukhumvit opposite the mosque (what a rip-off waste of space he is!) but I cant find anybody who will just sit down with me and tell me what needs to be done to sort it out once and for all. The lady at the Sri Racha hospital actually put a temporary sort of plug/tube in last year, which seemed to help for a while but as soon as that fell out the problem returned.

FBN, you seem to be pretty well informed, if by any chance you do come across a name of someone I'd be eternally grateful, in the meantime I can only keep sending out e mails to various hospitals and hope I get lucky (as yet I dont even get replies!) Thanks.

[ericg1953]

The underlying problem is the narrowing of the ear canal. The chronic infection has also caused some fibrosis and the chronic swelling also contributes. The infection will not clear as the occlusion prevents normal circulation of air that the ear canal needs.

The short time solution would be to have the ear canal cleaned under direct vision by an experienced ENT with the proper equipment every time there is a flare-up of the infection. This needs to be done as often as needed (daily to weekly) to prevent the canal from blocking up from secretions. Syringing the ear will probably just complicate the whole issue. The foul smelling discharge is probably a pseudomonas bacterium that thrives under these conditions and is highly resistant to most antibiotics. Likely to be a mixed infection with fungal elements in there as well. The effective cleaning of the canal to remove the debris is more important than antibiotics.

The long term solution would be to try and restore the ear canal so widening, if possible, may be the final solution. This, however, can only safely be done if there is no active infection. It also needs to be confirmed that the infection is confined to the outer ear and that the middle ear and ear drum is intact.

I am not aware of any medical center in Thailand that does this but it is likely that you may need to see a consultant at a university hospital or a hospital where one of these specialists work privately.

Thanks for the responses guys. Yes its my understanding that the real cause is the narrowed ear canal (I'm actually in great discomfort with it again right now) and I have been to both Bangkok/Pattaya and the hospital in Sri Racha and I dont know how many times to the supposed ear 'specialist' on Sukhumvit opposite the mosque (what a rip-off waste of space he is!) but I cant find anybody who will just sit down with me and tell me what needs to be done to sort it out once and for all. The lady at the Sri Racha hospital actually put a temporary sort of plug/tube in last year, which seemed to help for a while but as soon as that fell out the problem returned.

FBN, you seem to be pretty well informed, if by any chance you do come across a name of someone I'd be eternally grateful, in the meantime I can only keep sending out e mails to various hospitals and hope I get lucky (as yet I dont even get replies!) Thanks.

I have seen this Dr. at Bumrungrad in BKK and really liked him. His training is excellent as well Name: Dr. Prayuth Tunsuriyawong

Specialty: Otolaryngology (Ear, Nose:Throat)

Language: Spoken: English,Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand, 1993

Board Certifications:

- Diploma of The Thai Board of Otolaryngology, 1996

Fellowships:

- Rhinology, University of Pennsylvania, USA, 1999

- Rhinology and Otology, Harvard Medical School, USA, 1998

Assistant Professor, Mahidol University, Thailand

Special Clinical Trainings:

- Endoscopic Sinus Surgery (ESS)

Special Clinical Interests:

- Advance ESS, Endoscopic dacryocystorhinostomy, Endoscopic orbital and optic nerve decompression,

Smell and Taste Disorders

Day Time Location

Mon 09:00 - 12:00 EENT

Mon 13:00 - 16:00 EENT

Tue 09:00 - 12:00 EENT

Wed 09:00 - 13:00 EENT

Wed 15:00 - 16:00 EENT

Thu 10:00 - 12:00 EENT

Thu 13:00 - 16:00 EENT

Fri 09:00 - 12:00 EENT

Fri 13:00 - 14:00 EENT

Sat 09:00 - 12:00 EENT

ad and really liked him. He has excellent training as well

[zimmer]

The underlying problem is the narrowing of the ear canal. The chronic infection has also caused some fibrosis and the chronic swelling also contributes. The infection will not clear as the occlusion prevents normal circulation of air that the ear canal needs.

The short time solution would be to have the ear canal cleaned under direct vision by an experienced ENT with the proper equipment every time there is a flare-up of the infection. This needs to be done as often as needed (daily to weekly) to prevent the canal from blocking up from secretions. Syringing the ear will probably just complicate the whole issue. The foul smelling discharge is probably a pseudomonas bacterium that thrives under these conditions and is highly resistant to most antibiotics. Likely to be a mixed infection with fungal elements in there as well. The effective cleaning of the canal to remove the debris is more important than antibiotics.

The long term solution would be to try and restore the ear canal so widening, if possible, may be the final solution. This, however, can only safely be done if there is no active infection. It also needs to be confirmed that the infection is confined to the outer ear and that the middle ear and ear drum is intact.

I am not aware of any medical center in Thailand that does this but it is likely that you may need to see a consultant at a university hospital or a hospital where one of these specialists work privately.

Thanks for the responses guys. Yes its my understanding that the real cause is the narrowed ear canal (I'm actually in great discomfort with it again right now) and I have been to both Bangkok/Pattaya and the hospital in Sri Racha and I dont know how many times to the supposed ear 'specialist' on Sukhumvit opposite the mosque (what a rip-off waste of space he is!) but I cant find anybody who will just sit down with me and tell me what needs to be done to sort it out once and for all. The lady at the Sri Racha hospital actually put a temporary sort of plug/tube in last year, which seemed to help for a while but as soon as that fell out the problem returned.

FBN, you seem to be pretty well informed, if by any chance you do come across a name of someone I'd be eternally grateful, in the meantime I can only keep sending out e mails to various hospitals and hope I get lucky (as yet I dont even get replies!) Thanks.

I have seen this Dr. at Bumrungrad in BKK and really liked him. His training is excellent as well Name: Dr. Prayuth Tunsuriyawong

Specialty: Otolaryngology (Ear, Nose:Throat)

Language: Spoken: English,Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand, 1993

Board Certifications:

- Diploma of The Thai Board of Otolaryngology, 1996

Fellowships:

- Rhinology, University of Pennsylvania, USA, 1999

- Rhinology and Otology, Harvard Medical School, USA, 1998

Assistant Professor, Mahidol University, Thailand

Special Clinical Trainings:

- Endoscopic Sinus Surgery (ESS)

Special Clinical Interests:

- Advance ESS, Endoscopic dacryocystorhinostomy, Endoscopic orbital and optic nerve decompression,

Smell and Taste Disorders

Day Time Location

Mon 09:00 - 12:00 EENT

Mon 13:00 - 16:00 EENT

Tue 09:00 - 12:00 EENT

Wed 09:00 - 13:00 EENT

Wed 15:00 - 16:00 EENT

Thu 10:00 - 12:00 EENT

Thu 13:00 - 16:00 EENT

Fri 09:00 - 12:00 EENT

Fri 13:00 - 14:00 EENT

Sat 09:00 - 12:00 EENT

ad and really liked him. He has excellent training as well

Thanks Eric thats extremely helpful. I did last week send an e mail to Bumrungrad but no reply as yet. Now I have an actual name and clinic times I may as well just take a ride up there because right now its as bad as its been for a while. Thanks again.

[wpcoe]

For a second recommendation, I've had excellent success with Dr. Pasakorn at the ENT clinic at BNH Hospital in Bangkok.

I had problems with chronic ear infections that the ENT clinic at Bangkok-Pattaya Hospital just couldn't seem to take care of. I was not pleased with doing several (I think it was four) courses of oral antibiotics in rapid succession. One visit with Dr. Pasakorn ended the infections with a topical antibiotic and a regimen of vinegar syringe rinses. He had previously performed surgery to correct my deviated septum, as well.

[zimmer]

For a second recommendation, I've had excellent success with Dr. Pasakorn at the ENT clinic at BNH Hospital in Bangkok.

I had problems with chronic ear infections that the ENT clinic at Bangkok-Pattaya Hospital just couldn't seem to take care of. I was not pleased with doing several (I think it was four) courses of oral antibiotics in rapid succession. One visit with Dr. Pasakorn ended the infections with a topical antibiotic and a regimen of vinegar syringe rinses. He had previously performed surgery to correct my deviated septum, as well.

Noted...and thanks again.