What causes middle ear infections? The cause depends on the type of otitis media. Secretory otitis media occurs when fluids resulting from a cold or allergy enter the iddle ear by way of the eustachian tube. Acute purulent otitis media is caused by pus from a bacterial infection and may result in a rupture eardrum. Chronic otitis media is caused by the lingering presence of an untreated bacterial infection, infected adenoids, or problems with the eustachian tube.

Middle ear infections are among the most common childhood illnesses, with half of all children having at least one episode. The eustachian tube that connects the middle ear with the nasal passages is small and runs horizontally to the middle ear. Because this tube to the middle ear isn’t slanted to the middle ear, it is easy for fluid and bacteria at the back of the nose to run unto the middle ear. Temporary hearing loss can occur during the infection, but hearing usually returns to normal as the infection clears and the fluid drains. Ear infections tend to recur, especially if the child has infected adenoids.

Ear wax defined
Ear wax is a normal product of the ear which protects the skin of the ear from water and infection. Ear wax is formed from wax glands in the external ear canal as well as other components such as dead skin, sweat, and oil. The primary component of ear wax is keratin (derived from dead skin). Ear wax thus differs slightly from cerumen which is the secretory product of the ceruminous glands in the external auditory canal (Hawke, 2002).

Different individuals vary considerably in the amount and consistency of their ear wax. There are two types described, wet and dry, which are inherited. Dry wax is common in Asia, while wet wax is common in western Europe. Dry wax, also known as "rice-bran wax", contains by weight about 20% lipid (fat). Oddly enough, rice-bran wax is associated with a lower incidence of breast cancer (Hawke, 2002).

Wet wax consists of approximately 50% lipid (Burkhart et al, 2000). Wet wax can be either soft or hard, the hard wax being more likely to be impacted. While ear wax is generally simply felt to be a nuisance, in medieval times, ear wax was used as a component of pigment for illumination of manuscripts (Petrakis, 2000). Too little ear wax increases the risk of infection (Fairey et al, 1985). Too much wax also increases the incidence of infection and hearing loss. So, you want just enough.

While we are not aware of a study of this, some people (and some ears) are "wax producers", and others remain wax free without much maintenence.

What can go wrong with ear wax ?
1. Wax can plug up the ear, causing hearing to be reduced, and a full feeling in the ear.
2. Wax can trap bacteria in the ear, leading to infection. This is usually painful or at least itchy.
3. Ear wax can obscure vision when the doctor looks in your ears, possibly hiding a dangerous process.