By Ojoma Akor
The statement released by the presidency on Sunday, announcing that President Muhammadu Buhari would see an Ear, Nose and Throat (ENT) specialist for a persistent ear infection during his 10-day vacation in the United Kingdom , was not only greeted with debates on the necessity of the trip, but also speculations on what could be wrong with Mr President’s ear, and the severity of the ailment.
Mr President embarked on the trip on the recommendation of his personal physician and an E.N.T specialist in Abuja, to enable him access further evaluation after he had been treated here, according to the statement.
The ear is an organ for hearing and also takes care of balance in a normal human being, said Professor Titus S. Ibekwe, a Professor of Otorhinolaryngology, University of Abuja, and Head, Department of Ear, Nose and Throat(ENT), Head & Neck, University of Abuja Teaching Hospital.
He said the ear is divided into three different parts, the outer ear, the middle ear and the inner ear, and it is the inner ear that contains two important organs called the cochlea system and the vestibular system. The vestibular system is for balance while the cochlear system is for hearing.
According to him any of these organs can get diseased at any point in time ,one of which is infection. The infection could occur in the outer, middle and inner ear.
When the outer ear is infected it is called “Otitis externa”, if the middle is infected it is called “Otitis media”, and if the inner ear is infected it is called “Otitis interna” or the name of the specific organ affected in the inner ,that is vestibulitis- the organ that takes care of balance, or cochlitis if it is the organ for hearing .
The ENT specialist said the types of ear infections people have, is dependent on the type of organism that is involved, which can be bacteria infection , fungi infection or viral in nature.
“Any of these three parts of the ear could be infected at any point in time, and the magnitude of this infection also depends on certain factors,” he said.
Factors that determine the type of infection
He said the first one, is how virulent the organism causing the infection is. The second factor is the immune status of the patient. The expert said ear infection in people who are immune-suppressed is more severe than ordinary people, and this include people who have diabetes, cancer, HIV, and kidney infection, among others.
Any age range for ear infection?
Prof. Ibekwe said “No age group is immune to ear infection, it can affect anybody and everybody. Although the extreme of ages, that is the very young and very old tend to be more predisposed because of the immune status ; in a child the immune system is still developing while in an adult, the immune system is no longer as strong as it used to be like middle age and young age .”
How does ear infection affect a person’s activity, and what are the symptoms?
Professor Ibekwe who is also Immediate past First Vice President, Nigerian Medical Association answered that the symptoms depend on the type of ear infection that the person has, the part of the ear that is involved, as well as the immune system of the individual.
“Otitis externa” which is infection of the outer ear is usually associated with severe pain, he said. “If you touch the ear lobe of the person, the person will feel very severe pain. Sometimes it could be associated with some discharge coming out of the ear, something like pus maybe coming out . Most times when it is diagnosed appropriately and the correct drugs are given, the ailment is taken care of,” he said.
However, if the person is diabetic , the “Otitis externa” or outer ear infection may progress to the one called “Otitis extena maligna” a severe outer ear infection usually seen in immune-compromised patients and those with metabolic diseases like diabetes mellitus.
According to him , the “Otitis extena maligna” behaves like a malignant disease, so it eats into the tissues very fast. It is very severe and needs a more aggressive management. That is apart from treating the ear, you also need to control the persons diabetes level and boost immune status of the patient.
He said when the ailment is caused by fungus growing in the ear, it is also very painful and the discharge that comes is most times dark in colour .
“Fungus ear infection needs very long treatment because it is very resistant and the drugs have to be taken up to three weeks ,sometimes up to four weeks and consistently I norder to get results .You also advise the patient to keep water from entering the ear and keep it dry”, he said.
Candida can also grow in the ear and results in discharge that is close milky in colour, he said.
The expert said middle ear infection is associated severe discharge that draws like Okro soup. In children, it causes serious fever when it starts, and most times, the ear drum ruptures and drains outward from the middle ear.
For the inner ear, if you have vestibulitis, that is the organ for balance, it presents with the eye of the person spinning and turning, dizziness that is almost non-stop, fever and hearing loss.
If you have cochlitis, it usually results in hearing loss for the patient. It needs to be taken care of early, and the earlier one gets to the doctor, the better to get good results.
How to stop persistent infections?
He said avoiding pouring water in the ear, proper treatment, taking complete dose of drugs and long enough especially for fungi infection, and abiding by the instructions given to you by your doctor, can help with persistent or recurrent infections.
What should you do when you notice any problem with your ear, nose and throat?
The doctor said these organs are very sensitive places, and once you notice any problem affecting any of them, don’t start self medication but just go straight to the hospital and see your ear, nose and throat doctor, or meet the available doctor there who will attend to you, and refer you to an ENT specialist.
Moving our health system forward?
Prof. Ibekwe opined that Nigeria has the best manpower, and most state-of -the art hospitals abroad are manned by Nigerian doctors because they have brains and are well trained.
He said both government individuals and organizations have roles to play in the provision of modern equipment, capacity building, and facilities.
He also called for the earmarking of a pool of fund, called medical development fund ,saying it will encourage medical personnel within and outside the country to come and assist the country’s health system.
The ENT specialist called for public private partnership as government cannot do it alone. He said there is need to revitalize and add value to our health insurance so that most of the populace including the grassroots will be covered as no country thrives with out -of-pocket expenses.
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