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Dr. Das, MD
Dr. Das, MD, Doctor
Category: Medical
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Experience:  MBBS, MD, with wide experience in all aspects of medical treatment, including cancer therapy.
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I have had tremendous problems with the right side of face,

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I have had tremendous problems with the right side of face, both ear and sinus. I had to have a cholesteotoma removed at age 28 (I'm 45 now), and my MRIs show severe, massive scarring on the right side of my head.
I usually carry extra supplies of Augmentin and Cipro for emergency ear problems because I'm so used to ear infections, I can feel when they're developing. And I don't take the anti-biotics unless I really need them...they usually will expire before I use them.
Currently I don't have a fever, and I don't think I have an ear infection in my right ear. However, my right ear is very sore in the inside for about the past two weeks?
I have hmo insurance and am seeing my general practioner's physician assistant on Friday. It will take a few weeks to get authorization to see an ENT.
Any suggestions on medications, treatments, or what she should be looking for? Thanks!
Welcome and thank you for your question.
Since you have a history of repeated ear infections, the soreness that you have now, is likely to be the beginnings of another infection.
But the soreness ( known as otalgia) may be also be due to referred pain from other causes like impacted teeth, sinus disease, inflamed tonsils, infections in the nose and pharynx.
The physician assistant will be looking for signs of any infection - if it is present, it is very likely that you will be prescribed a course of antibiotics and anti-inflammatory medicines. But you may need to be referred to en ENT specialist for a more thorough examination of the ear, nose and throat. You may also be referred to a dentist, if necessary.
I hope this helps.
If there’s more I can do, please use the reply tab and let me know how I can be of further assistance. It’s my goal to provide you with excellent service. Please rate me highly and provide me with feedback. Leaving a Bonus will be highly appreciated.
Dr. Das, MD and 3 other Medical Specialists are ready to help you
Customer: replied 4 years ago.

If I already tried Cipro and Augmentin, what's left for a sore, inside ear? What could I recommend to the physician assistant (since she's not an ENT.)

The ENTs always give me those two anti=biotics. Zythromax gives me bacterial infections. I really don't want another appointment with an ENT.

What kind of anti-inflammatory medications (again, the physician assistant may not know)?

If I had an MRI (I think you are a radiologist?) that said I have mild, degenerative arthitis in my neck and spine, that can still cause pain, right?

I find that Norco helps with my back and spinal pain, but then I have to go and see a pain management doctor. It never ends!


Thank you for the reply.
Amoxicillin is the drug of choice in middle ear infections. Amoxicillin plus Clavulanate ( which is what Augmentin is composed of) is even better. But some people do develop resistance to Amoxicillin in which case, drugs of the cephalosporin group are useful (Cephalexin, Keflex, Cefixime etc.). Zythromax or cipro is less effective. Taking probiotics ( medicines containing lactobacilli) help to decrease recurrent bacterial infection of the ear.
Standard anti-inflammatory medicines like ibuprofen or acetaminophen is best.
Yes, if you have degenerative arthritis in the neck and spine, you can have radiating pain to the ears.
Please try Ibuprofen - it is available as 200mg tablets without a prescription. Take 1 tablet thrice a day and see if it helps.
I hope this helps.
Dr. Das, MD and 3 other Medical Specialists are ready to help you
Customer: replied 4 years ago.

You've been wonderful with details that I will mention to the physician assistant on Friday!
My last MRI in January 2013 (for essential tremors, lucky me!) reported that I have severe, massive scarring on the right side of my head in my sinuses and ear. It's been such a chronic problem...if this were 50 years ago, I'd probably be dead from the cholesteotoma!

I'm on disability so I can't give you a bonus, but you certainly deserve it!