Otitis is a bacterial infection of the middle ear which is common in children. The middle ear becomes inflamed and produces symptoms like fever, feeling of fullness in the ear and ear pain. It builds up fluids inside the ear leading to inflammation and pain. Common cold or any respiratory infection can cause building of fluids in the ear. Antibiotics are prescribed for managing otitis media and long term ear infection can affect the hearing ability.
Types :
- Otitis media develops due to swelling of middle ear. The term ‘media’ indicates middle and ‘otitis’ means inflammation.
- Acute otitis is of short term and occurs suddenly. Fluid gets collected in the middle ear causing ear pain and bulging eardrum.
- Chronic otitis is long term ear infection lasting for about a month or more. After an acute ear infection the fluid may still remain in the eardrum or tympanic membrane for many months if it is not properly treated. This situation can damage the eardrum affecting the hearing ability.
Symptoms :
Very often, children would develop otitis infection and may show signs of ear pain. The child would start pulling at the ear and can have difficulty in getting sleep. Infants with otitis can have problems in feeding and would cry persistently. He may act irritable most of the time due to ear pain and discomfort. Children can also develop fever and pus like discharge from the infected ear. For adults otitis can produce symptoms of ear pain, feeling of fullness in the ear and fluid drainage from the ear.
Otitis Media Causes :
Bacteria or virus is the root cause of otitis. Ear infection always follows another illness like cold or flu or respiratory infection. Swelling of Eustachian tubes (a narrow tubing running from middle ear to inner regions of throat) and accumulation of fluid inside the ear and blockage of this tube can cause otitis. Any infection on the adenoids (small pads found in the back of nose) can cause ear infection. In chronic cases, due to pressure created by effusion (fluid accumulation) a hole may develop on the eardrum affecting the hearing ability.
Who are at risk?
Infants and children are more prone to develop otitis media than adults. The path leading to eardrum is very narrow and hence they may not be able to drain off the fluids properly. The size of the Eustachian tube is not fully developed. Children who are left in the daycare centers can get otitis easily due to more exposure with other children. Bottle feeding increases the risk of developing ear infection since the infant takes in more air than regular breastfeeding. Seasons like fall or winter can increase the chance of developing allergies and ear infection. In the USA about 75% of the children of 1-3 years, have got otitis infection at least one time.
Complications :
Otitis infection would often get resolved within few days or a week. If left untreated for long, it can cause complications like perforation in the eardrum leading to impaired hearing. For some children it can affect cause delay in speech and normal development if they have had frequent episodes of otitis in young age. In extreme cases, untreated infection can spread to bones thereby damaging them.
Diagnosis :
Often, symptoms are enough to detect otitis media infection. Your doctor would use a special device to look into the ears and nasal passage. Pneumatic otoscopy is done in some cases to check how much fluid is collected at the back of eardrum. For some cases he may use other testing procedures like tympanocentesis or acoustic reflectometry.
Otitis Media Treatment :
Very often otitis infection can be treated with antibiotics with suitable doses based on the age of the child and intensity of infection. Your doctor would wait for few days to see if the symptoms are improving. In the meantime, you can use warm compress or over the counter painkillers to manage the ear pain. Drugs like Tylenol or ibuprofen can give immediate relief from pain. Ear drops like Aurodex or similar ones are given for otitis if the eardrums are not damaged and torn.
Antibiotics are given only if the pain is severe and the child is above one year. If the symptom of ear pain is accompanied with high fever, antibiotics are prescribed even for infants. Follow the instructions of your doctor in completing the course of antibiotics. Draining of fluid from the ear tubes is done if the infection is recurrent causing frequent accumulation of fluid in the ear.
This procedure is known as myringotomy in which the doctor would make a tiny hole inside the eardrum to drain off the fluids from the middle ear. Usually the procedure is performed on outpatient setting. Tiny tubing is placed in the opening to prevent further collection of fluids. The opening of the eardrum would close automatically once the tube is removed. For children with chronic ear infections, your doctor would monitor the condition closely to prevent any impairment of hearing.
Tips For Prevention :
Since common cold or respiratory tract infection is the major cause of otitis make sure that your child is not getting cold frequently. Teach your children the right method of coughing or sneezing. If your child is getting frequent attacks of cold from daycare center you have to find suitable alternative or not send him to daycare. Breastfeeding the baby gives him/her to build more antibodies necessary to fight ear infection.