What Is Otitis Media?
Otitis media means inflammation of the middle ear.
The inflammation occurs as a result of a middle ear infection. It can occur
in one or both ears. Otitis media is the most frequent diagnosis recorded
for children who visit physicians for illness. It is also the most common
cause of hearing loss in children.
Although otitis media is most common in young
children, it also affects adults occasionally. It occurs most commonly in
the winter and early spring months.
Is Otitis Media Serious?
Yes, it is serious because of the severe earache
and hearing loss it can create. Hearing loss, especially in children, may
impair learning capacity and even delay speech development. However, if it
is treated promptly and effectively, hearing can almost always be restored
to normal.
Otitis media is also serious because the infection
can spread to nearby structures in the head, especially the mastoid. Thus,
it is very important to recognize the symptoms (see list) of otitis media
and to get immediate attention from your doctor.
How Does The Ear Work?
The outer ear collects sounds. The
middle ear is a pea sized, air-filled cavity separated from the outer
ear by the paper-thin eardrum. Attached to the eardrum are three tiny ear
bones. When sound waves strike the eardrum, it vibrates and sets the bones
in motion that transmit to the inner ear. The inner ear converts
vibrations to electrical signals and sends these signals to the brain. It
also helps maintain balance.
A healthy middle ear contains air at the same
atmospheric pressure as outside of the ear, allowing free vibration. Air
enters the middle ear through the narrow eustachian tube that connects the
back of the nose to the ear. When you yawn and hear a pop, your eustachian
tube has just sent a tiny air bubble to your middle ear to equalize the air
pressure.
What Causes Otitis Media?
Blockage of the eustachian tube during a cold,
allergy, or upper respiratory infection and the presence of bacteria or
viruses lead to the accumulation of fluid (a build-up of pus and mucus)
behind the eardrum. This is the infection called acute otitis media.
The build up of pressurized pus in the middle ear causes earache, swelling,
and redness. Since the eardrum cannot vibrate properly, you or your child
may have hearing problems.
Sometimes the eardrum ruptures, and pus drains out
of the ear. But more commonly, the pus and mucus remain in the middle ear
due to the swollen and inflamed eustachian tube. This is called middle
ear effusion or serous otitis media. Often after the acute
infection has passed, the effusion remains and becomes chronic, lasting for
weeks, months, or even years. This condition makes one subject to frequent
recurrences of the acute infection and may cause difficulty in hearing.
What Are The Symptoms Of Otitus Media?
In infants and toddlers look for:
- pulling or scratching at the ear, especially if accompanied by the
following...
- hearing problems
- crying, irritability
- fever
- vomiting
- ear drainage
In young children, adolescents, and adults look
for:
- earache
- feeling of fullness or pressure
- hearing problems
- dizziness, loss of balance
- nausea, vomiting
- ear drainage
- fever
Remember, without proper treatment, damage from an
ear infection can cause chronic or permanent hearing loss.
What Will Happen At The Doctor’s Office?
During an examination, the doctor will use an
instrument called an otoscope to assess the ear’s condition. With it, the
doctor will perform an examination to check for redness in the ear and/or
fluid behind the eardrum. With the gentle use of air pressure, the doctor
can also see if the eardrum moves. If the eardrum doesn’t move and/or is
red, an ear infection is probably present.
Two other tests may be performed for more
information.
An audiogram tests if hearing loss has
occurred by presenting tones at various pitches.
A tympanogram measures the air pressure in
the middle ear to see how well the eustachian tube is working and how well
the eardrum can move.
The Importance Of Medication
The doctor may prescribe one or more medications.
It is important that all the medication(s) be taken as directed and that any
follow-up visits be kept. Often, antibiotics to fight the infection will
make the earache go away rapidly, but the infection may need more time to
clear up. So, be sure that the medication is taken for the full time your
doctor has indicated. Other medications that your doctor may prescribe
include an antihistamine (for allergies), a decongestant (especially with a
cold), or both.
Sometimes the doctor may recommend a medication to
reduce fever and/or pain. Analgesic ear drops can ease the pain of an
earache. Call your doctor if you have any questions about you or your
child’s medication or if symptoms do not clear.
What Other Treatment May Be Necessary?
Most of the time, otitis media clears up with
proper medication and home treatment. In many cases, however, further
treatment may be recommended by your physician. An operation, called a
myringotomy may be recommended. This involves a small surgical incision
(opening) into the eardrum to promote drainage of fluid and to relieve pain.
The incision heals within a few days with practically no scarring or injury
to the eardrum. In fact, the surgical opening can heal so fast that it often
closes before the infection and the fluid are gone. A ventilation tube
can be placed in the incision, preventing fluid accumulation and thus
improving hearing.
The surgeon selects a ventilation tube for your
child that will remain in place for as long as required for the middle ear
infection to improve and for the eustachian tube to return to normal. This
may require several weeks or months. During this time, you must keep water
out of the ears because it could start an infection. Otherwise, the tube
causes no trouble, and you will probably notice a remarkable improvement in
hearing and a decrease in the frequency of ear infections.
Otitis media may recur as a result of chronically
infected adenoids and tonsils. If this becomes a problem, your doctor
may recommend removal of one or both. This can be done at the same time as
ventilation tubes are inserted.
Allergies may also require treatment.
So, Remember . . .
Otitis media is generally not serious if it is
promptly and properly treated. With the help of your physician, you and/or
your child can feel and hear better very soon.
Be sure to follow the treatment plan, and see your
physician until he/she tells you that the condition is fully cured.