What is Ear Infection (Otitis Media)?
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Otitis Media?
Otitis media is an infection of the middle ear, which is the air-filled space present behind the eardrum and contains the tiny vibrating bones of the ear that help in hearing. Children are more likely to develop an ear infection as compared to adults. Ear infections usually get cured on their own, and the treatment may include monitoring the problem and management of pain. Antibiotics are sometimes used for clearing the infection. Some individuals are prone to having multiple ear infections, which can lead to hearing problems.
In this article, we will be discussing in detail about otitis media or ear infections.
- What are the types of Otitis Media?
- What are the causes of Otitis Media?
- What are the risk factors of Otitis Media?
- What are the symptoms of Otitis Media?
- How to diagnose Otitis Media?
- What is the treatment for Otitis Media?
- What are the complications of Otitis Media?
- How to prevent Otitis Media?
What are the types of Otitis Media?
The different types of otitis media are:
- Acute otitis media: This is the most common type of ear infection. The symptoms are usually sudden and mild and include the middle ear getting swollen and infected, and fluid being trapped behind the eardrum. Fever may also be present.
- Otitis media with effusion: There may be some fluid left behind the eardrum after an ear infection has run its course. This condition is known as otitis media with effusion which has no symptoms as such, but the doctor can spot the remaining fluid.
- Chronic otitis media with effusion: This is a condition in which the fluid returns to the middle ear repeatedly, regardless of whether an infection is present or not. This causes a decrease in the ability to fight against other infections and can affect the hearing ability of a person.
- Chronic suppurative otitis media: This is a condition in which the ear infection does not go away even after treatment. This can lead to the formation of a hole in the eardrum.
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What are the causes of Otitis Media?
- Ear infections can occur due to bacteria and viruses in the middle ear.
- This can occur due to other diseases like cold, flu, or allergies.
- This can lead to the swelling and congestion of the throat, nasal passages, and eustachian tubes.
Role of eustachian tubes:
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- Eustachian tubes are a pair of narrow tubes running from the middle ear to the back of the throat, behind the nasal passages.
- The end of the eustachian tubes that are present near the throat opens and closes for the regulation of air pressure in the middle ear, draining the normal secretions from the middle ear, and refreshing the air in the ear.
- Swelling in the eustachian tubes can cause its blockage, and lead to fluid buildup in the middle ear.
- This fluid may become infected and lead to symptoms of an ear infection.
- In the case of children, the eustachian tubes are horizontal and narrower, making them difficult to drain and are more likely to get clogged.
Role of adenoids:
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- Adenoids are the two small pads of tissues present high in the back of the nose.
- Adenoids are believed to play a role in the immune system of the body, that is, the disease-fighting ability of the body.
- Since the adenoids are present near the eustachian tube opening, swelling of the adenoids can cause the blockage of the tubes.
- This can cause a middle ear infection.
- Irritation and swelling of the adenoids are known to play an important role in the ear infections that occur in children because the adenoids are larger in size in children as compared to adults.
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What are the risk factors of Otitis Media?
Certain factors increase the risk of developing otitis media and may include:
- Commonly seen in infants and children between 6 months and 2 years of age
- Family history of ear infections
- Having a cold
- Allergies
- More common in Native Americans and Hispanic children
- Chronic (long-term) illness like asthma and cystic fibrosis (inherited disorder causing damage to the lungs, digestive system, and the other organs in the body)
- Cleft palate (a birth condition in which the baby has an opening in the roof of the mouth)
- Exposure to air pollution or smoke
- Babies who drink from a bottle while lying down
- More common during fall and winter seasons
- Children being taught and care for in group settings
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What are the symptoms of Otitis Media?
The symptoms of otitis media include:
In children:
- Ear pain
- Pulling at or tugging an ear
- Trouble in sleeping
- More than usual crying
- Fussiness
- Loss of balance
- Fever of 100 F or higher
- Headache
- Loss of appetite
- Fluid drainage from the ear
In adults:
- Pain in the ears
- Trouble in hearing
- Fluid drainage from the ear
- Call your doctor immediately if:
- The symptoms are seen in a child less than 6 months old
- The symptoms are seen for over a day
- The ear pain is severe
- If the child is irritable or sleepless following a cold or other respiratory tract infections
- Pus or bloody fluid discharge is seen from the ear
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How to diagnose Otitis Media?
- Physical examination: The doctor will first physically examine the patient and ask about the symptoms of the patient, along with any medical or family history of the patient.
- Otoscopy: The doctor will use an instrument with a light on one end, known as a pneumatic otoscope to diagnose an ear infection. The otoscope helps the doctor to look inside the ear and check if any fluid is present behind the eardrum. The doctor generally puffs some air against the eardrum. If the middle ear is filled with fluid, the eardrum will show little or no movement.
- Tympanometry: A device seals off the ear canal, adjusts the air pressure in the canal, and causes the movement of the eardrum. This test helps in measuring how well is the movement of the eardrum and is an indirect measure of the pressure present within the middle ear.
- Acoustic reflectometry: The eardrum normally absorbs most of the sound made. However, the more the pressure from the fluid in the middle ear, the more will be the sound reflected from the eardrum. This test helps in measuring the amount of sound that is reflected back from the eardrum.
- Tympanocentesis: The doctor uses a tiny tube for piercing the eardrum for draining the fluid from the middle ear in this procedure. This fluid is tested for the presence of bacteria and viruses.
- Other tests: In case of a child suffering from multiple ear infections or fluid buildup in the middle ear, the doctor may refer the child to an audiologist (hearing specialist), developmental therapist, or speech therapist to test the child’s hearing, developmental growth, and speech or language skills.
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What is the treatment for Otitis Media?
The type of treatment recommended depends on the severity of infection, the age of the patient, and if the fluid stays in the middle ear for a long period of time. The different types of treatments for otitis media include:
- Await and watch approach:
- In most cases, the symptoms of ear infections improve on their own in one or two weeks without treatment.
- It is generally recommended to wait and watch in the following cases:
- Children between 6 and 23 months of age who have mild middle ear pain in one ear for less than 48 hours, and have a fever of less than 102.2 F.
- Children are older than 24 months who have mild middle ear pain in either one or both ears for less than 48 hours, and have a fever of less than 102.2 F.
- The doctor may suggest using some antibiotics to help in clearing the ear infections.
- Management of pain:
- Pain medications: The doctor may recommend using ibuprofen or acetaminophen for relieving the pain associated with ear infections.
- Anesthetic drops: These drops may be used for relieving pain if there is no tear or hole in the eardrum.
- Antibiotics:
- After observing the patient in the initial period, the doctor may recommend treatment using antibiotics in the following conditions:
- Children who are 6 months or older who have moderate to severe ear pain in one or both ears for at least 48 hours, or a fever of 102.2 F or higher.
- Children between 6 to 23 months of age who have mild pain in the middle ear, affecting one or both ears for less than 48 hours, and a fever of less than 102.2 F.
- Children who are 24 months or older who have mild middle ear pain in one or both ears for less than 48 hours, and a fever of less than 102.2 F.
- Follow the dosage recommended by the doctor and complete the entire antibiotic course to prevent recurrence of infection and resistance of bacteria to the antibiotic medications.
- Ear tubes:
- An outpatient (the patient is allowed to go home on the same day of the surgery) procedure known as myringotomy is performed by the surgeon for the treatment of chronic otitis media or otitis media with effusion.
- The surgeon makes a small hole in the eardrum, which helps in suctioning out the fluids from the middle ear.
- A small tube known as a tympanostomy tube is then placed in the opening to help in the ventilation of the middle ear and prevention of more fluid buildup.
- Some tubes may stay in place for four months to eighteen months, and then fall out on their own.
- Other tubes may stay in longer and may require surgical removal.
- The eardrum closes again after the removal or falling out of the tube.
- Antibiotic drops:
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- Chronic suppurative otitis media can be treated using antibiotic drops.
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What are the complications of Otitis Media?
The complications of otitis media include:
- Hearing loss
- Developmental or speech delay
- Tearing of the eardrum
- Spread of infection to the bones of the ear
- Meningitis (an infection that spreads to the brain or the membranes surrounding the brain)
- Mastoiditis (infection of the bony protrusion behind the ear, known as the mastoid)
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How to prevent Otitis Media?
Otitis media can be prevented by the following means:
- Avoid second-hand smoking (do not smoke, especially when children are around)
- Control allergies
- Prevent colds by washing hands regularly, avoiding sharing of foods, utensils, and toys
- Breastfeed your baby at least during the first six to twelve months of life
- Bottle feed the baby in an upright position
- If you notice your child snoring or breathing from the mouth, contact an ENT specialist immediately
- Make sure your child gets all the age-appropriate vaccinations including pneumococcal and other bacterial vaccines, seasonal flu shots, and all the other vaccinations
We hope that we could answer all your questions regarding otitis media through this article.
If you need more information and treatment of otitis media, you can contact an ENT Surgeon.
We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you the best advice and correct treatment plan.
