MIDDLE EAR INFECTION
A middle ear infection is a condition that occurs when a virus or bacteria causes the air-filled space behind the eardrum to become inflamed.
- Also called otitis media, a middle ear infection is the most common type of ear infection individuals face.
- This condition is more prevalent in children than in adults. The Lucile Packard Children’s Hospital at Stanford estimates that middle ear infections occur in 80% of children by the time they reach age 3.
- It is easier for parents to recognize the condition in children who are able to articulate how they are feeling than in infants and toddlers.
- Hearing problems and other serious complications can develop from long-term exposure to ear infections – persistent or frequent ear infections, persistent fluid in the middle ear.
- These complications may include impaired hearing, the spread of infection, tearing of eardrum, and even speech and developmental delay.
Some other conditions that may result in similar middle ear problems or that may be related to an ear infection may include:
- Otitis media with effusion (OME) which occurs when mucus and fluid persist or continue to build up in the middle ear after an infection has resolved. It may also occur following some dysfunction or noninfectious blockage of the Eustachian tube.
- Acute otitis media, this types comes on quickly and is accompanied by swelling and redness in the ear.
CAUSES
There are a number of reasons why a middle ear infection may occur. Although, they usually result from a previous respiratory tract infection such as cold, flu, or an allergy that spreads to the ears. These infections cause congestion and swelling of the nasal passage, throat and Eustachian tube.
Swelling, inflammation, mucus in the Eustachian tube (a pair of narrow tubes that run from each middle ear to high in the back of the throat, behind the nasal passage) from an infection of the respiratory tract can lead to blockage, causing the accumulation of fluid in the middle ear.
Bacteria or viruses will often grow in the fluid, producing the symptoms of an ear infection.
SYMPTOMS
The following symptoms are common in children:
- Crying more than usual
- Difficulty sleeping
- Ear pain, especially when lying down
- Tugging at the ears
- Difficulty hearing or responding to sounds
- Loss of balance
- Headache
- Drainage of fluid from the ear
- Fever of 100 c or higher
- Loss of balance
- Irritability
- Loss of appetite
- Diarrhea
In adults, symptoms may include:
- Diminished hearing
- Drainage of fluid from the ear
- Ear pain.
DIAGNOSIS AND TREATMENT
Diagnosis is based on symptoms and a physical examination. The doctor will listen to the child breathe with a stethoscope and also use a lighted instrument (an otoscope) to look at the ears, throat, and nasal passage for redness, swelling, pus and fluid.
The doctor may also carry out tympanometry to measure the movement of the eardrum and determine if the middle ear is working properly.
The doctor may also carry out acoustic reflectometry to measure how the sound emitted from a device is reflected back from the eardrum. Normally, most of the sound that enters the ear is absorbed by the eardrum. However, the more pressure there is from fluid in the middle ear, the more sound is reflected back from the eardrum.
TREATMENT
Some ear infections may resolve on their own without treatment with antibiotics. Treatment options will generally depend on the age of the child, and the severity of symptoms.
A wait-and-see approach is recommended by the American Academy of Pediatrics and the American Academy of Family Physicians as an option for:
- Children 6 to 23 months with wild inner ear pain in one ear for less than 48 hours and a temperature less than 102.2 F (39C).
- Children 24 months and older with mild inner ear pain in one or both ears for less than 48 hours and a temperature less than 102.2F
After the observation period, the doctor may recommend an antiobitic treatment.
An initial observational waiting time may be excluded in children younger than 6 months of age with confirmed acute otitis media.
To manage pain, a warm compress or pain medications may be recommended.