Otitis Media
(Earache · Ear infection · Middle Ear Infection)
In this condition factsheet:
Diagnosing Otitis Media
From a visual examination inside the ear with an otoscope (a lighted instrument for looking inside the ear) and description of the symptoms, your doctor can diagnose otitis media. In an infected ear, the eardrum usually appears red and swollen and pus may be seen behind the eardrum, which is usually clear and translucent.
When fluid or pus builds up in the middle ear, the doctor can perform a tympanometry. This is a simple hearing test that measures the pressure on both sides of the eardrums.
Treating and Preventing Otitis Media
Otitis media is often treated with antibiotics. To lower the chances of the infection returning, it's very important to take the antibiotics regularly and finish the entire course of treatment even if the symptoms improve quickly (if you or your child experience bothersome side effects from the antibiotic, contact your pharmacist or doctor). Some ear infections are caused by viruses and some infections get better without antibiotic treatment. Over 80% of ear infections improve naturally on their own without antibiotic treatment and with no complications. A short period of watchful waiting for 24 to 48 hours rather than antibiotics may be appropriate for children over 6 months of age with minimal symptoms who do not have recurrent infections or structural differences in their ears, and are not at high risk for complications. There are several antibiotics that may be used to treat otitis media. When deciding which antibiotic is the best one, the doctor will consider whether the infections are recurrent and whether bacteria may be resistant to certain antibiotics, as well as, a history of medication allergies. Treatment is usually given for 5 to 10 days depending on age and on the severity of the infection.
Antihistamines may help people who have allergies and ear infections. But no medications other than antibiotics will cure the ear infection if it's caused by bacteria. Pain relievers (e.g., acetaminophen*, ibuprofen) can be used to ease the pain of the infection and to lower a child's fever. Whether or not medications are needed, getting enough rest and drinking plenty of fluids (e.g., water) will help a child feel better.
Young children cannot "pop" open their ears to equalize ear pressures like older children and adults because their eustachian tubes are straight. As the head grows, the tube starts to curve downward into a more angled adult configuration, beginning at about age 3.5 years. This explains why ear infections naturally decrease dramatically by age 4. It also means that starting at this age, children (like adults) can chew sugar-free gum (e.g., when going up or down in an airplane) to help "pop open" their ears, allowing air to enter and fluid to drain, reducing ear discomfort and the chance of developing an infection.
Fluid buildup in the middle ear can be drained surgically. In a procedure called a myringotomy, a tiny opening in the eardrum is made so that fluid drains away or can be suctioned out. This procedure also allows air to reach the middle ear, which equalizes the pressure and facilitates drainage down the eustachian tube. The cause of fluid accumulation must also be treated. For instance, if allergic reactions are to blame for blocking the eustachian tube, then antihistamines can be given to relieve allergies.
If there is chronic infection or fluid buildup behind the eardrum, and especially if there is a documented loss of hearing, a small tube may be inserted into the opening made by myringotomy. Called PE ("pressure equalization") tubes, these devices allow air to enter the ear and any fluid to drain out. Most are designed to fall out within 6 months to 2 years. In the rare case where symptoms occur again, the PE tubes can be replaced.
If the child has a permanent hole in their eardrum that's causing chronic otitis media, the eardrum itself may be repaired by a procedure called a tympanoplasty.
It's hard to prevent ear infections since many children, especially those who attend daycare, are susceptible to colds. Careful hand-washing regimens can help reduce the chance of catching colds, so it's important to remind your kids to wash up as often as possible.
Breast-feeding seems to lower the chances of developing ear infections among infants and children by helping to boost their immunity. Another good preventative measure is to keep your home smoke-free as exposure to second-hand smoke increases the risk of middle ear infections. Immunization with the pneumococcal vaccine can lessen the likelihood of getting ear infections caused by certain types of bacteria.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Otitis-Media
References
