The middle ear is the space behind the eardrum , it is part of the chain of sound transmission and it contains the eardrum and the ossicles (hammer, anvil and stirrup). This part of the ear communicates with the pharynx (throat) through a tube called the Eustachian tube . The Eustachian tube favors the aeration of the ear and the elimination of secretions that are produced in the middle ear.
Types of otitis media
- Acute otitis media: it is an acute inflammation of infectious cause that usually occurs as a complication of a cold . It is a picture that appears quickly and evolves in a few hours. It is one of the most common diseases affecting infants and preschool children .
- Serous otitis media: it is an accumulation of fluid in the middle ear that usually occurs in children with recurrent AOM or with difficulties in emptying secretions due to a malfunction of the Eustachian tube. It is common in young children and does not cause pain or fever, only mucous discharge from the ear. It requires close monitoring by the Pediatrician and sometimes with the Otorhinolaryngologist, since if it persists for a long time it can affect hearing and language development.
It is one of the most frequent infections in childhood, especially between six months and two years of life. Approximately three out of four children have had an episode of otitis media by the age of three. Winter and fall are the times when this infection most often occurs.
- It is very common to occur after a common cold . Mucus from the nose blocks the Eustachian tube, secretions accumulate in the middle ear and become infected.
- Middle ear infections are caused by bacteria or viruses that enter through the nose and mouth. Places where there are a lot of children, like day care centers, help germs spread faster.
- Allergies and pollution , as well as exposure to tobacco smoke in infants, predispose to inflammation of the middle ear.
The symptoms of acute otitis media vary depending on the child’s age. Ear pain and fever usually occur after a typical scenario of a cold with mucus and abundant nasal mucus.
- Younger infants may have less striking local symptoms, with general symptoms being more frequent : fever, irritability, vomiting, diarrhea or refusal to feed. In some cases they may present otorrhea, that is, discharge in one or both ears.
- In older children , ear pain is the main symptom. It is a very intense pain that worsens when chewing, sucking or swallowing. Fever is not always present. On many occasions the eardrum is perforated and the ear discharges a bloody yellow liquid (otorrhea). Once the eardrum is perforated, the pain disappears.
The pediatrician will try to visualize the eardrum with an otoscope (a magnifying glass with a light that is inserted into the ear canal) in order to diagnose the inflammation. The eardrum is not always visible because the canal is clogged with earwax and cleaning may be necessary beforehand.
With this simple test, the doctor will see if the tympanic membrane is fine or very red, without light reflection, if there is a small perforation, if there is mucus inside the middle ear or if the eardrum is bulging.
Treatment of otitis media in children
Anti-inflammatories and analgesics are used to relieve pain , while antibiotics are not always necessary.
The pediatrician will evaluate the severity of the symptoms, the age and the state of health of the child:
Based on all this, two behaviors can be used:
If it is an otitis with mild symptoms, only on one side and without suppuration, it will be treated with antipyretics and analgesics and the evolution will be observed in two or three days. In almost 80% of cases, the symptoms disappear on their own without sequelae, since the infection that has caused the otitis is viral and mild. When symptoms persist after a few days with conservative treatment or worsening is observed, the use of antibiotics may be necessary .
It is also often recommended to apply dry heat to the ear to reduce pain and to wash the nose if there is mucus. But if there is otorrhea, the ear should not be wet.
Can an ear infection be prevented?
The prevention of otitis is complicated, because in most cases there is a personal predisposition of the child, but the following factors can help us and be protective:
- Keep the upper airways “clean” (nasal washes).
- Take the bottle semi-sitting or sitting, not lying down.
- Avoid passive exposure to tobacco smoke.
Is it always an ear infection?
Ear discharge is called otorrhea and can appear in one or both ears. This suppuration may or may not be accompanied by other symptoms.
If this suppuration is accompanied by inflammation , pain or fever, it will be of an infectious cause , such as acute otitis media or external otitis . If otitis media produces a tympanic perforation, you can see the output of a thick liquid , similar to whitish or yellowish mucus that is accompanied by a substantial improvement in pain. In external acute otitis, typical of swimming pools, the pain does not subside despite the fact that we see the suppuration.
Other causes of suppuration and pain in the ears are foreign bodies that the child himself has introduced.
What you should know…
- It is one of the most frequent infections in childhood, especially between six months and two years of life.
- It is very common to occur after a common cold. Mucus from the nose blocks the Eustachian tube, secretions accumulate in the middle ear and become infected.
- Antibiotics are not always necessary. Anti-inflammatories and analgesics are used to relieve pain.