Otitis Media are a bunch of inflammatory diseases of the middle ear, which is the area behind the eardrum that contains small bones and where the passing of air, vibrate, producing sound. Otitis Media is a very common infection that can also be very painful. Children are more susceptible to it than adults, as adults have a more developed immune system.

Otitis Media is a collective term used to describe a few similar inflammatory infections of the middle ear.

Types

There are three types of Otitis Media.

  •  Acute Otitis Media

Acute Otitis Media is characterized by an infection followed by ear pain. This may cause decreased appetite in the patient, and also cause irritability and poor sleep in children.

  •  Otitis Media with Effusion

Otitis Media with Effusion is usually characterized by a feeling of heaviness or fullness in the ear. But mainly, it is the presence of non-infectious fluid in the ear for an extended amount of time (almost three months).

  •  Chronic Suppurative Otitis Media

Chronic Suppurative Otitis Media is characterized by inflammation of the ear and discharge of fluid for an extended period (almost three months). It is mainly a complication of Acute Media Otitis.

Signs and Symptoms of Ear Infection

The signs of Otitis Media are greater in children than in adults. Common symptoms of otitis media in children are listed below:

  1.  Infection
  2.  Loss of appetite
  3.  Being fussy
  4.  Ear pain
  5.  Pulling on-ear
  6.  Sleep troubles
  7.  Loss of balance
  8.  Headache
  9.  Hearing troubles
  10.  Drainage of yellow or greenish fluid from the ear.

Common signs of Otitis Media in adults are:

  1.  Ear pain
  2.  Hearing troubles
  3.  Upper Respiratory Tract Infections

Causes

The cause of Otitis Media is mostly a problem with the Eustachian Tube. It is usually because of the swelling of mucous membranes of the nasopharynx, which happens because of allergies or respiratory infections.
It can also be because of trauma, such as a basilar skull fracture, which can lead to fluid buildup in the middle ear due to cerebral damage.

Diagnosis

The usual symptoms of OM overlap with other conditions, so the signs themselves are not enough to show which type of otitis media is present; it has to be supplemented by the motion of the tympanic membrane. Doctors can use a pneumatic otoscope with a rubber bulb attached to check the movement of the tympanic membrane.

 

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Other ways to diagnose OM include reflectometry, tympanometry, or a simple hearing test.

In severe cases, such as those involving a high fever or loss of hearing, methods such as audiometry, tympanogram, or a temporal bone CT and MRI can be used to check possible complications.

Diagnosis of OM in children is usually characterized by moderate bulging of the eardrum and recent onset of ear pain or intense redness of the eardrum. For confirmation, middle-ear effusion and inflammation of the eardrum have to be identified; signs of these are fullness, bulging, cloudiness, and redness of the eardrum.

The difference between acute otitis media (AOM) and otitis media with effusion (OME) is that antibiotics are not used for the treatment of OME. The best way to tell the difference is the bulging of the tympanic membrane, which suggests AOM, rather than OME.

Viral otitis may cause the formation of blisters on the outside of the tympanic membrane, which is called bullous myringitis.

However, sometimes even examination of the eardrum may not be able to confirm the diagnosis, especially if the ear canal is small. Sometimes wax in the ear canal makes it hard to get a clear view of the eardrum. Also, a child’s crying can cause the eardrum to look inflamed due to swelling of the small blood vessels on it, making it seem as if the redness is a sign of otitis media.

Risk Factors and Complications:

Risk factors for ear infections include:

  1.  Age
  2.  Infant feeding
  3.  Group Child Care
  4.  Seasonal factors
  5.  Cleft Palate
  6.  Poor Air Quality

Even though most ear infection is really simple to treat, getting ear infections again and again can lead to complications that may cause permanent damage. Some of them are

  1.  Impaired Hearing or Major Hearing Loss
  2.  Problems in Speech Development
  3.  Ruptured Eardrum
  4.  Mastoiditis

Prevention

Following steps can be taken to prevent ear infections:

  1.  Preventing Respiratory infections, common colds, or other illnesses.
  2.  Avoiding second-hand smoking.
  3.  Breastfeeding your infant. Or, if you use a bottle, make sure your child is positioned upright.
  4.  Asking your doctor about vaccinations for different diseases that can result in or cause ear infections, such as Pneumococcal conjugate vaccines (PCV).
  5.  Stay away from possible or sure allergens that can cause respiratory complications.

Steps for Treatment

Many steps can be taken for the treatment of OM.

  •  The Waiting Game:

Firstly, it is recommended to monitor the infection because most ear infections go away on their own in a few days. But if the infection persists for more than 48 hours, along with pain in the ear and a fever, then a doctor’s visit is recommended.

  •  Antibiotics:

Antibiotics like Ciprodex are used for treatment if the infection does not get better by itself in a few days. Almost 82% of the time, they are not required. But in worse cases, they are recommended, especially if the diagnosis reveals the cause of infection to be a bacterial agent like Streptococcus pneumoniae or Haemophilus influenza.

  •  Pain Management:

Doctors usually recommend over-the-counter painkillers for pain management, such as paracetamol, anesthetic drops, or ibuprofen. Make sure to take the recommended dosage, especially if you are giving them to kids.

  •  Tympanostomy Tube:

If the child has more than three AOM episodes in less than three months or four or more in six months, the doctors recommend this procedure. If recurring ear infections or fluid buildup occurs in the child’s ear, a tiny puncture is made in the eardrum so that suction can be used to suck out the fluid. Then a tube is adjusted in the ear to keep the middle ear ventilated and preventing fluid buildup. Some tubes have to stay for at least six months or a year, but some are designed to stay long-term.

  •  Alternative Medicine:

It is not recommended to find alternative routes for treatments, as they have not shown any results or improvements for the infection. Homeopathic medicine has been proven not to be effective for children suffering from OM.

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