Otitis Media (Middle ear infection)
Otitis media is an infection of the middle ear that affects mostly children. It is probably the reason for the majority of doctor visits made by children, from 6 months to 6 years of age. Infants and toddlers are prone to otitis media in part because they are more at risk for respiratory tract infections generally. Also, because the eustachian tube (the canal that connects the inner ear to the throat) is almost horizontal in young children, drainage is more difficult and microorganisms can easily infect the inner ear. As children grow, however, the angle of the tube changes and thus the risk of acquiring an ear infection decreases.
External ear infections (otitis externa) are common among swimmers, especially older children.It is called swimmer's ear.
Otitis media can develop at any time of the year. Since it often appears following a cold or the flu, however, it generally occurs more frequently during the winter when respiratory ailments are more common. Sharing toys, putting toys in the mouth, and sneezing are just a few of the ways otitis-causing microorganisms spread.
In the summer, swimmers sometimes develop external ear infections (swimmer's ear).
Children who attend daycare are more at risk, because their exposure is greater.
Symptoms and diagnosis
Diagnosing an ear infection in a child is not always easy. Signs to look for include pulling and rubbing the ear, a fever, crying while drinking, and hearing loss. However, other signs can be misleading because it's not uncommon for children to be irritable, cry, lose their appetite, or sleep-poorly for reasons other than otitis.
Only the child's doctor can confirm a diagnosis of otitis media. Using an otoscope (an instrument that enables a visual examination of the eardrum's tympanic membrane), the doctor looks for reddish colouring, swelling, and liquid (pus) in the inner ear, all symptoms of infection. Sometimes, the infection causes increased pressure, which can tear the tympanic membrane. On occasion, chronic otitis media can lead to permanent hearing loss. More rarely, serious complications, such as meningitis and pneumonia can develop.
Treatment goals are to reduce the pain, treat the infection, and prevent complications. Acetaminophen (e.g., Tylenol™, Tempra™) can relieve the pain and fever. Antibiotics (prescribed by your doctor) are used for the infection. Therapy usually lasts about 10 days. While most children feel fine after 2 to 3 days, the antibiotic treatment must be completed or the infection won't go away. On occasion, the infection-causing bacteria are resistant and don't respond to standard antibiotic therapy. In these cases, another course of therapy has to be undergone, using a different antibiotic. The doctor may even have to perforate the eardrum to drain secretions located behind it.
Children who have long-lasting or recurrent ear infections may benefit from a myringotomy, a procedure that involves inserting a tiny tube through the eardrum. The tube drains away the secretion and allows air to reach the inner ear. The child is put under general anesthesia during the procedure. It often succeeds in breaking the cycle.
Otitis media is almost impossible to prevent in some children. Some never get it and others get it repeatedly until they go to school. Nonetheless, the following measures are thought to reduce the risk of otitis media in children:
- Be breastfed
- keep your home smoke-free
- wash hands carefully and frequently, especially during flu and cold seasons
- never let a child bottle feed while lying down
If your child has recurrent ear infections, consider using a home sitter instead of daycare. Also, consult your family doctor about:
- eliminating or at least treating all allergies.
- administering a low-dose antibiotic therapy for a few months to prevent otitis media.
- vaccination against pneumococcus, one of the most common bacteria that can cause ear infections
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The patient information leaflets are provided by Vigilance Santé Inc. This content is for information purposes only and does not in any manner whatsoever replace the opinion or advice of your health care professional. Always consult a health care professional before making a decision about your medication or treatment.