Ear
Infections and Earache
What
Is Otitis Media?
Otitis media means inflammation of the middle
ear. The inflammation occurs as a result of a middle ear infection.
It can occur in one or both ears. Otitis media is the most frequent
diagnosis recorded for children who visit physicians for illness.
It is also the most common cause of hearing loss in children.
Although
otitis media is most common in young children, it also affects
adults occasionally. It occurs most commonly in the winter and
early spring months.
Is
It Serious?
Yes,
it is serious because of the severe earache and hearing loss it
can create. Hearing loss, especially in children, may impair learning
capacity and even delay speech development. However, if it is
treated promptly and effectively, hearing can almost always be
restored to normal.
Otitis
media is also serious because the infection can spread to nearby
structures in the head, especially the mastoid. Thus, it is very
important to recognize the symptoms (see list) of otitis media
and to get immediate attention from your doctor.
How
Does the Ear Work?
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The
outer ear collects sounds. The middle ear
is a pea sized, air-filled cavity separated from the outer
ear by the paper-thin eardrum. Attached to the eardrum are
three tiny ear bones. When sound waves strike the eardrum,
it vibrates and sets the bones in motion that transmit to
the inner ear. The inner ear converts vibrations
to electrical signals and sends these signals to the brain.
It also helps maintain balance. |
A
healthy middle ear contains air at the same atmospheric pressure
as outside of the ear, allowing free vibration. Air enters the
middle ear through the narrow eustachian tube that connects the
back of the nose to the ear. When you yawn and hear a pop, your
eustachian tube has just sent a tiny air bubble to your middle
ear to equalize the air pressure.
What
Causes Otitis Media?
Blockage
of the eustachian tube during a cold, allergy, or upper respiratory
infection and the presence of bacteria or viruses lead to the
accumulation of fluid (a build-up of pus and mucus) behind the
eardrum. This is the infection called acute otitis media.
The build up of pressurized pus in the middle ear causes earache,
swelling, and redness. Since the eardrum cannot vibrate properly,
you or your child may have hearing problems.
Sometimes
the eardrum ruptures, and pus drains out of the ear. But more
commonly, the pus and mucus remain in the middle ear due to the
swollen and inflamed eustachian tube. This is called middle
ear effusion or serous otitis media. Often after the
acute infection has passed, the effusion remains and becomes chronic,
lasting for weeks, months, or even years. This condition makes
one subject to frequent recurrences of the acute infection and
may cause difficulty in hearing.
What
Are the Symptoms?
In
infants and toddlers look for:
- pulling or scratching at the ear, especially
if accompanied by the following...
- hearing problems
- crying, irritability
- fever
- vomiting
- ear drainage
In
young children, adolescents, and adults look for:
- earache
- feeling of fullness or pressure
- hearing problems
- dizziness, loss of balance
- nausea, vomiting
- ear drainage
- fever
Remember,
without proper treatment, damage from an ear infection can cause
chronic or permanent hearing loss.
What
Will Happen at the Doctor’s Office?
During
an examination, the doctor will use an instrument called an otoscope
or a microsope to assess the ear’s condition. With it, the doctor
will perform an examination to check for redness in the ear and/or
fluid behind the eardrum. With the gentle use of air pressure,
the doctor can also see if the eardrum moves. If the eardrum doesn’t
move and/or is red, an ear infection is probably present.
Two
other tests may be performed for more information.
An
audiogram tests if hearing loss has occurred by presenting
tones at various pitches.
A
tympanogram measures the air pressure in the middle ear
to see how well the eustachian tube is working and how well the
eardrum can move.
The
Importance of Medication
The
doctor may prescribe one or more medications. It is important
that all the medication(s) be taken as directed and that any follow-up
visits be kept. Often, antibiotics to fight the infection will
make the earache go away rapidly, but the infection may need more
time to clear up. So, be sure that the medication is taken for
the full time your doctor has indicated. Other medications that
your doctor may prescribe include an antihistamine (for allergies),
a decongestant (especially with a cold), or both.
Sometimes
the doctor may recommend a medication to reduce fever and/or pain.
Analgesic ear drops can ease the pain of an earache. Call your
doctor if you have any questions about you or your child’s medication
or if symptoms do not clear.
What
Other Treatment May Be Necessary?
Most
of the time, otitis media clears up with proper medication and
home treatment. In many cases, however, further treatment may
be recommended by your physician. An operation, called a myringotomy
may be recommended. This involves a small surgical incision (opening)
into the eardrum to promote drainage of fluid and to relieve pain.
The incision heals within a few days with practically no scarring
or injury to the eardrum. In fact, the surgical opening can heal
so fast that it often closes before the infection and the fluid
are gone. A ventilation tube (commonly called Gromet’s
tube) can be placed in the incision, preventing fluid accumulation
and thus improving hearing.
The
surgeon selects a ventilation tube for your child that will remain
in place for as long as required for the middle ear infection
to improve and for the eustachian tube to return to normal. This
may require several weeks or months. During this time, you must
keep water out of the ears because it could start an infection.
Otherwise, the tube causes no trouble, and you will probably notice
a remarkable improvement in hearing and a decrease in the frequency
of ear infections.
Otitis
media may recur as a result of chronically infected adenoids
and tonsils. If this becomes a problem, your doctor may recommend
removal of one or both. This can be done at the same time as ventilation
tubes are inserted.
Allergies may also require treatment.
So,
Remember . . .
Otitis
media is generally not serious if it is promptly and properly
treated. With the help of your physician, you and/or your child
can feel and hear better very soon.
Be
sure to follow the treatment plan, and see your physician until
he/she tells you that the condition is fully cured.
Source:
This page is adapted from a brochure published by the American
Academy of Otolaryngology - Head and Neck Surgery, Inc., 2000
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