Earaches and Ear Infection
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 Otitis Media 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?
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 Of Otitus Media?
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 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 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.
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