Definition: Otitis Media
The medical term for a middle ear infection is otitis media. Otitis means ear inflammation and media means middle. It typically begins with sore throat or
cold from a viral or bacterial infection. Children are more likely than adults to get ear infections.
The infection spreads to the middle ear, leading to inflammation of the tissue and fluid build-up, which is why ear infections are painful.
Ear infections often clear up on their own. Other times, antibiotics are needed. Chronic or persistent infections may lead to complications such as hearing loss or ruptured eardrums. Drainage tubes are sometimes inserted to equalize pressure and help drain fluid.
Anatomy of the Ear
The ear is our sense organ for hearing and balance. It consists of three regions, the outer ear, middle ear, and inner ear.
Otitis media typically begins with sore throat or cold from a viral or bacterial infection. The infection spreads from the throat through the eustachian tube and into the middle ear, which becomes swollen and inflamed. The swelling seals off the eustachian tube, making it difficult to equalize pressure and may lead to severe pain. The irritated tissues secrete fluid that accumulates in the middle ear. The build up of fluid also prevents the ossicles from vibrating properly causing hearing problems. Finally, in extreme cases, the pressure from the excess fluid may rupture the eardrum.
Airborne viruses or bacteria can trigger inflammation that may lead to an ear infection
Shape of Eustachian Tube
The eustachian (or auditory) tube is a passageway that connects the middle ear to the throat. A child’s Eustachian tube is shorter, narrower, and more horizontal than an adult’s. For this reason, it does not drain the middle ear as well and becomes blocked more easily.
Different Types of Otitis Media
Acute Otitis Media
Acute otitis media is typically caused by
a viral infection, resulting in ear pain and a
reddened, inflamed, and bulging ear drum.
Occasionally, inflammation of the eustachian
tube may progress to a bacterial infection. Acute otitis media usually resolves quickly without damage to the ear drum.
Risk Factors Include:
Children between 6 months and 2 years of age have higher risk because of the shape of their eustachian tube and underdeveloped immunity
Children exposed to other children such as in group child care have more exposure to infections such as the common cold
Group Child Care
Babies who nurse from bottles while lying down have more instances of ear infections than breast-fed babies
Ear infections are more common in fall and winter when other infections, such as colds and sore throats are prevalent. Occasionally seasonally allergies lead to ear infections.
Poor air quality. Tobacco smoke or high levels of pollution exposure may increase risk to developing an ear infection
Acute Otitis Media
An otoscope is a lighted instrument for looking inside the ear canal that helps health care providers look for symptoms of an ear infection. In acute otitis media – the eardrum will appear reddened and bulging outward (from the fluid trapped behind it).
Diagnosing & Treatment
It is now known that most acute ear infections will improve without treatment. Therefore, pediatricians now recommend a wait-and-see policy if the child is older than 6 months, has mild symptoms, and is in good health.
Antibiotics are recommended if the child is younger, the symptoms are severe, and for chronic infections. Pain relievers and warm compresses may be used for pain.
In cases of serous otitis media, if fluid remains in the middle ear for months after the infection has cleared up, drainage tubes may be necessary. These are small plastic or metal tubes placed through the eardrum to equalize the pressure inside the middle ear and allow fluid to drain out. These tubes usually fall out on their own when they are no longer needed.
Facts and Tips for Healthy Ears
Since colds and sore throats often lead to otitis media, young children who are prone to them should not play with sick friends.
Ear infections are more common in fall and winter.
Exposure to second-hand tobacco smoke increases the risk of ear infection, especially in children prone to repeat infections.
Nursing from a bottle lying down increases the risk of infection.
Breast feeding for 6 months provides antibodies that offer protection from ear infections.
Research has shown that cold and allergy medications such as antihistamines and decongestants are not helpful in preventing ear infections.