Acute Otitis media is an inflammation of the middle ear (the cavity between the eardrum and the inner ear). Children are more commonly affected than adults because of the small size and horizontal position of their eustachian tube (the passage that connects the back of the nose to the middle ear). The eustachian tubes equalize the pressure between the middle ear cavity and the outside atmosphere and allow fluid and mucus to drain out of the middle ear cavity. This tube may become blocked by a bacterial or viral infection of the upper respiratory tract or by enlarged adenoids. Fluid produced by the inflammation cannot drain off through the tube and instead collects in the middle ear.
Symptoms of Otitis Media
Acute otitis media causes sudden, severe earache, deafness, and tinnitus (ringing or buzzing in the ear), sense of fullness in the ear, irritability, tugging or rubbing the ear, an unwillingness to lie down, fever, headache, a change in appetite or sleeping patterns, fluid leaking from the ear, nausea and difficulty in hearing. Occasionally, the eardrum can burst, which causes a discharge of pus and relief of pain. Complications of a single episode of otitis media are rare and include otitis externa (inflammation of the outer ear), and spread inward from the ear to the skull, causing, mastoiditis (inflammation of the mastoid bone cells), or into the brain, causing meningitis (inflammation of the membranes covering the brain and spinal cord) or a brain abscess. Complications in recurrent otitis media include perforation of the ear drum, damage to the bones in the middle ear (sometimes causing total deafness) or a cholesteatoma (a matted ball of skin debris which can erode bone and cause further damage to the ear).
Diagnosis of Otitis Media
Otitis media can be detected by examining the ear with an otoscope. In addition, two tests may be performed to give the E.N.T. Specialist information that cannot be learned through observation only. One of these tests is an audiogram, in which tones are sounded at various pitches. An audiogram is used to measure how much hearing loss has occurred. The second test, called a tympanogram, measures the air pressure in the middle ear; this indicates how well the eustachian tube is functioning.
Treatment of Otitis Media
After the diagnosis is made, a conservative treatment plan is considered by your otolaryngologist, considering the patient’s age, risk factors for having resistant bacteria, immunization status, and hearing status.
Surgery
Your doctor may recommend surgery if the child’s infection fails to respond to antibiotics, if the ear infections are chronic or hearing loss is indicated.
THE OPTIONS INCLUDE
Adenoidectomy. The doctor may suggest removing the adenoids (adenoidectomy). This procedure is only recommended for children 4 years of age or older, if the otitis media has lasted three months or more and the adenoids are repeatedly inflamed. Tonsillectomy. The doctor may suggest removing the tonsils (tonsillectomy) along with Adenoidectomy. This procedure is only recommended for children 4 years of age or older, if the otitis media has lasted three months or more and the tonsils are repeatedly inflamed. If there is damage to the eardrum the doctor may suggest tympanoplasty (surgical closure of a perforation in the eardrum by means of a tissue graft).