Infections in the middle ear can be caused by viruses or bacteria. These frequently cause in pain, inflammation, and fluid accumulation.
Before they become three years old, almost 75% of youngsters will have had at least one ear infection. The most common reason for a child’s visit to the doctor is an ear infection.
Glue ear, secretory otitis media, middle ear infection, and serous otitis media are all terms for ear infections.
Infections of the ear are widely understood, and their frequent recurrence necessitates ongoing investigation. This article discusses the symptoms and causes of ear infections, as well as the treatment choices and diagnostic methods available.
What is it?
A bacterial or viral infection of the middle ear is known as an ear infection. Inflammation and fluid buildup in the ear’s interior cavities are caused by this infection.
The middle ear is a space behind the eardrum that is filled with air. It has vibrating bones that translate sound from outside the ear into messages that the brain can understand.
Ear infections hurt because the swelling and accumulation of extra fluid puts pressure on the eardrum.
An ear infection can be acute or chronic. Chronic ear infections might harm the middle ear permanently.
Causes
An ear infection is frequently preceded by a cold, flu, or allergic reaction. These increase mucus in the sinuses, causing the eustachian tubes to discharge fluid slowly. The nasal passages, throat, and eustachian tubes will all be inflamed during the initial illness.
The role of eustachian tubes
The eustachian tubes run from the middle ear to the throat’s rear. These tubes’ ends open and reopen to control air pressure in the middle ear, restock air, and drain natural secretions.
The eustachian tubes can become blocked due to a respiratory infection or allergies, resulting in an accumulation of fluid in the middle ear. If this fluid becomes bacterially contaminated, infection may result.
Young children’s eustachian tubes are smaller and more horizontal than those of older children and adults. This implies that fluid is more likely to pool in the tubes instead of draining away, raising the risk of ear infection.
The role of adenoids
Adenoids are tissue pads found in the back of the nasal cavity. They respond to bacteria and viruses in the air and help the immune system function. The adenoids, on the other hand, can sometimes trap bacteria. The eustachian tubes and middle ear may get infected and inflamed as a result of this.
The adenoids are adjacent to the eustachian tube entrances and can cause the tubes to close if they expand. The adenoids in children are larger and more active than those in adults. Children are more likely to get ear infections as a result of these factors.
Symptoms
The signs and symptoms in adults are simple. Adults with ear infections suffer from ear pain and pressure, as well as ear fluid and hearing loss. Children are exposed to a broader spectrum of symptoms. These are some of them:
- ear pain, especially when lying down
- difficulty sleeping
- difficulty hearing
- fever
- lack of appetite
- headache
- tugging or pulling at the ear
- crying more than normal
- loss of balance
Types
In general, there are three types of ear infections.
Acute otitis media (AOM)
The most common and least dangerous type of ear infection is AOM. The fluid beneath the eardrum gets infected and bloated, and the middle ear becomes infected and swollen. Fever is another possibility.
Otitis media with effusion (OME)
There may be some fluid behind the eardrum after an ear infection has cleared. Although a person with OME may not show symptoms, a doctor will be able to detect any lingering fluid.
Chronic otitis media with effusion (COME)
COME refers to fluid returning to the middle ear on a regular basis, whether or not an infection is present. This reduces your ability to fight other infections and has a detrimental influence on your hearing.
Diagnosis
Ear infection testing is a simple procedure, and a diagnosis can often be determined solely on the basis of symptoms.
To examine for fluid behind the eardrum, the doctor will usually use an otoscope, which is a light-attached tool.
A pneumatic otoscope is sometimes used by a doctor to check for infection. This device uses a puff of air to check for retained fluid in the ear. The eardrum will move less than normal if there is any fluid behind it.
If the doctor is unsure, he or she may perform further tests to confirm a middle ear infection.
Tympanometry
The doctor employs a device that shuts up the ear canal and changes the pressure inside it. The eardrum movement is measured by the instrument. This allows the doctor to determine the middle ear pressure.
Acoustic reflectometry
The eardrum is bouncing sound against the eardrum in this technique. The amount of sound that bounces back shows the level of fluid buildup. The bulk of sound is absorbed by a healthy ear, whereas an infected ear reflects more soundwaves.
Tympanocentesis
A clinician may employ tympanocentesis if an ear infection has not responded well to treatment. A small hole is made in the eardrum and a small amount of fluid is drained from the inner ear during this treatment. The infection’s cause can then be determined using this fluid.
Treatments
Antibiotic treatment is required for infants under the age of six months to help prevent the spread of infection. Amoxicillin is frequently used as an antibiotic.
Unless the kid shows signs of a severe infection, doctors usually recommend monitoring the child without antibiotics for children aged 6 months to 2 years.
Ear infections usually go away on their own, and the only prescription required is pain relief. Antibiotics are only used in circumstances that are more serious or last longer.
The American Academy of Family Physicians (AAFP) advises patients to be on the lookout for:
- children aged 6 to 23 months who have experienced mild inner ear pain in one ear for less than 48 hours and a temperature of less than 102.2° Fahrenheit (39° Celsius)
- children aged 24 months and over with mild inner ear pain in one or both ears for less than 48 hours and a temperature of less than 102.2°F
Antibiotics are rarely recommended for children above the age of two. Antibiotic resistance develops as a result of overuse. Serious infections may become more difficult to treat as a result of this.
For persistent infections, the AAFP recommends acetaminophen, ibuprofen, or eardrops as pain relievers. These are useful for reducing fever and pain.
A warm compress, such as a towel, can help to relieve the pain in the affected ear.
If you have recurrent ear infections for several months or a year, your doctor may recommend a myringotomy. A surgeon creates a small cut in the eardrum to allow the build-up of fluid to be released.
To help air out the middle ear and prevent future fluid buildup, a very small myringotomy tube is implanted. These tubes are typically left in place for 6 to 12 months before falling out naturally rather than requiring manual removal.
Prevention
- Ear infections are very frequent, particularly among children. This is linked to a developing immune system and variations in ear architecture. There is no surefire way to avoid infection, however there are a few things you can do to lower your chances:
- Ear infections are less common in children who have been vaccinated. Inquire with your doctor about immunizations for meningitis, pneumococcal disease, and the flu.
- Wash your hands, as well as your child’s, frequently. This can help your child avoid having colds and flu by preventing bacteria from spreading to them.
- Second-hand smoking should never be exposed to a child. Ear infections are more common in infants who spend time with people who smoke.
- If at all possible, breastfeed infants. This aids in the improvement of their resistance.
- Feeding a newborn from a bottle while sitting up reduces the risk of milk going into the middle ear. When a baby is lying down, do not allow them to sip on a bottle.
- Allow your child to play with ill children as little as possible, and limit their exposure to group care or big groups of children.
- Antibiotics should only be used when needed. Ear infections are more common in children who have had an ear infection in the last three months, especially if antibiotics were used to treat it.
Ear infections are a common occurrence in most children’s lives. They can be unpleasant and debilitating, but if appropriately handled, they pose very few long-term issues.
Sources:
- http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001480.pub4/abstract
- http://www.aafp.org/afp/2013/1001/p435.html
- http://cmr.asm.org/content/16/2/230.full
- https://www.medicalnewstoday.com/articles/167409
- http://www.aafp.org/patient-care/clinical-recommendations/all/otitis-media.html
- https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_smoking_youth_508.pdf
- https://jamanetwork.com/journals/jama/fullarticle/211068
- http://www.ncbi.nlm.nih.gov/pubmed/25156728
