OTITIS MEDIA

Introduction:

Otitis media is an infection of the middle ear, the area just behind the eardrum. It happens when the eustachian tubes, which connect the middle ear to the nose, become blocked with fluid. With the infection, mucus, pus, and bacteria can also pool behind the eardrum, causing pressure and pain. Ear infections usually begin with a cold. Although adults can get ear infections, they are most common in infants and young children. That's because a child's eustachian tubes are narrower and shorter than an adults', and it's easier for fluid to get trapped in the middle ear. In fact, otitis media occurs in 75% of all children. It occurs most commonly between the ages of 6 - 11 months. By age 1, 60% of children will have had at least one episode of otitis media and 17% will have 3 or more episodes. Ear infections usually clear up on their own. Although it was common for doctors to give antibiotics to children with ear infections, now guidelines from the American Academy of Pediatricians suggest taking a wait and see approach for the first 72 hours.

With a severe ear infection, pressure may build up and cause the eardrum to rupture. Pus and blood may drain out. This usually relieves pain and pressure, and in most cases the eardrum heals on its own.

Signs and Symptoms:

There are two main types of ear infections: acute otitis media (AOM), and otitis media with effusion (OME), where fluid remains trapped in the ear even after the infection is gone.

Acute otitis media causes pain, fever, and difficulty in hearing. If a child is too young to talk, signs of an ear infection can include crying, irritability, trouble sleeping, and pulling on the ears.

Other symptoms that may be associated with an ear infection include sore throat (pharyngitis), neck pain, nasal congestion and discharge (rhinitis), headache, and ringing (tinnitus), buzzing, or other noise in the ear.

Causes:

Blockage of the eustachian tubes may be caused by:

• Respiratory infection (cold)
• Allergies
• Exposure to cigarette smoke
• Infected or overgrown adenoids (tonsils)
• For infants, being fed lying down (drinking a bottle while lying on the back)

Ear infections occur most often in the winter. They are not contagious, but a cold may spread among a group of children and cause some of them to get ear infections.

Risk Factors:

Risk factors for otitis media include:

• Age (children between 6 - 36 months are most likely to get ear infections)
• Attending daycare
• Recent illness (such as a cold or sinus infection)
• History of allergies (like hay fever, also called allergic rhinitis, or sinusitis)
• Exposure to secondhand smoke
• Having family members who are prone to ear infections
• Using a pacifier

Preventive Care:

You can reduce your child's risk of ear infection. Here are some tips:

• Don't expose your child to secondhand smoke.
• Keep your child away from other children who are sick.
• Always hold your infant in an upright, seated position during bottle feeding.
• Breastfeeding for at least 6 months can make a child less prone to ear infections.
• Don't use a pacifier.
• The pneumococcal vaccine (Prevnar) prevents infections such as pneumonia and meningitis, and studies show it slightly reduces the risk of ear infections.