Otitis Media - Facts and Information

Introduction

Main Item

Defining Otitis Media

Otitis media is a form of inflammation or infection of the middle ear that many times starts when an infection that has caused a cold, sore throat, or another form of breathing or respiratory problem, spreads to the person's middle ear. The infections may be either bacterial or viral infections. Approximately seventy-five percent of all children will experience at least one episode of otitis media by the time they are three years old. Nearly half of these children will experience three or more such ear infections within their first three years of life. Estimates place the medical and lost wages costs related to otitis
media at approximately five-billion dollar each year in America. While otitis media is mainly a disease involving younger children and infants, it may also affect adults.

The Human Ear

The human ear is comprised of three major parts: the outer ear, the middle ear, and the inner ear. The outer ear includes the, 'pinna,' which is the visible portion of the ear, as well as the person's ear canal. The outer ear extends to the, 'tympanic membrane,' or the person's eardrum, that separates their outer ear from their middle ear. A person's middle ear is a space that is filled with air; it is located behind their eardrum. The middle ear has three tiny bones within it: the malleus, incus, and stapes. These bones transmit sound from the person's eardrum to their inner ear. The inner ear contains the person's balance and hearing organs. The, 'cochlea,' contains the hearing organ, which converts sound into electrical signals that are associated with the origin of impulses that are carried by nerves to the person's brain, where their meanings are interpreted.

Effects of Otitis Media

Otitis media may cause a person severe pain, and can result in serious complications if they do not receive treatment for the condition. Infections that remain untreated have the potential to travel from the person's middle ear to nearby portions of their head, to include their brain. While the hearing loss caused by otitis media that the person can experience is commonly temporary, if the condition remains untreated the hearing loss has the potential to become a more permanent impairment. Persistent fluid presence in a child's middle ear and chronic otitis media may reduce the affected child's hearing abilities during a period of time that is critical for the development of both language and speech. Children who experience an early hearing impairment from frequent ear infections are likely to also experience language and speech disabilities.

Signs of Otitits Media

Otitis media can be difficult to detect because the majority of children who are affected by the disorder have not yet developed sufficient speech and language skills, meaning they are unable to tell someone what is bothering them. The more common signs related to otitis media to look for include:

fever
loss of balance
difficulty sleeping
unusual irritability
fluid draining from the ear
unresponsiveness to quiet sounds
tugging or pulling at one or both ears
signs of hearing difficulty such as sitting too close to the television or
being inattentive

Diagnosing Otitis Media

The easiest way to detect an infection in a person's middle ear is to look in their ear with an, 'otoscope,' a form of light instrument which permits a doctor to examine the person's outer ear and eardrum. If their eardrum is inflamed, it indicated an infection. There are a number of ways that a doctor can check for fluid in a person's middle ear. Using a form of otoscope called a, 'pneumatic,' otoscope, a doctor can blow a puff of air onto the person's ear drum to test for eardrum movement. When a person has fluid behind their eardrum it does not move as well as it would with air behind it.

Another test that a doctor can perform is referred to as a, 'tympanometry.' The test involves inserting a small, soft plug into the opening of the person's ear canal. The plug itself contains a speaker, a microphone, as well as a device that has the capability to change the air pressure in the person's ear canal. The instruments permit the doctor to take several measurements of the person's middle ear. The person being tested feels the air pressure change in their ear, or hears a few brief tones. The test does provide information on the condition of the person's middle ear, yet does not indicate the level, or how well, the person hears. A doctor might suggest a hearing test for someone who has frequent ear infections in order to determine the extent of any hearing loss they experience. A hearing test is commonly performed by an audiologist, who is specifically trained to measure hearing abilities.

Treatment of Otitis Media

There are a number of doctors who recommend the use of antibiotics for persons with an active middle ear infection. If the person with the infection is also experiencing pain, a doctor might also prescribe a pain reliever. A follow-up examination, once the person has completed the course of the prescribed antibiotic, is common.

Sadly, there are many types of bacteria that may cause otitis media; some of them have become resistant to forms of antibiotics. One of the reasons this has happened it because antibiotics are given for colds, flu, coughs, or viral infections when antibiotic treatment is not useful. When types of bacteria become resistant to antibiotics, the forms of treatments used then become less effective. What this means to people with otitis media is that they may have to use a number of different antibiotics before their ear infection clears. Antibiotic use also has the potential to cause side-effects such as rashes, nausea, and diarrhea.

When the infection the person is experiencing does clear, there may be some fluid remaining in their middle ear for up to several months. Usually, fluid in a person's middle ear that is not infected disappears within three-to-six weeks. Use of either decongestants or antihistamines is not recommended as a form of helpful treatment for otitis media at any point. At times, a doctor might treat a person with an antibiotic to speed the elimination of fluid.

Should the fluid in the person's middle ear persist for greater than three months, a doctor might suggest the insertion of tubes in their ears. Insertion of these tubes involves an outpatient operation by a surgeon known as an, 'otolaryngologist,' who specializes in the ears, nose, and throat. While the person is under anesthesia, the surgeon creates an opening the their eardrum and places a small plastic or metal tube into the opening of their eardrum. The tube ventilates the person's middle ear, helping to keep the air pressure in their middle ear equal with the air pressure in their environment.

The tube usually stays in the person's eardrum for six months to a year, and comes out spontaneously. In children, if they have either enlarged or infected adenoids, a surgeon might recommend removing their adenoids at the same time the ear tubes are inserted. Removal of the child's adenoids has been shown to reduce the incidence of otitis media in some children, although not for children under the age of four years. Research has shown that removing a child's tonsils, however, does not reduce the occurrence of otitis media.

The person's hearing should be restored, once the fluid is removed from their middle ear. Sometimes children might need to have the surgery again if they experience otitis media after the tubes come out. While the tubes are in place, it is important to keep water of of the person's ears. A number of doctors recommend that children with tubes in their ears wear ear plugs while they are swimming, or while they are bathing, so that water doesn't enter their middle ear.

Hearing should be fully restored once the fluid is removed. Some children may need to have the operation again if the otitis media returns after the tubes come out. While the tubes are in place, water should be kept out of the ears. Many physicians recommend that a child with tubes wear special ear plugs while swimming or bathing so that water does not enter the middle ear.

Preventing Otitis Media

There are no specific strategies that apply to every infant or child, such as either immunization against viral respiratory infections, or specific ones against particular bacteria that cause otitis media at this time. What is known is that children who receive care in group setting, as well as children who live with adults who smoke, experience more ear infections. A child who is prone to otitis media should avoid contact with playmates who are ill, as well as environmental tobacco smoke.