Ear infections are the most common reason for parents to take their children to a doctor. Most children under the age of five years have one or more bouts of this painful condition. Infants’ eustachian tubes become easily clogged so the fluid builds up and infections occur. The eustachian tube leads from the middle ear located behind the eardrum to the back of the throat. Its purpose is to drain fluid and bacteria that accumulate in the middle ear.
There are many types of infections in the ear but the most common type is known as otitis media. Otitis media is further divided into the acute phase and the chronic phase. Acute otitis media is a short painful episode while chronic otitis media either comes and goes or it lasts for a very long time. Otitis externa is a fairly common infection of the ear canal known as swimmer’s ear. Swimmer’s ear may be acute or chronic. If the otitis externa or swimmer’s ear infection spreads from the outer ear into the bones and cartilage at the base of the skull it’s known as malignant otitis externa. The condition is rare and is usually caused by the growth of hard to treat bacteria. Otitis media, in addition to having acute and chronic form also has the form where there is fluid in the middle ear but not necessarily infection. This type is known as otitis media with effusion or OME.
Simply put, anything that causes reduction in the size of the eustachian tube makes a child a candidate for an ear infection. Blocked eustachian tubes can be caused by infections due to colds or flu, allergies, tobacco smoke either direct or second hand. Children who have been breastfed are less at risk to get ear infections. Recent ear infections or recent illness of any type lowers the resistance level of the body and makes it more difficult to fight off infection. Children in large day care settings tend to have more ear infections. Children who use a pacifier positively often find themselves at risk.
OME is characterized by no symptoms other than a feeling of fullness in the ears and muffled sound or even hearing loss. General symptoms for otitis will vary, depending on whether it is acute or chronic. Typically, symptoms will include some or all of the following. Diarrhea, nausea, malaise, irritability, chills, fever, ear noise or buzzing, hearing loss, drainage from the ear, itching or other irritants in the ear or ear canal, and of course earache.
In most cases, some form of antibiotic will be given to fight the buildup of bacteria in the middle ear. In addition, if there is irritation or itching in the ear canal, antibiotic drops or oils may be used there. For chronic ear infection, care must be taken to complete the full dosage of antibiotics in order to knock out the infection. Otherwise, the infection tends to return again and again. Recurrent infections usually result when there are frequent colds or flu.
If a child suffers bout after bout of infection in the middle ear and doesn’t seem to be outgrowing the condition, many medical specialists will do a procedure known as a bilateral myringotomy and tubes or BMT. During this surgery, often performed right in the specialist’s office, small tubes called tympanostomy tubes are inserted into the eardrums. This provides ventilation of the space behind the eardrum. The pressure is equalized in the middle ear so that it is the same as atmosphere pressure. There will be drainage of the bacteria laden fluid into the back of the throat where it is swallowed.
Ear infections that are chronic or those that don’t clear up quickly can impact the speech of a child. If hearing loss occurs temporarily during the time when speech is first being learned and understood it can cause speech disability. If the chronic infections result in longterm damage to the middle ear or cause scarring of the ear drum to the point where hearing disability occurs, the child’s entire life may be affected.