Otitis media is a painful inflammation of the middle ear, the area directly behind the eardrum. When a person has a common cold, the Eustachian tube can get closed, allowing bacteria and inflammatory fluid to get stuck in the middle ear. The pressure increases and the eardrum will bulge. Otitis media, as well as otitis externa, falls under the heading of ‘ear infection’.
Cause
Between the middle ear and the nasopharynx runs a little canal, the Eustachian tube. Fluid from the middle ear can get through the Eustachian tube to the nasopharynx. Otitis media usually begins with a common cold. The Eustachian tube can thus be closed. In most cases, the inflammation is caused by bacteria. It’s unclear whether viruses can cause otitis media. However, it is suspected that viruses, due to the resulting inflammatory response, stimulate susceptibility to bacterial infection of the middle ear. A few hours after infection, the first symptoms will occur.
Symptoms
Otitis media is often accompanied by earache, malaise, fever and a runny ear. In case of a runny ear, the eardrum tears and there may be blood and pus coming out of the ear, thereby reducing pain. Very young children are not yet able to pinpoint the location of the pain. The symptoms in a young child are fever and crying. Older children may indicate that they have earache, rub or pull the painful ear and temporarily hear bad with the inflamed ear.
Diagnosis
Inspection of the ear shows a red and protruding (bulging) eardrum. The ear canal and the eardrum can be examined with an otoscope. This is a device that illuminates and magnifies the inside of the ear. The doctor looks whether there is pus in the middle ear.
Treatment
Otitis media can hurt a lot. The doctor will usually prescribe painkillers. In case of severe pain, the eardrum may be punctured. If there’s a stuffy nose, nasal drops can be prescribed. There may also be decided to give antibiotics. With proper treatment, the symptoms are usually gone within a few days. A teared eardrum is healed within a few weeks. If otitis media recurs and doesn’t respond to antibiotics, placing tympanostomy tubes may be considered, optionally in combination with removing the tonsils.
Prognosis
Ninety percent of the cases of acute otitis media heal within three days. Sometimes, a runny ear occurs. A runny ear usually heals spontaneously within two weeks. Checking is not necessary then. Complications are rare. The most serious complications are infection of the bone behind the ear (mastoiditis) and meningitis. Then, the child is increasingly seriously ill.
Considerations
- Wash hands regularly and also the child’s hands, to prevent infection. Especially after sneezing, blowing the nose or coughing. The pus from an ear infection can cause contamination.
- When feeding the baby, keep the baby as upright as possible or slightly leaning backwards. This way, the fluid cannot glide through the Eustachian tube to the middle ear and fluid cannot accumulate there to cause infections. Don’t give the child a bottle to bed.
- Stay away from cigarette smoke. This increases the risk of otitis media.
- Keep in mind that a person with otitis media should temporarily hear less well.
- In case of nose colds, it may help to use drops that prevent swelling of the mucosa. This way, the Eustachian tube cannot easily get clogged. Do this only in case of susceptibility to otitis media.
- If the throat and/or nose tonsils are enlarged, they may block the access from the pharynx to the Eustachian tube, so the aeration of the middle ear is not as good anymore. This can cause otitis media. Therefore, it can sometimes be useful to have the tonsils removed.
- Watch out that other people who have colds don’t infect another person who is quickly infected.
- A simple home remedy to relieve the pain and to counteract further inflammation is an onion. Cut the onion in small pieces and wrap the parings in a handkerchief. Put this to the ear and keep it in place with a hair band. Then let it act on the ear as long as possible.
- When the patient feels pretty good, antibiotics are not needed. Nose drops may then be sufficient. In case of severe pain and high fever, consultation with a doctor is necessary to prevent further infections and complications.
