LINDA J. DINDZANS, MD Office: 414-536-7000
JODI M. KORNAK, MD, MS,
FACS
Fax: 414-536-7001
Ear Infections and Earache
What Is
Otitis Media?
Otitis media
means inflammation of the middle ear. The inflammation occurs as a result of a
middle ear infection. It can occur in one or both ears. Otitis media is the
most frequent diagnosis recorded for children who visit physicians for illness.
It is also the most common cause of hearing loss in children.
Although
otitis media is most common in young children, it also affects adults
occasionally. It occurs most commonly in the winter and early spring months.
Is It
Serious?
Yes, it is
serious because of the severe earache and hearing loss it can create. Hearing
loss, especially in children, may impair learning capacity and even delay
speech development. However, if it is treated promptly and effectively, hearing
can almost always be restored to normal.
Otitis media
is also serious because the infection can spread to nearby structures in the
head, especially the mastoid. Thus, it is very important to recognize the
symptoms (see list) of otitis media and to get immediate attention from your
doctor.
How Does the
Ear Work?
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The outer ear collects
sounds. The middle ear is a pea sized, air-filled cavity separated
from the outer ear by the paper-thin eardrum. Attached to the eardrum are three
tiny ear bones. When sound waves strike the eardrum, it vibrates and sets the
bones in motion that transmit to the inner ear. The inner ear converts
vibrations to electrical signals and sends these signals to the brain. It
also helps maintain balance. |
A healthy
middle ear contains air at the same atmospheric pressure as outside of the ear,
allowing free vibration. Air enters the middle ear through the narrow
eustachian tube that connects the back of the nose to the ear. When you yawn
and hear a pop, your eustachian tube has just sent a tiny air bubble to your
middle ear to equalize the air pressure.
What Causes
Otitis Media?
Blockage of
the eustachian tube during a cold, allergy, or upper respiratory infection and
the presence of bacteria or viruses lead to the accumulation of fluid (a
build-up of pus and mucus) behind the eardrum. This is the infection called acute
otitis media. The build up of pressurized pus in the middle ear causes
earache, swelling, and redness. Since the eardrum cannot vibrate properly, you
or your child may have hearing problems.
Sometimes the
eardrum ruptures, and pus drains out of the ear. But more commonly, the pus and
mucus remain in the middle ear due to the swollen and inflamed eustachian tube.
This is called middle ear effusion or serous otitis media. Often
after the acute infection has passed, the effusion remains and becomes chronic,
lasting for weeks, months, or even years. This condition makes one subject to
frequent recurrences of the acute infection and may cause difficulty in
hearing.
What Are the
Symptoms?
In infants
and toddlers look for:
- pulling or scratching at the ear, especially
if accompanied by the following...
1.
hearing problems
2.
crying, irritability
3.
fever
4.
vomiting
5.
ear drainage
In young
children, adolescents, and adults look for:
- earache
- feeling of fullness or pressure
- hearing problems
- dizziness, loss of balance
- nausea, vomiting
- ear drainage
- fever
Remember,
without proper treatment, damage from an ear infection can cause chronic or
permanent hearing loss.
What Will
Happen at the Doctor’s Office?
During an
examination, the doctor will use an instrument called an otoscope to assess the
ear’s condition. With it, the doctor will perform an examination to check for
redness in the ear and/or fluid behind the eardrum. With the gentle use of air
pressure, the doctor can also see if the eardrum moves. If the eardrum doesn’t
move and/or is red, an ear infection is probably present.
Two other
tests may be performed for more information.
An audiogram
tests if hearing loss has occurred by presenting tones at various pitches.
A tympanogram
measures the air pressure in the middle ear to see how well the eustachian
tube is working and how well the eardrum can move.
The
Importance of Medication
The doctor
may prescribe one or more medications. It is important that all the
medication(s) be taken as directed and that any follow-up visits be kept.
Often, antibiotics to fight the infection will make the earache go away
rapidly, but the infection may need more time to clear up. So, be sure that the
medication is taken for the full time your doctor has indicated. Other
medications that your doctor may prescribe include an antihistamine (for
allergies), a decongestant (especially with a cold), or both.
Sometimes the
doctor may recommend a medication to reduce fever and/or pain. Analgesic ear
drops can ease the pain of an earache. Call your doctor if you have any
questions about you or your child’s medication or if symptoms do not clear.
What Other
Treatment May Be Necessary?
Most of the
time, otitis media clears up with proper medication and home treatment. In many
cases, however, further treatment may be recommended by your physician. An
operation, called a myringotomy may be recommended. This involves a small
surgical incision (opening) into the eardrum to promote drainage of fluid and
to relieve pain. The incision heals within a few days with practically no
scarring or injury to the eardrum. In fact, the surgical opening can heal so
fast that it often closes before the infection and the fluid are gone. A ventilation
tube can be placed in the incision, preventing fluid accumulation and thus
improving hearing.
The surgeon
selects a ventilation tube for your child that will remain in place for as long
as required for the middle ear infection to improve and for the eustachian tube
to return to normal. This may require several weeks or months. During this
time, you must keep water out of the ears because it could start an infection.
Otherwise, the tube causes no trouble, and you will probably notice a
remarkable improvement in hearing and a decrease in the frequency of ear
infections.
Otitis media
may recur as a result of chronically infected adenoids and tonsils. If
this becomes a problem, your doctor may recommend removal of one or both. This
can be done at the same time as ventilation tubes are inserted.
Allergies may also require
treatment.
So, Remember
. . .
Otitis media
is generally not serious if it is promptly and properly treated. With the help
of your physician, you and/or your child can feel and hear better very soon.
Be sure to follow the treatment plan, and see your physician until
he/she tells you that the condition is fully cured.
Reprinted from the