It is also referred to as otitis media. This is an infection that affects the middle part of the ear. It is behind the eardrum which is an air-filled space. Contains tiny vibrating bones for the ear. Affects children more than adults. In an ear infection, the eustachian tubes may become swollen and blocked. This may in turn lead to mucus buildup in the middle ear. Infection of the mucus leads to an ear infection.
Causes of ear infections
An ear infection is a result of a bacterial or viral infection of the middle ear. It can also result from other illnesses such as allergies or colds. They cause congestions plus swelling of the nasal passages, throat, and the eustachian tubes. Infections occur when:
- Eustachian tubes become swollen. Makes them become blocked, leading to fluid build-up in the middle ear. When the fluid is infected it leads to symptoms of ear infection.
- Swelling of adenoids. These are two small pads of tissues high in the back of the nose. They help in one’s immune system activity. Adenoids are located near the opening of the eustachian tubes. On swelling they block the tubes thus leading to middle ear infection. Children are more prone due to the large size of adenoids than adults.
The three common ear infections are;
- Chronic otitis is characterized by media that has effusion. Occurs when fluid remains in the middle part of the ear. May affect hearing.
- Chronic suppurative otitis media. An ear infection does not go away with the normal treatment. Can lead to a hole being in the ear drum.
- Otitis media with effusion. With no bacterial or viral infection, there is swelling and fluid buildup in the middle ear.
Symptoms
Different symptoms of ear infection may indicate several conditions thus important to get an accurate diagnosis and proper treatment. Common symptoms include:
- Trouble sleeping.
- Fever especially in children.
- Loss of appetite.
- Trouble responding to sounds or hearing.
- Children tend to cry more than usual.
- Headache.
- Ear pain when one lies down.
- Drainage of fluid from the ear.
- Children become fussy.
- Loss of balance.
Risk factors for ear infection
- Infant feeding. Bottle-feeding babies when lying down puts the infant at a greater risk of ear infection than babies that are breastfed.
- Age. Children between 6 months to 2 years are more prone to ear infections. This is due to the size and shape of the eustachian tube plus low immunity.
- Poor air quality. Air pollution increases ear infection risks.
- Group childcare settings are more prone to the spread of infections e.g. flu than stay-at-home.
- Cleft palate. Makes it difficult to drain the eustachian tube in children who have different bone and muscle structures.
- Seasonal factors. People with seasonal allergies have a higher risk of developing ear infections. More common when the pollen count is high.
Complications of ear infection
Recurrent ear infections can lead to serious complications. Include:
- Impaired hearing which gets better after infection clears. Permanent hearing loss occurs when there is permanent damage to the eardrum or structures of the middle ear.
- Spread of infection to nearby tissues especially those that do not respond to treatment.
- Tearing of the eardrum. Some tears may need surgery if it does not heal itself within 72 hours.
- Developmental / speech delays in children.
Prevention
- Breastfeeding children for the first 6 months. Breast milk contains antibiotics that help to fight infections.
- Children should be vaccinated regularly.
- No smoking in public areas especially where children are present.
- Children should be held in an upright position when being bottle-fed.
- Treatment of infections plus preventing the infections.
Diagnosis
- Physical examination by use of an otoscope to look at the ear, throat, and nasal passage. A pneumatic otoscope is used to check for fluid built up behind the eardrum.
- Acoustic reflectometry measures the amount of sound reflected back from the eardrum. Normally eardrum absorbs sounds but in cases where there is pressure from fluid in the middle ear. More of the sound is reflected in the eardrum.
- Tympanocentesis – fluid from the middle ear is drained by piercing the eardrum by use of a tiny tube. Fluid is then tested for the presence of bacteria or viruses.
Treatment
- Wait and see approach.
- Use of pain medications e.g. ibuprofen to give relief to the symptoms.
- Use of antibiotics.
- Use of ear tubes to drain fluid from the middle ear.
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