Middle Ear Infection (Otitis Media): Symptoms, Causes, Diagnosis & Treatment

Otitis media is an infection of the air-filled space behind the eardrum or middle-ear. There are two main types’viz. acute otitis media and otitis media with effusion. AOM is an infection of rapid onset that usually presents with ear pain while OME is typically not associated with symptoms. Chronic suppurative otitis media is middle ear inflammation which lastsmore than two weeks that results in episodes of discharge from the ear. All three types of otitis may be associated with hearing loss and may affect a child’s ability to learn.

Otitis media occurs more commonly among Indigenous peoples and those who have Down syndrome.Globally AOM affects about 11% of people a year (about 325 to 710 million cases). Half of the cases involve children who are less than five years of age and it is more common among males. Otitis media lead to 3,200 deaths in 2015, down from 4,900 deaths in 1990.More than 10 million cases per year are reported in India.

How does Otitis Media affect your body?

AOM is often followed by OME which causes painful earache. It may also affect the way other parts of the body feel as well. Middle ear infection causes fever, which helps the body fight infection, but it also may make a person’s head and muscles ache and cause a weak and overall tired feeling. Frequently the fever will cause vomiting, diarrhea, and a loss of appetite in children and infants. Crankiness and dizziness are also common in children.

What are the causes of Otitis Media?

The common cause of all forms of otitis media is dysfunction of the Eustachian tube because of which the gas volume in the middle ear is trapped leading to negative pressure in the middle ear. Eventually, the negative pressure can reach a point where fluid from the surrounding tissues is sucked into the middle ear’s cavity (tympanic cavity), causing a middle-ear effusion.

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By reflux of unwanted secretions from the nasopharynx into the normally sterile middle-ear space, the fluid may then become infected usually with bacteria or by virus.

What are the risk factors of Otitis Media?

Age– infants and children below 2 years of age are more susceptible to ear infections because of the size and shape of their eustachian tubes and their poorly developed immune systems.

Group child care– Children in day care or other group forming places are more likely to get colds and ear infections because they’re exposed to more infections, such as the common cold.

Bottle feeding-Bottle feeding a baby especially while lying down, tend to have more ear infections.

Seasonal change– Ear infections are most common during the fall and winter.

Poor air quality– Exposure to tobacco smoke or high level of air pollution can increase the risk.

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What are the symptoms of Otitis Media?

Symptom of acute otitis media:

  • Ear pain
  • Fever
  • Irritability (in infants)
  • Cough
  • Nasal discharge
  • Discharge from ear
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How is Otitis Media diagnosed?

Pneumatic otoscope– It is an instrument which is required to make a diagnosis of an ear infection by looking at the ear drum.

Tympanometry– This device seals off the ear canal, adjusts air pressure in the canal which cause movement in eardrum. This is done to know how well the eardrum moves and provides an indirect measure of pressure within the middle ear.

Acoustic reflectometry– This test measures how much sound emitted from a device is reflected back from the eardrum which again measure fluids in the middle ear.

Tympanocentesis– This test is done to determine the infectious agent in the fluid.

Acute otitis media is diagnosed by observing for fluid in the middle ear or if there are signs or symptoms of an infection and if the onset of symptoms was relatively sudden.

Chronic suppurative otitis media is diagnosed by looking for a persistent ear infection that resulted in tearing or perforation of the eardrum.

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How to prevent & control Otitis Media?

  • Maintaining hygiene– Teach children to wash their hands frequently and thoroughly and to cover their mouth when coughing or sneezing.Also, ask them to not share food item and other personal belongings.
  • Avoid secondhand smoke-Stay away from people who smoke and in air-polluted area. Use humidifier in house and stay in smoke-free environments.
  • Breast-feeding-Breast-feed your baby for at least first six months as the breast milk contains antibodies that provide protection from infections.
  • Correct use of pacifier– When bottle-feeding, hold the baby in an upright position and avoid propping a bottle while the baby is lying down.
  • Vaccinations-Get vaccinations at regular interval, as told by the doctor. Seasonal flu shots, pneumococcal, bacterial and other vaccines may help prevent ear infections.

Treatment of Otitis Media- Allopathic Treatment

As a part of treatment, wait and see approach is used for the first two days because symptoms of ear infections usually improve within the first couple of days on their own without any treatment. Recommended for:

  • Children 6 to 23 months with mild inner ear pain in one ear for less than 48 hours and a temperature less than .
  • Children 24 months and older with mild inner ear pain in one or both ears for less than 48 hours and a temperature less than 39℃.

For managing pain certain medications are given:

Treatment of Otitis Media- Homeopathic Treatment

  • Belladonna– This is prescribed for intense bouts of earache that come and go very suddenly, with heat and inflammation.
  • Chamomilla– This relieves pain and earaches associated with irritability and hypersensitivity to pain.
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Otitis Media- Lifestyle Tips

  • Wash hands and toys of children frequently to reduce the chances of getting a cold or other respiratory infection.
  • Avoid cigarette smoke and highly air-polluted areas.
  • Get yourself and children regular seasonal flu shots and pneumococcal vaccines.
  • Breast-feed infants instead of bottle feeding them.
  • Avoid giving pacifier to infants.
  • Place a warm washcloth next to the affected ear or use a heating pad.
  • Add vitamin C in your diet to help aid immune health by helping the white blood cells to destroy germs faster.
  • Use only pure or boiled water for drinking and cooking.

What are recommended exercise for person with Otitis Media?

To open the Eustachian tube and restore normal ear pressure, exercises like forcing yourself to yawn, holding your nose while swallowing, gently blowing your nose into a tissue or sucking on a sweet can be helpful.

Several yoga postures are good for the ears and may help to rebalance air pressure and restore hearing, for example, Karnapidasana, or the ear press.

Otitis Media & pregnancy- Things to know

  • Maternal use of antibiotics during pregnancy increases the risk of otitis media.
  • Use of antibiotics is associated with an increased risk of otitis media and ventilation tubes insertions in the offspring, early in life.
  • Antibiotics taken late in pregnancy mainly contributed to these effects, pointing toward potential transmission of an unfavorable microbiome from mother to child.

Common complications related to Otitis Media

  • Impaired hearing.
  • Speech or developmental delays.
  • Spread of infection.

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