OTITIS MEDIA

Our Ear

What is otitis media? Otitis media Latin for "Middle otitis" It is one of the two categories of ear inflammation that can underlie what is commonly called an earache, the other being otitis externa.

Classifications of Otitis Media Acute otitis media (AOM) There is congestion of the ears and perhaps mild discomfort and popping, but the. Viral acute otitis media can lead to bacterial otitis media in a very short time, especially in children, but it usually does not. The individual with bacterial acute otitis media has the classic "earache", pain that is more severe and continuous and is often accompanied by fever of 39 °C) or more.

Classifications of Otitis Media Otitis media with effusion (OME), also called serous or secretory otitis media (SOM), This can occur purely from a viral URI, with no pain or bacterial infection, or it can precede and/or follow acute bacterial otitis media. Fluid in the middle ear sometimes causes conductive hearing impairment, but only when it interferes with the normal vibration of the eardrum by sound waves. Over weeks and months, middle ear fluid can become very thick and glue-like (thus the name glue ear), which increases the likelihood of its causing conductive hearing impairment. Early-onset

Classifications of Otitis Media Chronic suppurative otitis media involves a perforation in the eardrum and active bacterial infection within the middle ear space for several weeks or more. There may be enough pus that it drains to the outside of the ear. Hearing impairment often accompanies this disease.

Acute otitis media

Otitis Media with effusion

Chronic suppurative otitis media

Signs and Symptoms In severe or untreated cases, the tympanic membrane may rupture, allowing the pus in the middle ear space to drain into the ear canal. If there is enough of it, this drainage may be obvious. Even though the rupture of the tympanic membrane suggests a traumatic process, it is almost always associated with the dramatic relief of pressure and pain. In a simple case of acute otitis media in an otherwise healthy person, the body's defenses are likely to resolve the infection and the ear drum nearly always heals. Antibiotic administration can prevent perforation of the eardrum and hasten recovery of the ear. Instead of the infection and eardrum perforation resolving, however, drainage from the middle ear can become a chronic condition. As long as there is active middle ear infection, the eardrum will not heal.

What is Pus? Causes The organisms causing pus in the ear occur due to cough, cold and sinusitis. Initially running nose, cold or cough may be present but later the bacteria enter into the middle ear through the eustachian tube. In children the eustachian tube (connecting the throat and middle ear) is very short and hence infection of the ear is very common after an attack of cold, cough or sinusitis. Signs & Symptoms When pus is formed in the middle ear, child complains of severe pain in the ear which is unbearable. In most cases the pus enters into the external ear and outside after the eardrum is ruptured. This reduces the earache and foul- smelling pus come out. Fever may be present in many cases. Vomiting, poor appetite, cough may be associated. Herbal Medicines Garlic, onion and ginger are useful both externally and internally.

What causes otitis media? Streptococcus pneumoniae and nontypable Haemophilus influenzae are the most common bacterial causes of otitis media. In older adolescents and young adults, the most common cause of ear infections during their childhoods was Haemophilu influenzae. The role of the anti-H. influenzae vaccine that children are regularly given in changing patterns of ear infections is unclear, as this vaccine is active only against strains of serotype b, which rarely cause otitis media. As well as being caused by Streptococcus pneumoniae and Haemophilus influenzae it can also be caused by the common cold. Colds indirectly cause many cases of otitis media by damaging the normal defenses of the epithelial cells in the upper respiratory tract. Another common culprit of otitis media includes Moraxella catarrhalis, a gram-negative, aerobic, oxidase positive diplococcus. Less commonly otitis media can be caused by Mycobacterium tuberculosis.

Progression Typically, acute otitis media follows a cold: after a few days of a stuffy nose the ear becomes involved and can cause severe pain. The pain will usually settle within a day or two, but can last over a week. Sometimes the ear drum ruptures, discharging pus from the ear, but the ruptured drum will usually heal rapidly. At an anatomic level, the typical progression of acute otitis media occurs as follows: the tissues surrounding the Eustachian tube swell due to an upper respiratory infection, allergies, or dysfunction of the tubes. The Eustachian tube remains blocked most of the time. The air present in the middle ear is slowly absorbed into the surrounding tissues. A strong negative pressure creates a vacuum in the middle ear, and eventually the vacuum reaches a point where fluid from the surrounding tissues accumulates in the middle ear.

Fact: Children below the age of seven years are much more prone to otitis media since the Eustachian tube is shorter and at more of a horizontal angle than in the adult ear. They also have not developed the same resistance to viruses and bacteria as adults. Numerous studies have correlated the incidence of acute otitis media in children with various factors such as nursing in infancy, bottle feeding when supine, parental smoking, diet, allergies, and automobile emissions; but the most obvious weakness of such studies is the inability to control the variable of exposure to viral agents during the studies

Treatment

acute otitis media To treat the pain caused by otitis media oral as well as topical analgesics are often used. Oral agents may include ibuprofen, acetaminophen, and / or narcotics. Topical agents have also been shown to be effective, such as antipyrine and benzocaine ear drops.

Chronic cases or with effusion In chronic cases or with effusions present for months, surgery is sometimes performed by an otolaryngologist or by an otologist, to insert a tympanostomy tube (also called a "grommet") into the eardrum to allow air to pass through into the middle ear, and thus release any pressure buildup and help clear excess fluid within.