What is Otitis Media(Middle Ear Inflammation) ?
Middle ear inflammation, called otitis media in the medical literature, is an inflammation of the ear chamber called the middle ear, which is located behind the eardrum and in which the small bones that enable people to hear sounds vibrate. Children are more likely to get otitis media than adults.
In most cases, otitis media usually resolves spontaneously. For this reason, treatment basically aims to monitor the problem and manage the pain caused by inflammation. In some cases, antibiotics are used to clear the infection. Some individuals are prone to otitis media and may experience more than one inflammation. This can lead to the development of hearing problems and other serious complications in the individual.
What Causes Otitis Media (Middle Ear Inflammation) ?
Otitis media is caused by a bacteria or virus in the middle ear. This infection is usually caused by another illness or medical problem, such as a cold, flu, or allergies. The infection can cause blockage or swelling of the nasal passages, throat, and eustachian tubes.
The Eustachian tubes are a pair of narrow tubes that run from the middle ears to the back of the nasal passages at the back of the throat. The end of these tubes extending into the throat can be opened and closed to regulate air pressure in the middle ear, freshen the air in the ear, and drain normal secretions from the middle ear.
Swollen Eustachian tubes can become blocked, causing fluid to accumulate in the middle ear. If this fluid becomes infected over time and otitis media symptoms may occur. In children, the eustachian tubes are narrower and more horizontal. This makes it difficult to empty the tubes and increases the possibility of clogging.
Adenoids are two small pads of tissue that are made up of tonsil-like lymphatic tissue and believed to play a role in the functioning of the immune system. Because the adenoids are close to the opening of the Eustachian tubes, swelling of the adenoids can block the tubes. This can lead to otitis media. Swelling and irritation of these glands is more likely to play a role in cases of otitis media in children because children have relatively larger adenoids than adults.
There are other conditions associated with middle ear inflammation, or other conditions that can cause similar middle ear problems. For example, otitis media with effusion or otitis media results from swelling and fluid accumulation in the middle ear, ie effusion, without bacterial or viral infection. This may occur due to continued fluid accumulation after the otitis media has healed. This can also occur due to some dysfunction of the Eustachian tubes or due to non-infectious blockages.
Chronic otitis media with effusion is the name given to the condition that occurs when fluid remains in the middle ear and frequently fills the middle ear in the absence of bacterial or viral infection. This makes children susceptible to new otitis media and can damage their hearing over time.
Chronic suppurative otitis media is a type of otitis media that does not go away with normal treatment methods. This type can cause a rupture in the eardrum.
Certain factors increase an individual's risk of developing otitis media. For example, children aged 6 months to 2 years are more susceptible to otitis media, both because of the size and shape of their Eustachian tubes and because their immune systems are still developing.
It has been observed that in places where children are taken care of collectively, the probability of catching otitis media in children is higher than that of children who are cared for individually. This is thought to be due to the higher risk of contracting infections such as the common cold or flu in places where children are housed.
Differences in bone structure and muscles in children with a congenital cleft can make it difficult for the Eustachian tube to flow. This increases the risk of developing otitis media. It has been observed that feeding babies in bed also increases the risk of otitis media.
Middle ear infections are most common in autumn and winter. Individuals with seasonal allergies face a higher risk of otitis media as the pollen count is higher during these periods. Exposure to tobacco smoke or high levels of air pollution can increase an individual's risk of developing otitis media.
What are the Complications that May Occur with Otitis Media (Middle Ear Inflammation) ?
Cases of otitis media usually do not cause long-term complications. However, repeated otitis media can lead to serious complications. These complications include primarily hearing impairment. Under normal circumstances, mild hearing loss that comes and goes with otitis media is quite common, but it usually gets better once the infection clears. Constant recurrence of otitis media or fluid in the middle ear can cause more significant hearing loss. Permanent hearing loss may occur if some permanent damage to the eardrum or other middle ear structures occurs due to infection.
In infants and toddlers, if hearing is temporarily or permanently impaired due to otitis media or for any other reason, delays in speech, social and developmental skills may be observed.
Untreated infections or infections that do not respond well to treatment may in some cases spread to other surrounding tissues. The infection that occurs on the mastoid, which is the bone protrusion behind the ear, due to otitis media is called mastoiditis. Mastoiditis infection can cause bone damage and the formation of inflamed cysts. In rarer cases, a severe otitis media can spread to other tissues in the skull, including the brain or the membranes surrounding the brain, and cause meningitis.
Eardrum tears due to otitis media normally heal within 72 hours. However, in some cases, surgical repair may be required.
How to Prevent Otitis Media (Middle Ear Inflammation) ?
Avoiding colds and other similar illnesses can reduce the risk of otitis media. For this, especially children should be taught not to share eating and drinking utensils and it should be expressed that they wash their hands frequently. Children should be shown sneezing into the elbow. Particularly during the seasons of illness, the time children spend as a group should be limited. In cases where the child is sick, it is recommended to take the necessary steps to be cared for at home and to keep him away from the school environment.
It is necessary to avoid smoking or secondhand smoking. No one should smoke inside the house, and smoke-free environments should be preferred outside.
The baby should be kept in an upright position, especially when the baby is fed with a bottle. Drinks should not be given to the baby's mouth while the baby is lying down, and a bottle should not be left in the baby's cradle.
In addition to these, seasonal flu vaccines and other bacterial vaccines such as pneumococcus and similar can indirectly help prevent otitis media.
What are the Symptoms of Otitis Media (Middle Ear Inflammation)?
The onset of signs and symptoms of otitis media usually develops quickly. These signs and symptoms may differ depending on whether the condition develops in children or adults.
Common signs and symptoms during otitis media in children include earache especially when lying down, fever of 38°C and above, headache, constant pulling on one ear, loss of balance, loss of appetite, fluid discharge from the ear, crying more than normal, discomfort and discomfort. yelling, trouble hearing or responding to sounds, and trouble sleeping.
Common signs and symptoms of middle ear pain among adults include ear pain, fluid leaking from the ear, and trouble hearing.
The various signs and symptoms of otitis media can point to a number of different underlying conditions. In these cases, it is important to make an accurate diagnosis and start the treatment process quickly.
Signs and symptoms of otitis media that last longer than a day, occur in a child younger than 6 months old, cause severe ear pain, are sleepless or restless in an infant or toddler after a cold or other upper respiratory infection, or hear from the ear If fluid, inflammation or bloody discharge is observed, a doctor should be consulted as soon as possible.
How Is Otitis Media (Middle Ear Inflammation) Diagnosed ?
Under normal conditions, the diagnosis of otitis media can be easily made based on the symptoms described by the individual and the physical examination. The doctor will use a lighted instrument called an otoscope to look at the ears, throat, and nasal passages to confirm the diagnosis. It is also possible to listen to the heartbeat with the help of a stethoscope.
An instrument called a pneumatic otoscope is usually the only specialized tool required by a doctor to diagnose otitis media. This instrument allows the doctor to examine the ear and decide if there is fluid behind the eardrum.
The doctor gently blows air into the eardrum with a pneumatic otoscope. Normally, this blown air causes the eardrum to move. But if the middle ear is filled with fluid, the doctor will observe that the eardrum moves little or not at all.
In rare cases where there is any doubt about the diagnosis, or if the condition has not responded to continued treatments, or if other long-term or serious problems have arisen, he may order the development of different tests. can do other tests if available.
The tympanometry test, which can be applied at this stage, measures the movement of the eardrum. The device, which completely closes the ear canal, adjusts the air pressure in the canal, causing the eardrum to move. The device measures how well the eardrum is moving and provides an indirect measurement of pressure within the middle ear.
The acoustic reflectometry test measures how much sound is reflected back from the eardrum. This provides an indirect measurement of the amount of fluid in the middle ear. Normally, the eardrum absorbs most of the sound, but if there is excess fluid behind the eardrum and pressure is high in the middle ear, more sound is reflected back from the eardrum.
In rare cases, doctors may use a small tube that pierces the eardrum to drain fluid from the middle ear. This procedure is called tympanocentesis. The received fluid is tested for viruses and bacteria. It is an effective method for identifying infections that do not respond to previous treatments.
How Is Otitis Media (Middle Ear Inflammation) Treated ?
Some cases of otitis media resolve spontaneously without the need for antibiotic treatment. The best solution for the sick individual always depends on many factors, such as the individual's age and the severity of symptoms.
The symptoms of otitis media usually resolve within the first few days, and most infections go away on their own within one to two weeks without any treatment. Therefore, waiting for a certain period of time may be beneficial for the treatment process. These waiting times are 48 hours for children aged 6 to 23 months with mild middle ear pain in one ear and a fever below 39°C.
In children older than 24 months, if there is a slight pain in one or both ears and if the fever is below 39 °C, the waiting period is again 48 hours.
How Is Otitis Media (Middle Ear Inflammation) Treated ?
Evidence from scientific research suggests that treating otitis media with antibiotics may be beneficial for children in some cases. On the other hand, using antibiotics too often can cause bacteria to become resistant to the drug. For this reason, it is necessary to consult a doctor before using any antibiotic. After the initial observation period, the doctor will initiate antibiotic therapy if deemed necessary.
Your doctor will advise the individual on the treatment that should be performed to reduce the pain caused by otitis media. During this treatment process, the doctor may recommend the use of over-the-counter medications to relieve pain.
Anesthetic drops to be instilled in the ear can be used to relieve pain as long as there is no hole or tear in the eardrum.
In cases of otitis media with effusion, i.e. if water in the ear persists after the otitis media has healed, the doctor may recommend a middle ear drainage procedure. During this surgical procedure, called a myringotomy, the surgeon makes a small hole in the eardrum that allows it to absorb fluids from the middle ear.
A small tube, called a tympanostomy tube, is inserted into the opening to help ventilate the middle ear and prevent further fluid buildup. Some tubes are designed to stay in the ear for up to a year, then dry and fall out on their own. After the tube is dropped, the crack or hole in the eardrum closes by itself.
A chronic infection called chronic suppurative otitis media, which results in a hole or tear in the eardrum, is more difficult to treat. This condition is usually treated with antibiotics administered as drops. How to draw fluid from the ear canal with the application of drops is shown to the individual by the doctor.