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Otitis Media: Types, Causes, Symptoms, Diagnosis & Treatment

Otitis Media

Otitis Media

Otitis media refers to the inflammation of the middle ear. Otitis media affects the space behind the eardrum. Otitis media is most common in infants and children, 75% of whom have had at least one episode by the age of 1 year.12 About 20% of cases of otitis media occur in adults, particularly in those with a history of these infections as a child.

Otitis media is more commonly reported during the winter season, outbreaks of respiratory syncytial or influenza virus. Genetic predisposition is also involved in causing otitis media.

Some allergies cause irritation (growing) of the nasal entries and upper respiratory tract, which can broaden the adenoids. Extended adenoids can impede the Eustachian tube, keeping ear liquids from depleting. This prompts liquid development in the middle ear, causing stress or pressure, pain, and conceivable contamination.

People with persistent ailments are bound to foster ear contaminations, particularly patients with resistant insufficiency and constant respiratory illness, like cystic fibrosis and asthma. Otitis media is more common in the male gender. Immunodeficient people are also at higher risk for developing otitis media.

Lack of breastfeeding in infants also puts them at higher risk for developing ear infections. Increased exposure to tobacco smoke or significant degrees of air contamination can build the danger of ear diseases. Children under 3 years of age are more prone to the development of ear infections.

Types Of Otitis Media

The most common types of otitis media are discussed below,

Acute Otitis Media

Acute otitis media happens suddenly causing inflammation and redness. Liquid and bodily fluid become caught inside the ear, making the kid have a fever and ear torment.

Otitis Media With Effusion

In otitis media with effusion, middle ear liquid is available, however, signs and side effects of contamination are missing. Pus and mucus keep on collecting in the middle ear. It may cause hearing problems. It is also known as serous otitis media.

Chronic Otitis Media With Effusion

Pus and mucus stay in the middle ear for a drawn-out period or return over and over, even though there is no contamination affecting the hearing of your child.

Causes Of Otitis Media

The Eustachian tube is the cylinder that runs from the center of the ear to the rear of the throat. An acute otitis media happens when your youngster's Eustachian tube gets swollen or hindered and traps liquid in the center ear. The caught liquid can get contaminated. In small kids, the Eustachian tube is more limited and flatter than it is in more seasoned youngsters and grown-ups. This makes it bound to get tainted.

Intense otitis media for the most part follows a viral upper respiratory tract disease that causes Eustachian tube defects and mucosal growing in the middle ear. Microscopic organisms and viruses that colonize the nasopharynx consequently enter the middle ear and are not cleared as expected by the mucociliary system. Within the sight of effusion, the microorganisms multiply and cause contamination.

In otitis media with effusion, middle ear liquid is available, however, signs and side effects of contamination are missing.

Children will, in general, be more vulnerable to otitis media than grown-ups because the structures of their Eustachian tube are more limited and more flat which facilitates bacterial entry into the middle ear.

Most of the cases of otitis media are caused by bacteria, although certain viruses are also involved in causing otitis media. Influenza virus and rhinoviruses are commonly reported in causing otitis media.

Streptococcus pneumoniae and Haemophilus influenzae are the two most commonly encountered bacterial pathogens in causing otitis media. However, Moraxella catarrhalis and Streptococcus pyogenes are also reported in causing otitis media but in rare cases.

Symptoms Of Otitis Media

The signs and symptoms of otitis media may vary from person to person. The most common symptoms of otitis media are severe ear pain, runny nose, nasal congestion, cough, irritability, difficulty sleeping, unable to stay asleep, tugging or pulling at one or both ears, pus discharge, difficulty in hearing, and loss of balance.

Non-specific symptoms such as fever or vomiting may also be present. The complications developed as a result of otitis media are mastoiditis, meningitis, septicemia, and disseminated infection. Examination shows a discolored, thickened, and bulging eardrum.

Diagnosis Of Otitis Media

Pneumatic otoscopy or tympanometry demonstrates an immobile eardrum; 50% of cases are bilateral. Pneumatic otoscopy or tympanometry is a specialized instrument used for the detection of ear infections. This instrument puffs air against the eardrum which causes the eardrum to move. If there is pus in the middle ear, little or no movement will take place.

Laboratory tests such as gram stain, culture, and sensitivities of draining fluid or aspirated fluid if tympanocentesis is performed.

Other tests used for otitis media are Tympanometry, Acoustic reflectometry, and Tympanocentesis. Tympanometry is used for measuring the movement of the eardrum. Acoustic reflectometry measures how much sound is reflected back from the eardrum.

In tympanocentesis, a specialist may utilize a minuscule cylinder that pierces the eardrum to empty liquid out of the middle ear, a strategy called tympanocentesis. The liquid is tried for infections and microorganisms. This can be useful if a disease hasn't reacted well to past medicines.

Treatment Of Otitis Media

The aim of treatment in otitis media is to reduce the severity of pain and prevent infection. Over-the-counter painkillers are used for the reduction of pain. Commonly used painkillers are ibuprofen and acetaminophen. These painkillers should be avoided in children because of the risk of Reye syndrome.

There is no need for antibiotics for mild cases of otitis media. Approximately 80% of cases of otitis media resolve without using antibiotics. Painkillers are prescribed for the treatment of mild otitis media. You can also use a warm, moist cloth over the infected ear to reduce the severity of pain. Over-the-counter (OTC) ear drops or anesthetic ear drops are also used for the reduction of pain.

Overuse of antibiotics should be avoided because of the increased risk of resistance. Moreover, they do not reduce the risk of short-term complications such as hearing problems and they do cause side effects.

However, your doctor may prescribe antibiotics for the treatment of severe ear infections. Antibiotic treatment is more beneficial in children under two years of age than in older children. If antibiotic treatment is to be given, it should be effective against the three main bacterial pathogens: S. pneumoniae, H. influenza, and S. pyogenes.

Commonly used antibiotics for the treatment of otitis media are amoxicillin, penicillin, ampicillin, cefdinir, ceftriaxone, cefpodoxime, cefuroxime, and clindamycin. The streptococci are usually sensitive to penicillin, but these are much less active against H. influenzae, so the broader spectrum agents, amoxicillin or ampicillin are preferred.

Both erythromycin and the earlier oral cephalosporins such as cefalexin are insufficiently active against H. influenza and should not be used. Alternatives include co-amoxiclav (a combination of amoxicillin and the β-lactamase inhibitor clavulanic acid) or an orally active later-generation cephalosporin such as cefixime.

Surgery is also recommended if there is no effective response to treatment. In case of an adenoid infection, your doctor will remove it. In some cases, your surgeon recommends you insert small tubes into your ear to drain air or fluid from your ear.