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ALLERGY ALERT
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Before we can understand why children get ear infections, you should
understand the anatomy of the ear. As shown in the diagram, the ear has three parts.
These parts are the external ear, the middle ear and the inner ear. The external ear
goes from the outside up to the eardrum or tympanic membrane and includes the external ear
canal. This part of the ear gets infected in the summer during swimming. Otitis
externa or swimmer's ear occurs when infected water gets trapped in the canal. Germs
grow and infect the external canal causing inflammation. This type of infection
needs eardrops for treatment.
The middle ear lies behind the eardrum and contains three little bones.
These bones transmit eardrum vibrations from the eardrum to the hearing organ
located in the inner ear. Usually, this middle ear chamber is air filled to permit
easy vibration of the three little bones. The eustachian tube is an open airway
between the middle ear and the mouth. This tube drains fluid that may accumulate in
the middle ear. Behind the middle ear is the inner ear. This is the location of the
hearing organ (the cochlea) and the balance canals (the labyrinth). Sound vibrates
the eardrum, which in turn vibrates the middle ear bones. These bones in turn
vibrate nerve endings in the cochlea. Nerves carry the impulses from the cochlea to
the brain.
Otitis media results from infection of fluid that has accumulated in the
middle ear. A child's eustachian tube is shorter, narrower, and more horizontal
than that of an adult. When your child has a cold or allergies, the mucous membranes
become swollen. The nasopharynx, eustachian tube, and middle ear become inflamed
and congested. This results in obstruction of the draining tube and fluid accumulates in the middle ear. Then, like the water in a stagnant pond, this fluid can become infected.
What are the symptoms of otitis media? Usually, it starts as an upper
respiratory tract infection. Your child may complain of ear pain. He may have
loss of appetite, or just lay around not wanting to do anything. He may have
fever. Other signs may include headache, diarrhea, drainage from the ear, and a
yellow or green nasal discharge. An infant may pull or rub the ear. He may be
irritable, fussy, or whinny. He may be sucking at the bottle vigorously for a
few seconds and suddenly pull away, crying out in pain. Infants also may seem
more comfortable in an upright position and may cry out when placed in a prone
position.
How is otitis media treated? Bacteria usually cause otitis media. We treat this
infection with antibiotics. The type of antibiotic used usually depends on the
age of your child, past infections and ease of giving the medicine. Pain
relievers and decongestants are sometimes also used. It is important to give
your child the full course of treatment. Your child may start to feel better
after a day or two. If you stop the medication after just a few days, the germs
may come back and the symptoms may soon return. It is also important to have
the ear rechecked after you finish the medicine. Sometimes there is still an
infection even though your child does not have symptoms. Some children get ear
infections frequently. Often we must change the type of antibiotic we use
before we get one that works. When the ear infections are recurrent, severe and
long lasting we may decide on a minor surgical procedure called a myringotomy.
The surgeon makes an incision in the eardrum and removes the fluid from the
middle ear. He may then place a tiny ventilating tube, called a tympanotomy
tube, in the eardrum. This allows the fluid to drain continuously from the
middle ear. Another procedure is an adenoidectomy. This procedure removes the
adenoids from around the opening of the eustachian tube. This lets the tube
function more effectively.
Are there ways in preventing ear infections? At the first sign of a cold give
your child an antihistamine and/or decongestants. Theoretically, this will dry
your child out and prevent congestion of the eustachian tube. Never give a
bottle when putting your child to bed. The milk or formula may flow from the
mouth into the middle ear via the eustachian tube. Substitute a pacifier or
sterile water. Remember, although ear infections are common they are minor
illnesses and I can easily treat it.
Copyright © 2010 Westbury Pediatrics
