Types of otitis media in children
External otitis is an inflammation of the skin of the ear canal, with which the pain increases sharply when pulling on the auricle. Acute otitis media is an inflammation behind the eardrum, the most common variant in preschool children. Exudative otitis media occurs without pain: the fluid in the tympanic cavity simply reduces hearing, and parents notice that the child asks more questions and turns the TV louder. Prolonged exudative otitis media is especially important to identify on time, because persistent hearing loss in a baby delays speech development.
- Otitis externa - pain when pressing on the tragus
- Acute otitis media - pain, fever, hearing loss
- Purulent otitis media with membrane perforation and suppuration
- Exudative otitis - fluid in the ear without pain
- Recurrent otitis media - three or more episodes in six months
Reasons and what increases the risk
The trigger factor is almost always a viral infection of the upper respiratory tract: the mucous membrane of the auditory tube swells, air does not enter the middle ear, and fluid accumulates there, to which bacteria then attach. The younger the child, the higher the risk due to the anatomy of the auditory tube. Additional contributions include enlarged adenoids blocking the mouth of the tube, frequent contact with infections in the garden and inhalation of tobacco smoke.
- ARVI and persistent runny nose
- Ages up to three years
- Adenoids and chronic adenoiditis
- Visit to kindergarten
- Bottle feeding while lying down
- Smoking in the house
- Allergic rhinitis
How to understand that a child has otitis media
For older children, the picture is clear: the ear hurts, hearing becomes worse, the temperature rises. In an infant, sudden restlessness at night, monotonous crying, refusal of the breast or bottle after several sucking movements, or attempts to rub the ear help to suspect otitis media. The appearance of pus from the ear usually means that the membrane has ruptured - after this the pain often subsides, but a visit to the doctor is still required. The diagnosis can only be reliably confirmed by examining the ear.
- Ear pain that gets worse when lying down
- Restless crying and poor sleep
- Refusal to eat, baby stops breastfeeding
- Fever and lethargy
- Hearing loss, the child asks again
- Ear discharge
Treatment
The main thing in the first hours is to relieve pain: children's antipyretics and painkillers in an age-appropriate dose prescribed by a doctor relieve the condition faster than drops. Be sure to restore nasal breathing - rinse the nose with saline solution, if necessary, use vasoconstrictor drops for a short course. Not everyone needs antibiotics: they are prescribed to children under two years of age, with bilateral and purulent otitis media, high fever and severe condition, and in an older child with a mild course, the doctor may choose observation for 48 hours. Ear drops are used only for their intended purpose—if the eardrum is perforated, many of them are contraindicated.
- Anesthesia in an age-related dose
- Rinse the nose with saline solution
- Antibiotic according to indications and full course
- Ear drops only after examining the membrane
- Toilet ear with suppuration
- Do not put warm oil or alcohol into your ear.
Complications and prevention
Most children recover without consequences, but fluid in the ear sometimes remains for several weeks and reduces hearing: therefore, a month after otitis media, the doctor checks the ear again. Dangerous, although rare, are mastoiditis, paresis of the facial nerve and intracranial complications - it is these that control visits allow us to notice in time. Breastfeeding, an upright position when bottle-feeding, a lack of tobacco smoke at home, treatment of adenoids, and routine vaccinations help reduce the incidence of otitis media.
- Follow-up examination after 3–4 weeks
- Hearing test for persistent exudate
- Breastfeeding in the first months
- Bottle feeding in a semi-sitting position
- Stop smoking indoors
- Treatment of adenoids and allergic rhinitis
- Scheduled vaccination according to the calendar
