Otorhinolaryngological Diseases
Otitis Media (OM)
​Overview:
  • OM is very common in children.
  • It is often associated with bacterial or viral infections.
  • Drainage of fluid from the middle ear is an advanced symptom requiring immediate medical consultation.
  • Children with frequent Otitis may need hearing and speaking tests.
  • Feeding infants while laying down is the most common risk factor.
  • Treatment varies based on otitis type, severity and cause.
Introduction:
OM is often caused by a middle ear bacterial or viral infection, filling the mastoid space behind the eardrum with fluid.  It is common in children, due to several causes, including:
  • The eustachian tube (a tube that runs from the middle of the ear to the back of the throat) is short, carrying viruses and bacteria through the nose or pharynx to middle ear, which causes otitis.
  • Compared to adults, children are immunodeficient; making them more vulnerable to infectious diseases.
 
Types of Otitis Media :
 
There are three subtypes of OM, as follows:
 
First Type: Acute Otitis Media (AOM)
This can be associated with a viral or bacterial infection. It may be related to viral upper respiratory or nasal cavity infection. AOM symptoms usually clear up by treating the infection.
 
Second Type: otitis media with effusion (OME)
It is mainly caused when fluid, called an effusion, becomes trapped behind the eardrum, for some reasons, including:
The Eustachian tube is blocked due to viral upper respiratory infection, effusion and fluid trapped behind the eardrum.
The Eustachian tube does not function properly, usually due to cleft throat, frequent cold or sudden exposure to air pressure.
 
Third Type: Chronic Suppurative Otitis Media (CSOM):
It is associated with delayed treatment of Acute Otitis cases. This leads to accumulation of fluid and effusions for two weeks or more behind the eardrum, which could drain out from one's ear.
 
Causes:
  • Viral respiratory infections, such as cold and flue.
  • Allergy.
  • Negative smoking.
  • sinusitis or tonsillitis.
  • Milk drainage into infant’s ear during feeding.
 
Symptoms:
In Children:
  • Ear pain, mainly when lying down.
  • Sleeping difficulty.
  • Crying more than usual.
  • No response to sounds.
  • Imbalance.
  • High temperature (38°+) 
  • Ear effusions.
  • Appetite loss.
In adults; 
  • Ear pain.
  • Sleeping difficulty.
  • Ear effusions.
  • Hearing loss.
 
When you must see a doctor?
  • If symptoms persist for more than 24 hours.
  • If you have acute ear pains.
  •  If fluids drain out of the ear.
  • If an infant below 6 months have these symptoms.
  • If an infant cannot sleep due to cold or other viral respiratory infections.
 
Diagnosis:

OM is diagnosed based on reported symptoms. Preferably, a doctor would examine the ear with an otoscope, in addition to:

  • Testing middle ear efficiency.
  • Using reflectometry (to measure reflected sound).
  • Taking a sample of fluid or discharge from the middle ear.
 
If child suffers from acute otitis or ongoing accumulation of fluids in the middle ear, doctor may refer him/her to an audiologist, speech therapist or growth specialist to test hearing, speaking skills and linguistic understanding.
 
Risk Factor:
  • Children between 6 months to two years.
  • Infants fed while lying down.
  • Seasonal infections such as cold and influenza.
  • Seasonal allergy patients.
  • Exposure to negative smoking or polluted air.
 
Complications:

Recurrent infection and accumulation of fluids may lead to dangerous complications:

  • Hearing loss.
  • Delayed growth and speaking skills.
  • Untreated inflammation may affect adjacent membranes.  
Treatment:
  • If simple or viral, monitor the child. You better consult a specialist till inflammation clears up.
  • If otitis is recurrent and is getting critical, joined with acute symptoms, patient needs treatment with oral or injected antibiotics in case of bacterial infection. Make sure your child takes them daily throughout the treatment time, even if his/her case improves.
  • If it is due to allergy, antihistamine or decongestant ear drops may help clear the symptoms.
  • In acute non-responsive cases, doctor may have to use a special instrument to discharge the rapped fluid out of the ear.
 
Prevention:
  • In cold cases, treat infected persons immediately, especially children, to prevent AOM.
  • Children with recurrent AOM (4+ times a year) may take antibiotics.
  • Keep an eye on children health, mainly if they get recurrent AOM.
  • Make sure your child takes routine vaccines.
  • Keep children away from negative smoking.
  • Keep children away from AOM patients.
  • Support the baby's head a little up when feeding.
  • Breastfeeding at least for six months enhances the baby's immunity, and makes him/her less vulnerable to otitis media.

 

 

 

Content Evaluation
Reading times
Last Update 04 March 2018 10:13 AM
Do you find this content useful? Yes No Suggest
Satisfaction of visitorsA sign of happiness
Satisfaction of visitors Completely satisfied Satisfied Neutral Not Satisfied Completely dissatisfied
This site can be viewed on all screen tones and all smart devices and supports all kinds of browsers
All Rights Reserved – Ministry of Health – Kingdom of Saudi Arabia ©