What is otitis media?

Otitis media is inflammation of the middle ear, or middle ear infection. It occurs in the area between the ear drum ( the end of the outer ear ) and the inner ear, including a duct known as the Eustachian tube. Otitis media is very common in childhood, with the average toddler having two to three episodes a year, almost always accompanied by a viral upper respiratory infection ( URI ), mostly the common cold. It may be caused by virus or bacteria.

Symptoms

Patients who can communicate usually describe feelings of pain or discomfort in the affected ear. However, most cases occur in children who are unable to communicate specific complaints.

• Acute otitis media
• Earache
• Fever ( not required for the diagnosis )
• Accompanying or precedent URI symptoms ( very common )
• Decreased hearing
• Acute otitis media in infants
• Infants may be asymptomatic.
• Irritability may be the only symptom.

Etiology

Streptococcus pneumoniae and nontypable Haemophilus influenzae are the most common bacterial causes of otitis media. Tubal dysfunction leads to the ineffective clearing of bacteria from the middle ear. In older adolescents and young adults, the most common cause of ear infections during their childhoods was Haemophilus influenzae. As well as being caused by Streptococcus pneumoniae and Haemophilus influenzae it can also be caused by the common cold. Colds indirectly cause many cases of otitis media by damaging the normal defenses of the epithelial cells in the upper respiratory tract.

Treatment

• Management of pain
• Antibiotics ( at least 10 days)

Prevention

General measures to prevent otitis media consist of breast-milk feeding; avoidance, insofar as possible, of exposure to individuals with respiratory infection; avoidance of environmental tobacco smoke; and pneumococcal vaccination.