Ear infection symptoms in a baby: What to look for

One of the hardest parts of caring for a little one is seeing them in pain and feeling powerless to help. They might not be able to talk, but they’re communicating their distress loud and clear. Crying, restlessness and disrupted eating habits are all signs something is wrong. But what exactly is the matter? It could be an ear infection.

Ear infections in babies are incredibly common. About 75% of children get one before their third birthday, and an unlucky 25% will get them more than once.

Read on to learn more about baby ear infection symptoms, as well as possible causes, treatment options and when your baby should see a doctor.

Type and causes of ear infections in babies

An ear infection happens when fluid containing bacteria or viruses gets trapped in your ear. Over time these “trapped germs” can grow into an infection. Viral infections typically go away on their own within a week or so, but bacterial infections may need antibiotics to be cured.

Your child’s doctor can help determine whether your child may have a viral or bacterial ear infection, and the location of the infection. The type of ear infection is determined by where fluid builds up: outer ear, inner ear or middle ear.

The most common type of ear infection that babies get is a middle ear infection, also known as “otitis media.” Middle ear infections happen when fluids build up due to a cold, allergies or the flu. So it’s not uncommon for a little one to suffer from one of these conditions, then soon after develop an ear infection.

Why does it seem like you and your child get the same cold, but your kiddo develops symptoms of an ear infection, and you don’t? It comes down to size and anatomy.

Babies have smaller ears, with smaller and more level eustachian tubes – the tubes that drain fluid away from the ears. Because of their size and position, eustachian tubes can’t drain as easily in children as they do in adults, so ear infections are more likely to happen. Babies also lack the fully developed immune systems that healthy adults have. As a result, they are much more susceptible to infections.

Baby ear infection symptoms

Your baby can’t tell you what’s wrong, but they’ll give you plenty of clues by displaying the following symptoms:

• Disrupted sleeping
• Crying and fussiness
• Rubbing or pulling at their ear
• Rubbing the side of their head
• Trouble hearing
• Fluid draining from their ear
• Blood in their ear
• Fever

Every child is different, so they likely won’t have all the above symptoms. And while fevers are common with ear infections, the thermometer doesn’t tell the whole story. Babies can have an ear infection without running a fever.

If you think your child has an ear infection, a great first step can be contacting your care provider’s nurse line. If you’re a HealthPartners patient or insurance plan member, you can call our CareLine at 800-551-0859 or 952-993-4665 to speak with a nurse 24/7. They’ll listen to your child’s symptoms and offer suggestions to help manage them. They can also help you decide when and where to seek care.

Is it an ear infection or just teething?

It can be difficult to tell if your baby is aggravated by a new tooth coming in or if it’s an ear infection. Teething can cause some pain but typically not as much pain as ear infections cause. Symptoms of teething include:

• Increased saliva
• Drooling
• An increased desire to chew on firm objects

Fever and trouble sleeping are rarely associated with teething, so be sure to look out for these differentiators. Additionally, if your baby’s hands are going to their mouth more than their ear or side of their head, it’s a good indication that baby may be teething.

When babies should be seen by a doctor for ear infection symptoms

While many ear infections can be treated at home, some need medical attention. Watchful waiting is the recommended course of action for children over 2. For babies, you’ll want to see a doctor or clinician if:

• Your baby has a fever, especially if they are younger than 3 months old, or if your older baby’s temperature is above 102 degrees Fahrenheit.
• The ear infection symptoms aren’t getting better after a couple of days.
• There’s fluid draining from the ear.
• Your baby is experiencing changes or loss of hearing.
• Your baby is experiencing a lot of pain or discomfort.

Ear infection treatment for babies

When it comes to treating ear infections in babies, doctors will make recommendations based on several factors, including symptom severity and the age of your child.

For children under 2 years old, antibiotics are often the treatment of choice. That’s because their young immune systems often need a little help to fight off ear infections. Older children with no health complications may be able to fight the infection without the use of antibiotics.

However, if a baby’s symptoms are mild and an ear exam isn’t worrisome, a doctor may recommend watchful waiting for 48-72 hours from the onset of symptoms. During this time symptoms can improve, and the infection may resolve itself.

Whether antibiotics are prescribed or not, your doctor will likely recommend infant acetaminophen or ibuprofen (depending on their age and weight) to help baby be more comfortable.

Babies are resilient, so it’s possible that your little one will be back to normal within 24 hours of beginning antibiotic treatment. However, it’s important that you continue to give your baby the prescribed dosage of antibiotics to make sure the infection is cured – and prevent it from coming back. If your baby’s symptoms don’t improve within 72 hours, call your doctor.

What happens if baby’s ear infection is left untreated?

Ear infections can often go away on their own. And while it’s possible that untreated ear infections can lead to complications like meningitis or permanent hearing loss, it’s very rare. It’s important to always seek medical care if you suspect an ear infection in your child and they’re experiencing worse or worrisome symptoms.

Are there home remedies for baby ear infections?

Home remedies for baby ear infections like warm compresses and over-the-counter pain relievers formulated for infants can help manage symptoms. While they don’t cure the infection, these remedies can help your little one feel more comfortable while their body fights it off – with or without the help of antibiotics. Of course, giving your baby plenty of snuggles can help them get through it, too.

Preventing ear infections in babies

Most babies will experience an ear infection in their young lives, but there are ways to prevent it from happening more than necessary. The following are some precautions to take to make sure you’re doing everything possible to help your baby avoid ear infections:

• Wash your hands – It’s a classic prevention tip because it works. The more germs you can keep away, the healthier your baby will be. Since ear infections are often the result of a head cold or flu, reducing baby’s risk for these will prevent ear infections.
• Avoid exposing your baby to cigarette smoke – Secondhand smoke has been found to increase instances of ear infections in babies.
• Keep your baby away from sick people – Again, this will reduce their risk of catching anything that might cause an ear infection down the line.
• Don’t let your baby fall asleep with a bottle – Fluids can become trapped and may lead to ear infections.
• Vaccinate your baby – Help keep ear infections at bay by following the childhood immunization schedule and receiving other vaccinations that protect your baby from the flu or other ailments.

Recurrent ear infections

Sometimes there’s no way to avoid ear infections for your baby. When chronic ear infections happen, it might be time to talk to your doctor about ear tube surgery. During this common procedure, tiny tubes are placed in your child’s ear. These will help fluid drain and reduce the chance of ear infections. This is a common procedure that makes a big difference for many children.

Ear infections for breastfed babies

There is evidence to suggest that breastfed babies have a lower chance of developing ear infections. Some studies indicate that babies who are exclusively breastfed for the first year of life are half as likely to develop an ear infection as babies who are formula fed.

Get your baby the care they need

When your little one is sick, all you want to do is help them feel better. When baby ear infection symptoms first appear, a great first step is calling your care provider’s nurse line. For HealthPartners patients and members, our CareLine is available 24/7 at 800-551-0859 or 952-993-4665.

But depending on your baby’s symptoms and age, it may be best to get in-person care. Whatever you need, we’re here for you.

Swimmer’s ear: Causes, symptoms and how to treat it

It starts with an itch inside your ear. Your ear opening may look a little red. There’s also discomfort when you pull on your outer ear or push the little bump in front of your ear’s opening. You might even have some clear fluid draining from your ear. What’s going on?

These are all symptoms of swimmer’s ear, a condition that can affect people of all ages. In the beginning, swimmer’s ear is usually pretty mild. But without treatment, the symptoms of swimmer’s ear can go from mild to severe, causing worsening pain and serious complications.

Read on to learn about swimmer’s ear, what causes it and when to get help.

What is swimmer’s ear?

Swimmer’s ear is an infection of the outer ear canal which runs from the eardrum to the outside of your head. Another name for swimmer’s ear is otitis externa.

Swimmer’s ear vs. ear infection: What’s the difference?

Swimmer’s ear is a common type of ear infection that affects the outer ear. It’s also possible to get infections in your inner and middle ear.

One difference between swimmer’s ear and other types of ear infections is what causes them. Swimmer’s ear happens when things from the outside get into your ear canal, causing bacterial growth.

Inner and middle ear infections usually follow an illness such as the flu, a cold or allergies, which causes fluid buildup or inflammation inside the ear.

What are the symptoms of swimmer’s ear?

Symptoms of swimmer’s ear change, based on how far along it is. Getting treatment for swimmer’s ear while it’s still in the early stages can help keep it from getting worse.

Mild symptoms of swimmer’s ear

• An itch in your ear
• Some redness in your ear canal
• Discomfort when you push or pull on your ear
• Clear, odorless fluid coming from your ear

Moderate symptoms of swimmer’s ear

• Increasing itchiness
• Ear pain that gets worse when you chew or move your ear
• An ear canal that looks more red
• A feeling of fullness in your ear
• Muffled hearing or hearing loss
• Lots of fluid coming from the ear – it may be yellow or yellow-green, and it’s often smelly

Advanced symptoms of swimmer’s ear

• Severe ear pain that may spread to your face, neck or side of your head
• Swelling in your ear canal, outer ear or glands in your neck
• Redness both in the ear canal and the outside of the ear
• Fever

Of course, if you have an itchy, red, swollen ear canal, it doesn’t necessarily mean that you have swimmer’s ear. You may have a different type of ear infection, allergies or a skin irritation. Here’s a way to tell: if it doesn’t hurt when you pull on your earlobe, it’s probably not swimmer’s ear.

But even if it’s not swimmer’s ear, it’s still a good idea to talk to a doctor and get treatment for whatever is causing your ear problems.

What causes swimmer’s ear?

Despite the name, you don’t need to go swimming to get swimmer’s ear. It can happen whenever dirty water, sand, dirt or other debris gets into your ear canal and stays there for a long time or comes in contact with irritated skin, causing bacteria or fungi to grow.

Usually, water that gets in your ear flows out on its own so that the ear canal can dry. Your earwax can also kill the fungi and bacteria that’s in the dirty water or debris. But this process is interrupted when you get swimmer’s ear.

How does the ear canal get irritated?

If the skin of your ear canal is injured or damaged, you’re more likely to get swimmer’s ear. Here are a few reasons why that might happen:

• Your ear canal is too dry– A healthy amount of earwax helps protect you against infection. Cleaning your ears too often can hurt the skin, making it more likely that you’ll get an infection.
• You stick things in your ears– If you’re in the habit of putting fingers, pens, pins or Q-tips in your ears, you’re more likely to damage the skin of your ear canal. Infections are more likely to form if you have broken or irritated skin in your ears.
• You have a skin condition in your ear– If your skin is irritated or inflamed because of eczema or psoriasis, it’s more likely to crack open or become injured.
• You wear a hearing aid– You could have irritation in the ear canal if your hearing aid doesn’t fit well or is causing an allergic reaction. If your hearing aid seems uncomfortable, talk to an audiologist about a hearing aid evaluation.

How does water get stuck in your ear?

Usually, when water gets in your ear, it comes out quickly and easily. But sometimes, it’s difficult for water to flow out once it gets in. Here are some reasons why:

• You have a lot of ear hair– Hair in the ear canal can trap dirty water or debris.
• Your ear canal is swollen– This can happen if the skin of the ear canal is injured or irritated.
• There’s impacted earwax– While a healthy amount of earwax keeps your ears safe from swimmer’s ear, impacted earwax can make it more likely to trap dirty water or debris, causing germs to grow.
• You live in a warm, humid climate– If the air is always humid, it’s difficult for your ear canal to dry out.

How can you tell if you have water in your ear?

If you have water in your ears, your ears may feel plugged and you may have muffled hearing. You may also have ear pain, a loss of balance, ringing in the ears, a runny nose or a sore throat.

Is swimmer’s ear contagious?

No, swimmer’s ear doesn’t spread between people.

How long does swimmer’s ear last?

Mild cases of swimmer’s ear sometimes clear up on their own within a few weeks. But if your swimmer’s ear has advanced symptoms, it can take longer to go away. With treatment, swimmer’s ear will likely go away in 7-10 days.

What are the complications of swimmer’s ear?

Swimmer’s ear usually isn’t serious, but if left untreated, it could cause problems such as:

• Temporary hearing loss (hearing usually returns to normal after the infection is gone)
• Ear infections that don’t go away or keep coming back
• Damage to the bones and cartilage in your ear
• An infection in nearby tissue, the skull, brain or nerves

If you have complications following a swimmer’s ear infection, your primary care doctor may recommend you make an appointment with an ear, nose and throat doctor. They specialize in ear care and can help you get back to feeling, and hearing, better.

When should I go to the doctor for swimmer’s ear?

Even if you have mild symptoms of swimmer’s ear, it’s a good idea to talk to your primary care doctor. They’ll be able to determine what’s causing your symptoms and get you on the road to recovery.

Seek immediate medical care if you experience any of the following:

• Fever
• Severe pain in or around the ear
• Hearing loss or changes
• Fluid coming from your ears that’s yellow, yellow-green or smelly

Your doctor will be able to tell if it’s swimmer’s ear by looking in your ear and asking some questions. If you have pus coming from your ear, your doctor may collect a sample to send in for testing.

You can also start a Virtuwell visit for swimmer’s ear any time, day or night to get treatment for swimmer’s ear. They’ll see anyone over the age of 5 years old.

How to get rid of swimmer’s ear

During the appointment, your doctor will provide information about how to make sure that your infection doesn’t get worse. They may recommend one or more of the following as part of your swimmer’s ear treatment plan:

Prescription eardrops

Prescription eardrops are a common treatment for swimmer’s ear. They may contain steroids, antibiotics or antifungal ingredients depending on the cause or severity of your ear infection. The ear drops work by calming the inflammation while also killing the bacteria or fungus causing the infection. Most of the time, you’ll place drops in your ear 3-4 times a day for five days.

Heat

Holding a warm washcloth to your ear can help keep the pain away. Another option is using a heating pad on low – just make sure you don’t fall asleep while it’s on since you could burn yourself.

Over-the-counter pain medication

Acetaminophen (Tylenol), ibuprofen (Advil or Motrin) or naproxen (Aleve) may make you feel more comfortable. But not every medication is appropriate for children. If you’re not sure what you should give your child, contact your doctor or nurse line.

Keep your ears dry

It’s best to keep water out of your ear until the infection is gone. If you swim, use a swimming cap that fits snuggly over your ears and consider using soft earplugs when showering or bathing. Also, carefully towel off your ears any time they get wet.

Tips to prevent swimmer’s ear

If you’ve had swimmer’s ear before, you’re more likely to get it again. Keeping germy water out of your ear goes a long way toward preventing future ear infections. You’ll have the best protection if you don’t swim in dirty water and keep soap, bubble bath and shampoo out of the ear canal. You may also consider using earplugs when swimming or showering – especially if you’ve had ear tube surgery.

In addition, take the steps below to protect the skin in your ear canal and keep the insides of your ears as dry as possible.

How to avoid irritating your skin

Remember, you’re more likely to get swimmer’s ear if the skin in the ear canal is damaged. So, anything you do to protect your ear should help reduce your chance of swimmer’s ear.

• Don’t stick anything in your ear.Even Q-tips and earwax removal tools can damage the ear canal and cause impacted earwax. There are other ways to clean your ears without Q-tips.
• Don’t overclean your ears.While earwax may seem unappealing, it helps protect your ears from injury and may even kill the bacteria and fungi that can cause swimmer’s ear.
• If possible, limit use of earplugs and earbuds.If you use them a lot, they could irritate your ear canal or lead to earwax buildup. Safe use of earbuds involves cleaning them at least weekly. Also, change your earplugs regularly.

How to remove water from your ear

If dirty water sits in your ear for too long, it’s possible you could get swimmer’s ear. These are things you can try to get the water out of your ear:

• Over-the-counter (OTC) eardrops– Fluid-drying eardrops such as Swim Ear can help dry out your ear. The isopropyl (rubbing) alcohol in the eardrops combine with the water in the ear to help dry out your ear.
• Use a hairdryer– Use a hairdryer on the lowest setting to gently dry your ears. Just point it at your ears for a couple of minutes from a safe distance. Consider doing this each time you shower or get your ears wet.
• Chewing and yawning– Moving your mouth can relieve pressure inside your ear, making it easier for water to flow out.
• Pull your ear– Tilt your head so the plugged ear faces the floor. Then pull back the top part of your ear. This straightens out the ear canal, allowing trapped water to drain.
• Push it out– Close your mouth, plug your nose and then push air into your cheeks. This can help lower the pressure in your ears, allowing the water to come out.
• Create suction– Place a flat hand over your affected ear and push down for a couple of seconds. When you remove your hand, the suction effect may loosen the trapped water.

Getting treatment for swimmer’s ear

If you notice symptoms of swimmer’s ear, it’s time to talk to a doctor. While the symptoms can be mild in the beginning, untreated swimmer’s ear can get worse and cause serious problems. The good news is that swimmer’s ear usually goes away pretty quickly with treatment.

For people of all ages, an in-person or video visit with a primary care doctor can get you an official diagnosis and personalized treatment plan. Or for those 5 years old and older, online treatment through Virtuwell is available anytime day or night.

KP list of Top 7 Inexpensive and Effective Adult Products

Ear Drops are liquid medicines for topical use. They are used to treat and prevent infections of the outer and middle ear. Preparations may contain different components – antibiotics, local anesthetics, anti-inflammatory drugs and hormones glucocorticosteroids ¹ . Consider the most popular ear drops.

KP 9 top 7 ear drops list for adults0007

Important! All drugs have side effects and contraindications. Our material is an overview and does not serve as a guide to action. Before buying funds, consult your doctor.

Antibacterial ear drops

Antibacterial ear drops are used only for diseases caused by a bacterial infection. For example, preparations based on rifamycin, ciprofloxacin, ofloxacin are used in acute external otitis media and perforated stage of otitis media.

Contraindications to the use of such drugs is individual intolerance to the components, for some drugs – pregnancy and lactation.

Antifungal ear drops

Otomycosis (fungal otitis media) is an inflammatory process in the ear caused by molds or yeast-like fungi. Most often, a fungal infection develops when the external auditory canal is damaged during hygiene procedures, swimming in water, or frequent use of headphones and earplugs.

In addition, the development of the disease can be provoked by endocrine diseases (primarily diabetes mellitus), prolonged use of antibiotics and hormonal drugs, and work in damp dusty rooms.

Drops containing the antifungal agent chlornitrophenol can be used to treat these conditions. Indications for taking the drug are fungal diseases of the external auditory canal.

Contraindication of for use is hypersensitivity to the components of the drug.

Anti-inflammatory ear drops

Anti-inflammatory ear drops are used for allergic, bacterial or fungal diseases of the ears. They relieve the severity of symptoms, but do not affect the cause of the disease, that is, pathogenic microorganisms.

So, the composition of such drugs may include NSAIDs choline salicylate, the hormone dexamethasone. These substances are used for the symptomatic treatment of ear pain in acute and chronic otitis media and otitis externa, and also lead to a decrease in the inflammatory response and accelerate recovery.

Some drugs are contraindicated during pregnancy, lactation, violation of the integrity of the eardrum, children under 1 year of age.

Antibacterial and anti-inflammatory ear drops

For ear inflammation, combined preparations can be used, for example, drops combining antibacterial and anti-inflammatory components (ciprofloxacin + dexamethasone, and framycetin + gramicidin + dexamethasone). Such funds are used for acute external and otitis media.

Their main contraindications are: pregnancy, breastfeeding, childhood, perforation of the eardrum.

Antibacterial and analgesic ear drops

Ear drops with an analgesic component are used for pain in otitis externa and otitis media. This effect is possessed by drugs based on the antibiotics neomycin and plimyxin B, as well as lidocaine, which helps to eliminate pain and itching.

Similar drops you can not use in case of hypersensitivity to the components, during pregnancy and lactation. In children under 1 year old, ear drops are used only in case of emergency and under the supervision of a physician.

Anti-inflammatory and analgesic ear drops

For otitis media, your doctor may prescribe a drug based on the anti-inflammatory drug phenazone and the anesthetic lidocaine. Drops eliminate symptoms, but do not affect the progression of the disease. It is recommended to use them for no more than 10 days.

Contraindications for the use of are perforation of the tympanic membrane and hypersensitivity to the components. The drug can be used by children, pregnant and lactating women.

Combined preparations

Quite often, in inflammatory diseases of the ear, especially for the treatment of otitis externa and otitis media, preparations based on four active ingredients are used: the broad-spectrum antibiotic chloramphenicol, the hormone beclomethasone dipropionate, the antifungal agent clotrimazole, and the anesthetic lidocaine. The combination of these substances helps to cope with the infection, reduce the inflammatory process and improve the patient’s quality of life.

Contraindications : hypersensitivity to the components of the drug, children under 6 years of age, violation of the integrity of the eardrum.

How to choose ear drops

The pharmaceutical market offers a wide range of ear drops for consumers. All of them differ in active substances, price, manufacturer, appearance. Consider the basic rules for choosing drops for the ears ² :

1. It is important to know the cause of the disease and the drug to act on it.
2. Anti-inflammatory drops (which contain a glucocorticosteroid or non-steroidal anti-inflammatory drug) do not affect the microflora, but only reduce the inflammatory response ³ .
3. Antibacterial drugs are only effective against bacteria, not fungi or viruses.
4. If there is no positive effect within 3 days, it is necessary to change the drug.

In order for the treatment to be correct, it is necessary to consult an ENT doctor. Self-medication can harm the body ⁴ , so the choice of effective ear drops is best left to a specialist.

Also, our expert MD, professor, ENT surgeon of the highest category Konstantin Dobretsov recommends that you carefully read the instructions before using ear drops. Some ear drops contain an ototoxic component (for example, an antibiotic from the aminoglycoside group), which, if the eardrum is perforated, can enter the inner ear and cause hearing loss. Therefore, some ear drops are used only for otitis externa.

– You should also warm the ear drops before using them. It is important to support the bottle either in your hand or under a tap of warm water. When cold drops (below 30 degrees) are instilled into the ear canal, dizziness may occur. You should not be afraid of dizziness, this is a normal reaction that disappears on its own after a few minutes, the expert adds.

Doctors’ opinions about ear drops

Ear drops should be used for inflammation of the ear (otitis media). However, ear inflammation is different, which means that the drops are different from each other.

– So, the ear is external – the external auditory meatus and the middle – the tympanic cavity. These two sections are separated by the tympanic membrane. Thus, if there is inflammation in the skin of the ear canal, this is otitis externa, and if on the mucous membrane of the tympanic cavity, it is otitis media. Infection with otitis externa occurs when swimming in water, abuse of cotton swabs and headphones.

Acute otitis media is overwhelmingly caused by a runny nose or acute sinusitis. As a result of the spread of bacteria into the tympanic cavity, inflammation occurs, but since the tympanic membrane is impenetrable, the use of ear drops in acute otitis media is ineffective. They are used only if there is a rupture of the eardrum, but this is not always the case. But with acute otitis externa, the use of local therapy in the form of drops is just necessary.

Drops in the ear may consist of one component, but most often they are combined, they have several effects at once, says Konstantin Dobretsov, MD, professor, ENT surgeon of the highest category

Popular questions and answers

We discussed important questions related to the use of ear drops, with ENT doctor Anna Makarova.

How to relieve ear pain at home?

– To relieve ear pain in the early stages, drops that contain lidocaine are suitable. They should be used on gauze (cotton) turunda. It is also better to use any non-steroidal anti-inflammatory drug inside, which has a pronounced analgesic effect, such as ibuprofen, ketoprofen or nimesulide. Pain can be associated with both otitis externa and otitis media, and nerve inflammation (neuralgia).

An indispensable addition to the treatment is a mandatory visit to the ENT doctor. If the otolaryngologist excludes pathology on his part, then you should contact a neurologist.

What should I do if my ear is leaking pus?

— Unfortunately, there are no ways to help with primary suppuration from the ear at home. Patients are urgently advised to contact an ENT doctor for diagnosis, since purulent otitis media is dangerous because of the consequences of intracranial complications.

Is it possible to insert cotton wool with alcohol into the ear?

— No, by no means, as there is a risk of burning the skin of the ear canal, and in the future this is fraught with a deterioration in the condition.

Sources :

1. Clinical guidelines “Fungal otitis”, 2016.
   http://glav-otolar.ru/assets/images/docs/clinical-recomendations/KR304%20Gribkovye%20otit.pdf
2. Okovity S.V., Ivkin D.Yu., Malygin. S.V. // Drug therapy of otitis externa and otitis media // Journal “Bulletin of Otorhinolaryngology”// 2012.
   https://medi.ru/info/290/
3. Svistushkin V. M., Sinkov E.V. // Otitis externa: from differential diagnosis to etiotropic therapy // MS. 2016. No. 18.
   https://cyberleninka.ru/article/n/naruzhnyy-otit-ot-differentsialnoy-diagnostiki-k-etiotropnoy-terapii
4. Kunitsky VS // The choice of topical drugs for inflammatory diseases of the middle ear // Bulletin of Pharmacy. 2006. No. 2 (32).
   https://cyberleninka.ru/article/n/vybor-topicheskih-lekarstvennyh-sredstv-pri-vospalitelnyh-zabolevaniyah-srednego-uha

Otitis media ᐈ Treatment and symptoms

Description

Otitis media is the medical term for inflammation of the ear.

Distinguish:

• otitis media is an inflammation of the inner ear, often called labyrinthitis
• otitis media: inflammation of the middle ear, (occurs in both acute and chronic forms) sinks

If inflammation of the middle ear is permanent or intermittent, then we are talking about a chronic form of otitis media. In this case, in most cases, patients develop a defect in the tympanic membrane (a hole in the membrane). There are three forms of chronic otitis: chronic purulent inflammation of the mucosa, chronic purulent inflammation of the mucosa and bone structures of the middle ear, and cholesteatoma. None of the above three forms of chronic inflammation of the middle ear (otitis media) can be treated without professional medical help and surgical therapy.

Symptoms

Typical symptoms of acute otitis media are sudden sharp pains, as well as a sensation of noise and throbbing in the ears, all of which may be accompanied by dizziness and hearing loss.

With purulent inflammation of the middle ear, the eardrum is often damaged and bloody-purulent fluid is released from the ear. After perforation of the eardrum, pain in the ear may disappear.

Non-specific symptoms of otitis media include fever (most common in young children), weakness, severe malaise, nausea and vomiting.

Symptoms of chronic otitis media

1) during the active (secretory) phase of the inflammatory process, yellowish purulent discharge flows out through the ear canal, often with a pungent odor, which can lead to infectious inflammation of the ear canal mucosa. In this case, inflammation can spread to the bones of the middle ear and provoke adhesions in connective tissues and bone structures. These phenomena, called tymanofibrosis and tymanosclerosis, cause progressive hearing loss that is also caused by bacterial toxins from the chronically inflamed middle ear mucosa. With damage to the middle and inner ear, sensorineural hearing loss may occur, i.e. combined deafness. Chronic otitis media, as a rule, after the secretory phase does not cause fever and pain. Patients usually see a doctor when they experience discomfort due to discharge with a putrid odor from the auricle, with progressive hearing loss, dizziness, tinnitus, problems with balance, coordination of movements, or when even more severe complications occur.

2) Symptoms of chronic suppuration of the mucous membrane and bone tissue:

Discharge from the auricle is purulent, viscous, mucous, yellow in color with a putrid odor. In an acute middle ear infection, pressure builds up behind the eardrum, often causing severe pain in the mastoid region. In a number of situations, the inflammatory process in purulent otitis media passes to the bone tissue of the temporal region and the mastoid process of the temporal bone.

In case of exacerbation of chronic inflammation of the middle ear, the so-called super-infection, the pain intensifies and the temperature rises. The patient has a gradual weakening of hearing until it is completely lost, tinnitus, in rare cases dizziness, imbalance, paralysis of the facial nerve (neuritis). In a number of situations, the inflammatory process in purulent otitis media passes to the bone tissue of the temporal region and the mastoid process, and the pus that has accumulated above the eardrum does not break through it and does not go out through the auditory tube, then the infection can penetrate through the venous vessels into the cranial cavity, which leads to severe intracranial complications, such as blood poisoning (sepsis), inflammation of the venous vessels of the brain with the formation of blood clots in them, meningitis (infectious inflammation of the meninges), encephalitis or brain abscess

3) Symptoms of cholesteatoma:

Cholesteatoma (a tumor-like formation that develops in the cavity of the middle ear) has various symptoms depending on the stage of development of the disease: from a feeling of fullness in the ear and dull aching pain in the mastoid process, to neuralgia (shooting sharp pain ) in the ear, and at the stage of exacerbation of cholesteatoma, it is characterized by prolonged pain, fever, discharge from the auricle, progressive hearing loss with or without tinnitus, dizziness, imbalance, neurosis (paresis) of the facial nerve. The disease usually develops slowly. Growing in size, cholesteatoma can destroy nearby bone structures of the skull, its contents will penetrate the brain, which can cause infectious inflammation of the lining of the brain (meningitis), inflammation of the brain (encephalitis), brain abscess and other serious consequences.

Causes and risks

One of the causes of inflammation of the middle ear is an acute respiratory disease of the nasopharynx. Acute otitis media in 80% of cases develops on the basis of a viral infection of the mucous membrane of the upper respiratory tract. The most common infectious agents are rhinovirus, RS (respiratory syncytial) virus, influenza virus, which multiply rapidly in the nasopharynx and Eustachian tube. In addition, in about 20% of patients, the infection is also caused by a certain type of bacteria that penetrates through the Eustachian tube into the middle ear, such as, for example, streptococci (Streptococcus pneumoniae) or influenza bacillus (Haemophilus influenza).

This process is observed mainly in patients with frequent cases of chronic inflammation of the nasal mucosa or paranasal sinuses.

Possible causes of chronic otitis media include allergic diseases of the upper respiratory tract or (less commonly) swelling in the nasopharynx. A special form of chronic otitis media – cholesteatoma can be congenital (genuines Cholesteatom) or result from a fracture of the longitudinal temporal bone (post-traumatic cholesteatoma).

Primary acquired cholesteatoma occurs as a result of retracted saccular cavity (pocket) of the tympanic membrane and negative pressure inside the middle ear. As soon as the retraction becomes too deep, and keratin is no longer able to be removed from the fold, its remnants begin to accumulate in it. Secondary acquired cholesteatoma occurs due to the ingrowth of squamous epithelial cells from the edges of the rupture in the eardrum. Such a gap most often occurs as a result of an infectious inflammatory process in the middle ear.

Examination and diagnosis

In order to identify acute inflammation of the middle ear, to establish the diagnosis of acute otitis media, an otolaryngologist examines the eardrum, nasopharynx, nasal cavity and paranasal sinuses. In some cases, it is necessary to check the balance and coordination of the patient’s movements in order to timely identify the possible consequences of the disease, for example, labyrinthitis with toxic damage to the inner ear. In this case, such research methods as tympanometry, threshold audiometry, sound audiometry are used.

The diagnosis also includes hearing tests. Often, an analysis of discharge from the auricle is performed. If complications are suspected, such as mastoiditis (inflammation of the mastoid process of the temporal bone) or other side effects, an X-ray examination is performed. With the help of an x-ray, the results of computed tomography of the temporal bone or cranium, it is possible to determine in a timely manner the feasibility of surgical intervention.

Treatment

Treatment of otitis media is mainly symptomatic. This means that it is aimed at eliminating the symptoms of the disease, and not the cause that caused the disease. This is due to the fact that otitis media is caused by various viruses and bacteria that are resistant to many antibiotics, so not every antibiotic provides an effective treatment result.

Decongestant nasal sprays are recommended in the early stages of the disease. Additionally, anti-inflammatory, antipyretic and analgesic drugs of natural origin are prescribed, for example, tablets, which include Bromelain. Tablets with the active ingredient Diclofenac also have anti-inflammatory, decongestant and analgesic effects. In case of intolerance to Diclofenac, it can be replaced with Ibuprofen, if there are no contraindications to taking it. Children are advised, after consulting a doctor, to take paracetamol as an analgesic and antipyretic. Treatment of otitis also includes the instillation of anesthetic drops into the ear canal, but only as directed by a doctor. Self-medication is unacceptable, since the symptoms will be mild and make it difficult to diagnose the disease.

Treatment with antibiotics is prescribed by a doctor to prevent serious complications after otitis media and reduce the risk of the consequences of inflammation of the middle ear. At the same time, it is important to strictly comply with all prescriptions regarding the frequency and duration of taking antibiotics.

If the tympanic membrane does not rupture during inflammation and the purulent contents that have accumulated above it do not get out, the doctor may make a small incision in the anterior lower part of the membrane so that the pus can flow out through this hole. This procedure is performed for adults under local anesthesia, and for children under general anesthesia. Due to the fact that the incision in the eardrum can heal on its own within a few days, the doctor often inserts a small plastic, titanium or gold tube into it to facilitate the outflow of purulent contents, ventilate the middle ear and ensure normal air pressure in it. If such a drainage tube does not come off on its own within 6-12 months due to the fact that the hole is clogged with sulfur or squeezed by a thickened scar on the eardrum, then it is removed surgically. The tympanic membrane is restored in most cases by itself.

If otitis media often occurs in children at an early age, then it is recommended to remove enlarged from birth or chronically inflamed tonsils, adenoids, children’s “polyps”. In children in adolescence with frequent or chronic inflammation of the nasal mucosa and paranasal sinuses, accompanied by otitis media, surgery is a necessary treatment. Here we are talking about the so-called sanitation of the nasopharynx, nose and paranasal sinuses. None of the above forms of chronic inflammation of the middle ear is treated only with surgery – it is only necessary when conservative treatment does not give the desired result.

Course of treatment and prognosis

As a rule, with timely diagnosis and proper treatment, otitis media proceeds without consequences and is completely curable.