Earache and Cold: Differentiating Acute Otitis Media from Upper Respiratory Infections

06.12.197821.11.2021 by alexxlab

What are the key symptoms of acute otitis media in children. How can parents distinguish between a cold and an ear infection. What are the risk factors for developing acute otitis media. When should parents seek medical attention for a child’s earache. How is acute otitis media typically diagnosed and treated in primary care.

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Understanding Acute Otitis Media: Prevalence and Risk Factors

Acute otitis media (AOM) is a common childhood ailment that often causes concern among parents. As the second most frequent reason for pediatric visits to family physicians, it’s crucial to understand its prevalence and associated risk factors.

AOM primarily affects young children, with peak incidence occurring between 6 and 15 months of age. By their third birthday, an astounding 80% to 90% of children will have experienced at least one episode of AOM. The annual incidence rate for children under 3 years old is approximately 30%.

Key Risk Factors for Acute Otitis Media

Attendance at day-care centers or nursery schools
White ethnic origin
Male sex
Enlarged tonsils and adenoids
Previous history of AOM
Bottle feeding
Use of pacifiers or soothers
Parental smoking
Family history of AOM
Anatomic disorders of the nasopharynx (e.g., cleft palate, Down syndrome)

Understanding these risk factors can help healthcare providers and parents identify children who may be more susceptible to developing AOM. It’s important to note that while these factors increase the likelihood of AOM, they do not guarantee its occurrence.

Differentiating Earache: Is It AOM or Something Else?

While acute otitis media is the most common cause of earache in children, it’s essential to consider other potential causes. Healthcare providers must be vigilant in ruling out more serious conditions that may present with similar symptoms.

Common Causes of Earache in Children

Acute otitis media
Upper respiratory tract infections (common cold)
Otitis externa

Less Common Causes to Consider

Foreign body in the ear
Mumps
Temporomandibular joint pain
Cervical spine pain
Pharyngeal tumors
Mastoiditis
Meningitis
Dental pain
Sinus pain

In primary care settings, causes other than AOM, otitis externa, and the common cold are relatively rare. However, healthcare providers must remain vigilant for potential red flags that may indicate a more serious condition.

Recognizing Alarm Symptoms and Signs in Earache Cases

When evaluating a child with earache, it’s crucial to be aware of alarm symptoms and signs that may indicate a more serious underlying condition. These red flags can help healthcare providers determine whether further investigation or immediate intervention is necessary.

Alarm Symptoms to Watch For

Sudden onset of severe pain
Known contact with serious infectious diseases
Unusual drowsiness or high fever
Pain extending beyond the ear
Recent foreign body insertion

Alarm Signs During Examination

Presence of a rash
Neck stiffness
Unusual drowsiness or altered mental state
Ear discharge
Severely ill appearance

The absence of these alarm symptoms and signs can help reassure healthcare providers that the earache is likely due to a more benign cause, such as AOM or an upper respiratory tract infection.

Clinical Examination: Key Components in Diagnosing AOM

A thorough clinical examination is essential for accurately diagnosing acute otitis media and ruling out other potential causes of earache. Healthcare providers should follow a systematic approach to ensure all relevant aspects are assessed.

Essential Elements of the Clinical Examination

General appearance and alertness
Temperature measurement
Inspection of the nose and throat
Palpation of cervical lymph nodes
Otoscopic examination of both ears
Assessment of facial symmetry and movement
Examination of the mouth and teeth
Evaluation of neck mobility
Palpation of the mastoids, temporomandibular joints, and maxillary sinuses

During the otoscopic examination, healthcare providers should pay close attention to the appearance of the tympanic membrane. In cases of AOM, the affected eardrum may appear red, less reflective, or bulging. However, it’s important to note that these signs may not always be present, especially in the early stages of infection.

Diagnostic Challenges: When AOM Isn’t Clear-Cut

Diagnosing acute otitis media can sometimes be challenging, particularly when the clinical presentation is not straightforward. Healthcare providers must carefully consider all available information to make an accurate diagnosis.

Factors Complicating AOM Diagnosis

Subtle or early-stage symptoms
Difficulty visualizing the tympanic membrane
Presence of concurrent upper respiratory tract infection
Limited patient cooperation during examination (especially in young children)
Variability in tympanic membrane appearance among individuals

In cases where the diagnosis is uncertain, healthcare providers may consider additional diagnostic tools or opt for a watchful waiting approach, depending on the child’s age and overall clinical picture.

Treatment Approaches for Acute Otitis Media in Children

The management of acute otitis media in children has evolved over the years, with a growing emphasis on judicious use of antibiotics and consideration of watchful waiting in appropriate cases.

Key Considerations in AOM Treatment

Age of the child
Severity of symptoms
Presence of risk factors for complications
Likelihood of spontaneous resolution
Potential benefits and risks of antibiotic therapy

For children under 6 months of age, immediate antibiotic treatment is generally recommended due to the higher risk of complications. In older children with mild to moderate symptoms, a watchful waiting approach may be appropriate, provided that close follow-up is possible.

Antibiotic Options for AOM

Amoxicillin (first-line treatment in most cases)
Amoxicillin-clavulanate
Cefdinir
Cefuroxime
Azithromycin (for patients with penicillin allergy)

The choice of antibiotic should be based on local resistance patterns, patient allergies, and previous treatment history. Healthcare providers should also consider the potential for adverse effects and antibiotic resistance when prescribing.

Preventing Acute Otitis Media: Strategies for Parents and Caregivers

While it may not be possible to prevent all cases of acute otitis media, there are several strategies that parents and caregivers can employ to reduce the risk of occurrence and recurrence in children.

Effective Prevention Strategies

Breastfeeding for at least six months
Avoiding passive smoke exposure
Limiting pacifier use, especially after 6 months of age
Practicing good hand hygiene
Keeping vaccinations up to date, including influenza and pneumococcal vaccines
Avoiding bottle-feeding while the child is lying down
Treating allergies promptly

Parents should also be educated about the importance of proper ear care, including avoiding the insertion of objects into the ear canal and protecting the ears during water activities.

The Role of Xylitol in AOM Prevention

Some studies have suggested that xylitol, a natural sugar substitute, may help prevent acute otitis media in children. Xylitol can be found in chewing gum, lozenges, or syrup form. While more research is needed to fully establish its effectiveness, xylitol may be a safe and potentially beneficial option for some children.

When to Seek Medical Attention: Guidelines for Parents

Educating parents about when to seek medical attention for their child’s earache is crucial for ensuring timely and appropriate care. While many cases of AOM may resolve on their own, certain situations warrant prompt evaluation by a healthcare provider.

Indications for Immediate Medical Attention

Severe ear pain or sudden worsening of symptoms
High fever (above 39°C or 102.2°F)
Ear discharge or bleeding
Swelling or redness behind the ear
Stiff neck or severe headache
Changes in mental status or extreme irritability
Persistent symptoms beyond 2-3 days, especially in young children

Parents should also be advised to follow up with their healthcare provider if symptoms do not improve within 48-72 hours of starting antibiotic treatment or if new symptoms develop during the course of illness.

The Importance of Follow-Up Care

Even in cases where immediate medical attention is not necessary, follow-up care plays a crucial role in managing acute otitis media. Healthcare providers should schedule appropriate follow-up appointments to monitor the child’s progress, assess treatment effectiveness, and address any ongoing concerns or complications.

By providing clear guidelines and education to parents, healthcare providers can help ensure that children with earaches receive appropriate care and avoid unnecessary complications or prolonged discomfort.

Acute earache

Can Fam Physician. 2011 Sep; 57(9): 1019–1021.

Honorary Research Professor in the Department of Family Medicine at Memorial University of Newfoundland in St John’s

Correspondence: Dr Graham Worrall, Dr W.H. Newhook Memorial Clinic, Family Medicine, Box 449, Whitbourne, NF A0B 3K0; e-mail ac.num@llarrowgCopyright © the College of Family Physicians of CanadaThis article has been cited by other articles in PMC.

Parents worry a lot about their children having ear infections; they think such infections are very dangerous. Accordingly, they often bring their children in to see the family doctor.

In the middle of a typical Wednesday morning clinic, Mrs Green, a white, 31-year-old, married mother, brings her 3-year-old daughter, Amy, to see you. Mom says that Amy has been complaining about a pain in her left ear, and pulling at that ear, for 2 days. She has not had a cough or a runny nose, but she might have had a slight fever.
Amy was born by normal vaginal delivery and has been a healthy child. Her record shows that she has been seen only twice in your clinic, once for otitis media (treated with an antibiotic) and once for abdominal pain. There is no record of hospitalization or serious illness.

Epidemiology and population at risk

Acute otitis media (AOM) is predominantly a disease of children; you will rarely see an adult with it. After the common cold, it is the second most common reason why children are brought to their FPs.^¹ About 30% of children younger than 3 years of age visit their FPs with AOM each year, and by their third birthdays 80% to 90% of children have experienced AOM.^² The peak incidence is between 6 and 15 months; after 5 years of age, the incidence rate drops rapidly. Attendance at a day-care centre or nursery school greatly increases the risk of AOM; other risk factors are white ethnic origin, male sex, enlarged tonsils and adenoids, a previous history of AOM, bottle feeding, use of a dummy or soother, parental smoking, a family history of AOM,^³ and the presence of anatomic disorders of the nasopharynx such as cleft palate^⁴ and Down syndrome. ^⁵

Amy is in the age group most likely to experience AOM, and she has a documented previous attack of AOM. Amy is white, but has no predisposing abnormal anatomical features. You do not know whether her mother smokes, whether Amy goes to day care, or whether the family is prone to ear infections.

What else could it be?

Acute otitis media is far and away the most common cause of earache in children, but you stop to consider other possibilities—mostly mild but some potentially serious: foreign body, coryza causing eustachian tube blockage, mumps, otitis externa, tender cervical nodes, temporomandibular joint pain, cervical spine pain, pharyngeal tumours, mastoiditis, meningitis, dental pain, and sinus pain.

shows that otitis media, otitis externa, and the common cold cause most earaches in children. In primary care, other causes are rare.

Distribution of causes of earache

URTI—upper respiratory tract infection.

As Amy is an otherwise healthy child who is not taking any medications, it is likely that her earache is due to acute otitis media or an upper respiratory tract infection.
Before examining her, you consider whether any alarm features are present.

Alarm symptoms

Amy is not known to have been in contact with any serious infectious diseases; she does not attend day care. Mom cannot think of any toy or small item that is missing, and the pain did not come on suddenly. Amy has not been unusually drowsy or had a high fever. The pain is restricted to her ear on one side.

Alarm signs

Amy has no rash, neck stiffness, or unusual drowsiness; she seems alert. Her ear is not running, and she does not look particularly ill.

You ask more questions—the mother is a non-smoker, the family is not prone to ear infections. Mrs Green says her daughter has not complained of neck, sinus, or throat pain. Amy has not vomited.

Clinical examination

Amy is quiet but is alert and looks quite well to you. Her temperature is 37.8°C; she has a runny nose; her throat looks normal, and there are no swollen neck glands. Your otoscopic examination reveals that her left tympanic membrane looks redder and less reflective than her right one, but you do not see bulging, retraction, or fluid behind the eardrum. There is no perforation or discharge. Her face, mouth, and throat look normal. Your examination reveals no foreign body. There is no swelling in front of her ears; the mastoids, temporomandibular joints, and maxillary sinuses are not tender. Her cervical glands are normal in size and are not tender. Her teeth and mouth look normal, and you notice that during the examination Amy moves her neck freely.

You are now fairly confident that no serious cause of the earache is present (or at least not detectable at this stage). You are beginning to think AOM is likely.

How sure of your diagnosis are you?

It is difficult to confidently diagnose AOM; there is no criterion standard for diagnosis in primary care. Most studies have used a combination of symptoms and signs to diagnose AOM.^⁶–⁹ As ^⁶–⁹ shows, some features make AOM more or less likely.

Table 1.

Likelihood ratios for signs and symptoms of AOM

FEATURE	POSITIVE LIKELIHOOD RATIO	NEGATIVE LIKELIHOOD RATIO
Symptoms
• Earache	7.3	0. 4
• Cough	1.0	1.0
• Rhinitis	1.0	0.5
• Fever	0.9	1.3
• Diarrhea or vomiting	1.0	1.0
Signs
• Red TM	1. 1	1.0
• Very red TM	1.6	1.0
• Cloudy TM	16.2	0.2
• Bulging TM	20.3	0.4
• Retracted TM	0.8	1.0
• Reduced TM mobility	4. 7	0.1

Your patient has an earache, a cloudy tympanic membrane, and a history of previous AOM, all of which increase the chances of AOM being present. On the other hand, her slightly raised body temperature, the presence of a cold, and the slight redness of her eardrum do not increase the chances.
You decide that your young patient probably does have AOM. Now you have to think about management.

Is it likely to get worse?

The natural history of AOM has been elucidated by the experiences of thousands of placebo-group subjects in the trials of antibiotic treatment.^¹⁰,¹¹ It has been estimated that in around 80% to 85% of children with AOM, the fever and pain resolve within 2 to 3 days; after 7 days, the absence of all symptoms and signs (except for middle ear effusion) can be expected. These trials for children with AOM showed that very few treated children developed complications, but neither did those children who were given placebo. ^¹⁰,¹² Very few suppurative complications occurred either in the placebo or intervention groups.^¹¹ Complications of AOM, such as mastoiditis and meningitis, once moderately common, are now extremely rare in developed countries. Administration of antibiotics does not prevent these complications.

Because of the high spontaneous cure rate, there is controversy about the need for antibiotic treatment of AOM. Since a landmark trial done in the Netherlands, which found that only 2.7% of children who were treated with symptomatic relief therapy rather than antibiotics got worse rather than better,^¹³ many reviews of the antibiotic trials for AOM have been done. Typical of these is the Cochrane review that concluded that there is only weak evidence that routine antibiotic treatment improves the clinical course and outcomes of AOM.^¹⁰ If antibiotics are given to all children as soon as possible after AOM appears, less than 15% of them (who cannot be identified by clinical features) will experience any noticeable benefit, and the benefit will be modest and short-term. ^¹⁰

Deciding on the best treatment

How many children do I have to treat for one to benefit?

To achieve the absence of all signs and symptoms at 7 days, the number needed to treat (NNT) with antibiotics is about 8.^¹¹ This means that 7 out of 8 children with AOM either do not need antibiotics or will not respond to them. The NNT to reduce fever and pain at 2 days is about 21. The NNT to avoid contralateral AOM is 17. The NNT to reduce fever and pain using ibuprofen or acetaminophen is about 5.^¹¹

Trials have shown that ibuprofen and acetaminophen are equally effective in relieving pain and fever.^¹⁴

How many children do I have to treat to harm one?

With oral antibiotics, the number needed to produce diarrhea, vomiting, abdominal pain, or rash is about 11.^¹⁰

Which is the best antibiotic to use?

If you do decide to use an antibiotic for the treatment of AOM, amoxicillin remains the best first-line choice, because it gives adequate coverage of all the bacterial organisms that commonly cause AOM and has relatively few side effects. If amoxicillin is contraindicated or fails, the choice of agent remains unclear—there is no clear contender for second-best agent.^¹⁴,¹⁵ A Cochrane review found that although treatment failure was more likely to occur when an antibiotic course of fewer than 7 days was used, compared with a longer course, at least 17 children would have to be given a longer course to avoid 1 treatment failure.^¹⁶

Is it safe to wait and see what happens?

Most children with acute AOM will recover spontaneously. For those who do not, there seems to be no harm in delaying antibiotic treatment for a short time while providing symptomatic relief. There are several good-quality trials that show that if parents are given delayed prescriptions for antibiotics, which they are advised to use only if their children do not improve after a few days, far fewer children will take antibiotics.^¹⁷

You advise the mother that her daughter has AOM. You tell her that it will most likely improve by itself in a day or so. You suggest that she give Amy ibuprofen to relieve the earache and return to see you in 2 days. The mother says that they will be away from town for 2 days. You provide her with a delayed prescription for amoxicillin, which she can use if required. If, despite antibiotic therapy, Amy still does not improve, Mrs Green should seek further medical advice.

Footnotes

This article is eligible for Mainpro-M1 credits. To earn credits, go to www.cfp.ca and click on the Mainpro link.

La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du numéro de septembre 2011 á la page
e320.

Competing interests

None declared

References

1. Froom J, Culpepper L, Jacobs M, DeMelker RA, Green LA, van Buchem L, et al. Antimicrobials for acute otitis media? A review from the International Primary care Network. BMJ. 1997;315(7100):98–102. [PMC free article] [PubMed] [Google Scholar]2. Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years in children in greater Boston: a prospective cohort study. J Infect Dis. 1989;160(1):83–94. [PubMed] [Google Scholar]3. Uhari M, Mänysaari K, Niemalä M. A meta-analytic review of the risks factors for acute otitis media. Clin Infect Dis. 1996;22(6):1079–83. [PubMed] [Google Scholar]4. Sando I, Takahashi H. Otitis media in association with various congenital diseases. Preliminary study. Ann Otol Rhinol Laryngol Suppl. 1990;148:13–6. [PubMed] [Google Scholar]5. Davies B. Auditory disorders in Down’s syndrome. Scand Audiol Suppl. 1988;30:S65–8. [PubMed] [Google Scholar]6. Hayden GF, Schwartz RH. Characteristics of earache in children with acute otitis media. Am J Dis Child. 1985;139(7):721–3. [PubMed] [Google Scholar]7. Kontiokari T, Koivunen P, Niemalä M, Pokka T, Uhari M. Symptoms of acute otitis media. Pediatr Infect Dis J. 1998;17(8):676–9. [PubMed] [Google Scholar]8. Heikkinen T, Ruuskonen O. Signs and symptoms predicting acute otitis media. Arch Pediatr Adolesc Med. 1995;149(1):26–9. [PubMed] [Google Scholar]9. Uhari M, Neimalä M, Hietala J. Predicting acute otitis media with symptoms and signs. Acta Paediatr. 1995;84(1):90–2. [PubMed] [Google Scholar]10. Glasziou PP, Del Mar C, Sanders SL, Hayem M. Treatments for acute otitis media in children: antibiotic versus placebo. Cochrane Database Syst Rev. 2004;(2):CD000219. [PubMed] [Google Scholar]11. Marcy M, Takata G, Shekelle P, Chan LS, Mason W, Wachsman L, et al. Management of acute otitis media. Rockwell, MD: Agency for Healthcare Research and Quality; 2001. Evidence Report/Technology Assessment no. 15. AHRQ publication 01-E010. [Google Scholar]12. Del Mar C, Glasziou P, Hayem M. Are antibiotics indicated as initial treatment for children with acute otitis media? A meta-analysis. BMJ. 1997;314(7093):1526–9. [PMC free article] [PubMed] [Google Scholar]13. Van Buchem FL, Peeters MF, van’t Hof MA. Acute otitis media: a new treatment strategy. Br Med J (Clin Res Ed) 1985;290(6474):1033–7. [PMC free article] [PubMed] [Google Scholar]14. Alberta Clinical Practice Guidelines Program . Guidelines for the diagnosis and treatment of AOM in children. Edmonton, AB: Alberta Clinical Practice Guidelines; 2003. [Google Scholar]15. Scottish Intercollegiate Guidelines Network . Diagnosis and management of childhood otitis media in primary care. Edinburgh, Scotland: Scottish Intercollegiate Guidelines Network; 2003. Available from: www.sign.ac.uk. Accessed 2011 May 4. [Google Scholar]16. Kozyrskyj A, Klassen TP, Moffatt M, Harvey K. Short course antibiotics for acute otitis media. Cochrane Database Syst Rev. 2010;(9):CD001095. [PMC free article] [PubMed] [Google Scholar]17. Spurling GK, Del Mar CB, Dooley L, Foxlee R. Delayed antibiotics for respiratory infections. Cochrane Database Syst Rev. 2007;(3):CD004417. [PubMed] [Google Scholar]

Kids and Ear Infections – Children’s Health Orange County

About three-fourths of children have had at least one infection by the time they are 3 years old. It’s no wonder that ear infections are the most common cause of earaches in children.

Ear Infection Symptoms

An ear infection is an acute inflammation of the middle ear caused by fluid and bacteria behind the eardrum. “Usually it starts with a cold, so the child will have a runny nose and a cough. Colds can lead to ear infections in susceptible children,” says Dr. Nguyen Pham, an ear, nose and throat specialist at CHOC. “Older kids will pull on their ears and tell you their ears hurt. For infants, symptoms can include fever, irritability, or changes in their eating and sleeping patterns. A pediatrician can look at the eardrum to diagnose an ear infection.” Generally, ear infections are treated with oral antibiotics.

Protect Little Ears

“The best thing families can do is to have really good hand hygiene,” says Dr. Pham. “Everyone should wash hands constantly. Encourage children to not touch their faces with their hands or rub their eyes,” he says. Colds and the flu can frequently lead to ear infections, so children should be protected against colds and get a flu vaccine, Dr. Pham advises.

Hearing Loss Help

“An acute ear infection can lead to temporary hearing loss because of the fluid behind the eardrum. That type of hearing loss will get better over several weeks. If it doesn’t get better, that’s the time to go to the pediatrician or a specialist,” says Dr. Pham. If you suspect your child has hearing loss, ask for an audiogram, which is a formal hearing test. A pediatrician can perform this test or refer the child to a specialist such as an audiologist or otolaryngologist.

Is there an effective, preventative surgical treatment for children with frequent ear infections?

Children who have four or more ear infections per year meet the criteria to have ear tubes inserted into the eardrum. Ear tubes create a drainage pathway for bacteria behind the eardrum to get out, so infections don’t form. This is a commonly performed surgery in the U.S. and is very effective in preventing ear infections.

Fast Facts

Number of babies born in the U. S. with permanent hearing loss: 3 in 1,000
Percentage of children in the U.S. with some hearing loss: 10%
Percentage of children who will have at least one ear infection by their second birthday: 90%

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Coughs and colds in children – treatment, prevention, causes

Key facts

Most coughs and colds in children are caused by viral infections.
Cold viruses are spread easily through droplets from the nose and mouth of infected people.
Cold viruses can cause a runny nose, sore throat, cough and lethargy.
The best treatment for a cold virus is to rest at home so your child’s immune system can fight the virus.
Cough syrups and cold medicines are not considered effective or recommended for children.

What is the ‘common cold’?

The common cold is an infection caused by a virus. Hundreds of different viruses can cause colds and they usually affect the nose, ears and throat. They are easily spread from person to person through infected droplets from the mouth and nose. They can also be passed on through coughs and sneezes.

Colds are very common. Healthy preschool children often catch at least 6 colds per year. Sometimes, after recovering from a virus kids get sick with a new and different virus, so it can seem as though they are ‘always sick’. Children are more likely to catch a cold than adults because their immune system is still developing. Most children catch fewer cold viruses as they get older.

What are the symptoms of a cold?

Colds usually cause symptoms such as:

Less common symptoms include:

If your child is unwell with symptoms of a cold, you may be concerned that they have COVID-19 since some cold and COVID-19 symptoms are similar.

Speak to your doctor if you are concerned about COVID-19. Many doctors prefer to see children with respiratory symptoms via telehealth to stop them spreading their illness. You should call your GP’s practice before attending with your sick child to see what their arrangements are.

CHECK YOUR SYMPTOMS — Use the Coronavirus (COVID-19) Symptom Checker and find out if you need to seek medical help.

What causes coughs and colds?

Most cough and cold symptoms are caused by viruses and cause a mild illness that goes away on its own without needing special treatment.

Colds are not caused by getting cold or wet, or by going out with wet hair or bare feet.

In some cases, cold symptoms can be caused by other conditions. These include:

Some of these conditions can be treated easily at home, but others may need treatment from your doctor.

How can I prevent coughs and colds?

It is not possible to prevent all coughs and colds, but there are things you can do to reduce the chance of your kids getting sick.

These include:

frequent handwashing, especially after coughing, sneezing or blowing your nose,
coughing or sneezing into your elbow,
avoid sharing utensils and cups with others,
using tissues instead of hankies and throwing them out straight away.

Eating a balanced diet and getting enough sleep will also help keep your children healthy.

There is some evidence that regular zinc and probiotic supplements may reduce the number of colds children get over time, but more research still needs to be done to confirm this. At this stage, Australian doctors do not recommend regular vitamin supplements for healthy children. You may wish to speak to your doctor if you are concerned or want more information.

When should I seek medical help for a cough or a cold?

You should visit your GP if your child is finding their symptoms very unpleasant, or at any stage if you yourself are concerned.

Be sure to seek medical attention if your child is very unwell with symptoms such as:

wheezing
a ‘sucking in’ of the skin around the throat or under the ribs when breathing in
flaring of nostrils when breathing
breathlessness (only being able to speak a few words at a time)
fever with cold symptoms

These symptoms may mean your child’s illness is severe or is caused by something other than a cold virus. In this case, you may wish to discuss them with your doctor.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How are coughs and colds diagnosed?

In most cases, your GP can diagnose a cold by examining your child and asking you a few questions.

In some cases, your GP may refer the child for special tests such as a swab to test for COVID-19.

How are coughs and colds treated?

Most coughs and colds are caused by viruses and get better on their own within a week. If your child has a cold virus, antibiotics will not help them recover since antibiotics can only help treat bacterial infections. Other medicines such as decongestants, antihistamines and cough syrups have not been shown to help children recover from coughs and colds and are not recommended for young children. Vitamin supplements such as zinc, vitamin C and echinacea have also not been shown to help children recover from colds faster.

Special diets, or feeding your child more or less than usual (‘feed a fever, starve a cold’) have not been shown to have any effect on a cough or cold.

Humidifiers and steam treatments have also not been shown to have an effect on coughs or colds in children, although some parents find them helpful.

The best treatment for most coughs and colds is for your child to rest at home so their immune system can fight the virus. Making sure your child drinks plenty of fluids will help ease a sore throat and make a runny nose easier to blow. Saline nose drops or spray can also help thin mucus and make it easier to blow out. You can use a bulb syringe to gently suck mucus from your baby’s nose if they are too young to blow it themselves.

Honey has been shown to help ease children’s coughs, especially if given at bedtime. It can be given to children over 12 months of age.

Paracetamol or ibuprofen can be used to ease the pain of a sore throat or headache. The strengths of these over-the-counter medicines differ, so be sure to check the dose instructions on the pack and give your child medicines only as directed.

Coughs caused by other conditions, such as asthma or croup, are sometimes treated using inhalers or medicines such as steroids. Your doctor will prescribe these medicines and explain how to use them if they are needed.

What complications are linked to coughs and colds?

Most coughs and colds pass quickly with no medical treatment required and no complications.

In some cases, however, your child may develop a bacterial infection after being sick with a cold virus and the infection might then need medical treatment.

If your child’s symptoms do not improve within a week, or they get worse, or your child has a cough that continues for more than a few weeks after their illness, they should see a GP. The doctor may recommend some tests or treatments to rule out complications or another cause of your child’s symptoms.

When might my child need antibiotics?

Most coughs are caused by cold viruses, so antibiotics will not help your child get better any faster. Antibiotics are only used to treat bacterial infections.

A doctor may prescribe antibiotics when a cough is caused by a bacterial infection in the throat or chest, such as tonsillitis or pneumonia.

Resources and support

What every parent should know about coughs, colds, earaches and sore throats

Whooping cough (pertussis) is a respiratory tract infection that is very easily spread. Whooping cough usually starts off with cold-like symptoms, and develops into a cough. A bout of coughing is often followed by a deep intake of breath making the characteristic ‘whoop’ sound suggested by the name.

If you suspect your child has whooping cough, see your doctor.

What can I do about it?

You can help your child feel better by:

giving them small frequent meals and fluids often (such as sips of water or smaller feeds but more often).¹
keeping your home free of irritants such as cigarette smoke.¹
keeping your child at home for 3 weeks from the start of the cough (if no antibiotics are given) or until they have had at least 5 days of their course of antibiotics.²

Taking care of a child with whooping cough can be stressful. Ask for help from family and friends so that you can catch up with sleep.¹

How long will it last?

Whooping cough can last up to 6 weeks, with an ongoing cough lasting another 2 to 6 weeks.³

What about antibiotics?

Antibiotics may be prescribed during the first 3 weeks of infection. This helps stop the spread of infection to others, but may not reduce symptoms. If the cough has been present for longer than 3 weeks, antibiotics are unlikely to help.²

Seek help

If your child is having difficulty breathing.
If your child has problems catching their breath after a coughing spasm.

See card 12 ‘When should I seek further help?’ for more information.

Preventing whooping cough

Whooping cough can be prevented by vaccination. If you have whooping cough and you have been in close contact with anyone in the first 3 weeks of your infection, you must let them know that you have whooping cough and that they might be at risk of catching the infection including:

all household and family members
children and teachers at childcare or school
friends, especially pregnant women
work colleagues.

If you have been in close contact with someone with whooping cough, see your doctor as soon as possible.

References

1. Royal Children’s Hospital Melbourne. Whooping cough. Kids Health Info. 2008. [Online] (accessed 23 May 2017).

2. Antibiotic Expert Group. Antibiotic Therapeutic Guidelines v15. Therapeutic Guidelines Pty Ltd. [eTG Online] (accessed 24 March 2017).

3. Centers for Disease Control and Prevention. Pertussis (whooping cough). National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases 2015. [Online] (accessed 12 May 2017).

Runny Nose, Sore Throat, Ear Pain & More During Cold Winter Weather in Tooele, UT: ENT Specialists: ENTs

With winter officially upon us, you or someone you know is bound to be exposed to nasty ailments that frequently affect the ears, nose, or throat. From horrible colds, to a bad flu, and sore throats being the most common, the colder the weather gets, the chances of you catching something increases. The immune system is often compromised during the cold winter months, leaving you susceptible to common illnesses. Where there a few things you can do minimize the risk of getting sick, many people will still get a bug. With that in mind, we at ENT Specialists would like to discuss common illnesses that affect ears, nose and throat.

Why Do We Get Colds in Winter?

The common cold is the most likely offender this winter to hit many people. Generally, the common cold is derived from a viral infection which manifests in an assortments of ways. Depending on what type of virus attacks your respiratory system dictates the symptoms. Despite a host of the plethora of viruses responsible for the common cold, there are quite a few different systems that point to the illness. Generally, excessive mucus production in the nasal cavities and/or chest is one of the primary symptoms in addition to an irritated throat and eyes that get watery. Since the common cold is due to a viral infection, there is little you can do to address the underlying issue, but over the counter decongestants help treat the symptoms until the body clears out the infection. Keep in mind that a cold causes a person to lose a large portion of water so keeping hydrated is important. Bed rest is recommended. However, in the event that symptoms are prolonged over two weeks, call ENT Specialists.

Does Cold Weather Cause a Sore Throat?

The sore throat is another common winter ailment. A sore throat describes a symptom rather than pinpointing the diagnosis and without knowing the other discomforts, it can be a challenge to name the actual problem. When it comes to having a sore throat, it is important to know the cause; viral infection, bacterial infection, or a simple irritation from extreme temperature exposure or even allergies. Treatment differs from each instance.

Why Does Flu Spread in Cold Winter Weather?

The flu is one of the most offensive winter ailments that people are commonly exposed to. The flu can be dangerous with different circumstances. A relatively common disease that reoccurs on a seasonal cycle is influenza, a viral infection which attacks your respiratory system. The symptoms of the flu resolve themselves without intervention typically in healthy people. However, the danger is in severe cases, or with those who have a compromised immune system, such as children or the elderly. In these situations, the flu can be a significant health risk. Many people can avoid the flu with flu shots, be sure to ask your health care specialists to see if you are a good candidate.

Ear, Nose & Throat Care

No matter which common winter illness is affecting you, if it is prolonged over few weeks, or your symptoms are severe, do not hesitate contacting ENT Specialists. We are proud to specialize in ears, throats, and noses to help you find relief for the problems you face, call us today to schedule your appointment.

Sore throat | symptoms | treatment

Promotion! ENT doctor’s appointment 1500 ₽ – 8 (812) 200-48-48 More details

What to do if your throat hurts? We will give you tips that will definitely help, but temporarily, before visiting a doctor.
And we must not miss the symptoms in which the doctor needs to appear urgently!
A sore throat is something that each of us encounters from time to time. However, the fact that we have a sore throat quite often does not mean that it can be endured this time too.
Occasionally painful sensations can indicate a serious health threat. Don’t miss this moment! You can die. If you are vaccinated against all infectious diseases, the risk of dying is greatly reduced.

Sore throat – symptoms

If you have a sore throat and the following symptoms appear along with these pains, contact your physician or otorhinolaryngologist (ENT doctor) as soon as possible:
• Difficulty breathing.
• Difficulty opening your mouth.
• In addition to the throat, the ears, eyes, tongue and so on hurt.
• Blood in saliva.
• Swelling (enlargement) of the submandibular or cervical lymphatic glands.
• A lump in the throat that makes it difficult to swallow.
• Rash (rash) in the mouth or on the skin.
• High temperature.
• Hoarseness if it does not go away for a long time.
By the way, the ENT doctor is taking 24/7 at our trauma center on the emb. Black River, 41/2B. This is the only place in our city where you can get emergency outpatient ENT care for adults and children at any time.
If these symptoms are not present, then a visit to a doctor with a sore throat is still desirable in any case.

Sore throat – how to treat

What to do right now if your throat is sore:
1. Rinse with salt water.
Grandma’s method, but it may work a little, especially at the very beginning of the disease.
Saline solution reduces microbial activity, reduces inflammation and accelerates wound healing, which together leads to pain relief. 1 teaspoon of salt in a glass of warm water.You can also make a soda-salt solution: ¹⁄₄ teaspoon of baking soda and ⅛ teaspoon of salt in a glass of warm water.
2. Drink chicken stock if you have chicken at home.
Do not let your throat dry out. Chicken broth copes with this task best of all: it has not only moisturizing, but also a slight anti-inflammatory effect. And heat can reduce discomfort if it is caused by colds.
If broth, i.e. there is no chicken at hand, warm (not hot!) tea will do.Adding honey is a good idea. Honey also has a mild anti-inflammatory and softening effect on the pharynx, including helping to eliminate tickling and coughing.
Chamomile tea and other herbal teas have also worked well for sore throats.
3. Monitor the humidity in the room
Dry air is an unnecessary irritant for the nasopharynx. The optimum level of humidity in the apartment is 40-60%. And it’s easy to achieve.
4. Eat something cold.
For example, ice cream. Or drink a little cold milk.Cold constricts blood vessels, thereby reducing swelling, slowing down the development of the inflammatory process and reducing pain.
5. Suck up lollipop or caramel for colds, preferably without sugar.
This will increase salivation, which means that the mucous membrane will be moistened. Special pharmacy lozenges for sore throat contain additives – softening the throat or distracting from unpleasant sensations.
6. Use sprays and tablets.
Sprays and lozenges often contain local anesthetics (not antibiotics, topical antibiotics are not effective) that relieve pain: benzocaine, tetracaine, lidocaine … The use of such drugs is indicated, for example, for angina, when the sore throat is severe and sharp.
These drugs have contraindications, so consult your doctor first.
It is advisable to apply all these “grandmothers” and “grandfathers” methods described by me on the first day of illness and when it is not possible to go to the doctor at a given time. It is impossible to treat this, but it is imperative to go to the doctor.

Causes of sore throat

Why does the throat hurt?
Most often, sore throat is caused by viral diseases. This is how ARVI, flu, tonsillitis and more manifest themselves.However, the reason may be different, for example bacterial. Often, sore throat is a symptom of group A streptococcus infection: they are very contagious and, if inadequately treated, can lead to a number of complications: from middle ear infections to kidney inflammation and toxic shock syndrome.
Also sore throat can be caused by other, often non-obvious reasons:
• Allergies (to pollen, dust, mold, pet dander).
• A specific reaction to excessively dry indoor air.
• A variety of irritants, from tobacco smoke to chemicals found in detergents, wall paint, furniture, and more.
• Experienced muscle tension. If, for example, you screamed a lot at the new stadium in St. Petersburg, rooting for Zenit.
• Disorders of the digestive system. For example, gastroesophageal reflux disease (GERD), in which stomach contents, including hydrochloric acid, enter the esophagus and pharynx.
• HIV infection.
• A developing tumor.

Given the abundance of possible reasons, it is still better to entrust the diagnosis to a general practitioner or ENT doctor. The doctor will be able to correctly decipher what exactly caused the sore throat, if necessary, prescribe additional studies and recommend effective therapy.

Vanin D.N.

ENT trauma center CORIS
for adults and children – around the clock:
nab. Black River, 41 / 2B
(812) 200-48-08

90,000 The ear is blocked. How to distinguish otitis media from sulfur plug | Healthy life | Health

Our expert is otolaryngologist of the highest category, candidate of medical sciences Vladimir Zaitsev.

Cold and runny nose

There are several types of otitis media – external, middle and internal. The latter is quite rare, its main symptom is severe dizziness. But in most cases, ENT doctors have to deal with otitis externa or otitis media.

Otitis externa can be the result of trauma, local hypothermia, or infection in the ear. Otitis media occurs as a complication of the external or appears against the background of a runny nose, when mucus from the nose enters the auditory tube, and then into the middle ear.

Or maybe sulfur?

Congestion in the ear does not always indicate the presence of otitis media. Sometimes this is a sign of a waxy plug in the ear.

Let’s try to understand the symptoms.

Congestion in the ear. In the presence of a sulfur plug, congestion in the ear appears or intensifies after any water procedures (shower, bathing). From the water, the sulfur masses in the ear swell, the stunnedness increases, and then gradually decreases or disappears. There is no pain.

If we are talking about inflammation of the auditory tube (tubo-otitis), the congestion torments the patient constantly – its intensity does not change during the day and does not depend on external influences.

Pain. If the pain is shooting, most likely we are talking about otitis externa. Aching dull pain speaks of otitis media. Severe bursting pain and a feeling as if the ear is about to explode are symptoms of purulent otitis media. In this case, urgent action is needed. Pus can break out or, much worse, inside, which sometimes leads to inflammation of the lining of the brain – otogenic meningitis, which can be fatal.

Itching. If itching joins the pain in the ear, it is most likely that the otitis media is caused not by a viral or bacterial infection, but by a fungus. Be sure to tell your doctor about this symptom so that the doctor will immediately prescribe the correct treatment.

Otitis media is a very dangerous disease, so do not try to cure the disease yourself. Even harmless ear drops used without a doctor’s prescription can cause serious consequences. For example, if a hole in the eardrum appears against the background of otitis media, the medication can penetrate too deep into the ear and cause damage to the auditory nerve and hearing loss.

Warming up, which patients often prescribe to themselves, can also be dangerous. With purulent infections, warmth is contraindicated!

Therefore, in case of pain in the ear, be sure to see a doctor and strictly follow his recommendations.

Why did he come back?

Many are sure that if otitis media happened once, then the disease will recur constantly. But the point is not at all in the first episode of the disease, but in the anatomical features of the ear, which can be the cause of recurrent otitis media.

For example, behind the ear canal is the mastoid process of the temporal bone, which is normally covered with air cells. However, it happens that there are too few or no cells at all. This feature can lead to frequent otitis media.

Another cause of inflammation in the ear is a too convoluted external auditory canal, in which sulfur accumulates in abundance.

If you know about these features of the structure of your ear, it is worth paying special attention to the prevention of otitis media.

Click to enlarge

By the way

There are a number of drugs for the treatment of otitis media, but in some cases, conservative treatment is not enough. Therefore, sometimes doctors have to prescribe a puncture of the tympanic membrane. This is done so that the pus accumulated in the middle ear flows out and does not cause serious complications. The procedure is done strictly according to indications and, contrary to popular belief, does not lead to hearing loss. Therefore, in no case should you refuse the doctor’s recommendations.

Neuritis of the facial nerve / Diseases / Clinic EXPERT

Neuritis of the facial nerve or Bell’s palsy is a lesion of the facial nerve manifested by unilateral paresis or paralysis of the facial muscles. As a result, weakness develops in these muscles, leading to a decrease (paresis) or complete absence (paralysis) of facial movements and the appearance of facial asymmetry.

One in 3-5 thousand people get sick with neuritis of the facial nerve. Neuritis of the facial nerve is possible in any age group, the average age of the diseased is 40 years.Men and women in general get sick equally often.

Causes

Depending on whether the damage to the facial nerve is caused by an infection or not, a distinction is made between primary neuritis of the facial nerve (non-infectious) and secondary, or symptomatic, neuritis of the facial nerve (infectious).

The most common causes of primary neuritis of the facial nerve are:

local hypothermia of the neck and ear, especially under the influence of cold, wind, draft or air conditioner
Insufficient blood supply (ischemia) of the nerve due to vascular problems (selective damage to the facial nerve in circulatory disorder in the vertebral artery.).

It is generally accepted that secondary neuritis of the facial nerve is associated with an infectious factor, primarily with the herpes simplex virus type I. In addition to herpes, it can be diagnosed with ear diseases – otitis media, eustachitis, mastoiditis (the so-called otogenic neuritis).

It should be noted that neuritis of the facial nerve can occur without an inflammatory process. In such cases, experts talk about neuropathy of the facial nerve.

Symptoms

Usually, neuritis of the facial nerve develops gradually.At the beginning, there is pain behind the ear, after 1-2 days the asymmetry of the face becomes noticeable, a characteristic facial asymmetry is created on the side of the affected nerve:

smoothing of the nasolabial fold
absence of folds on the corresponding half of the forehead
eyelids are wide open and the so-called … lagophthalmos (“hare’s eye”) – a white strip of sclera between the iris and the lower eyelid
dry eyes or watery eyes may appear. In some cases, the symptom of “crocodile tears” develops – against the background of constant dryness of the eye, the patient experiences lacrimation while eating.

On the healthy side:

Sharp lowering of the corner of the mouth to the healthy side, as a result, the face tilts to the healthy side
Less sharp pulling of the nose to the healthy side.

All these disorders are especially noticeable when trying to make active facial movements.

The patient cannot close his eyelids. When he tries to do this, his eye turns upward (Bell’s symptom).

The weakness of the mimic muscles is manifested by the inability to move them:

when the teeth are bared – the mouth and nose are pulled even more sharply to the healthy side
cheek puffing fails
when frowning on the sore side, vertical folds do not appear
when lifting the eyebrows upwards no horizontal folds on the forehead
Drooling occurs due to insufficient function of the muscles of the mouth.

Additional symptoms may join the main picture:

Decrease or complete absence of taste sensations in the anterior 2/3 of the tongue
Increased auditory sensitivity (hyperacusis)
Pain in the mastoid region (behind the ear)
Increased sensitivity in the area of the auricle.

Diagnostics

The main method of examination for neuritis of the facial nerve is examination by a neurologist, however, in some cases additional laboratory and instrumental studies are performed, which depend on the symptoms identified by the neurologist:

blood pressure measurement
Doppler sonography and duplex examination head and neck

In some cases, the doctor may prescribe:

examination of ENT organs
electroneuromyography
X-ray examination of the skull
MRI (magnetic resonance imaging) of the brain.

It is especially important that in the conditions of the EXPERT Clinic it is possible to collegially discuss the patient’s problem with doctors of other specialties (consultation of the therapist, endocrinologist, otorhinolaryngologist, immunologist, dentist, etc.). This allows you to reduce the number of “unnecessary” examinations and speed up the correct diagnosis, and hence the appointment of adequate treatment.

Treatment

The effectiveness of treatment of neuritis of the facial nerve depends on the correct identification of the cause and the timeliness of initiation of therapy.As a rule, if a patient seeks a neurologist as early as possible, then the likelihood of recovery is much greater.

Self-medication is not permissible!

When diagnosed with neuritis of the facial nerve, treatment should be started as early as possible – preferably already in the first hours after the onset of symptoms. In this case, the success of the treatment of neuritis of the facial nerve will be maximum and in 75-80% of cases will completely eliminate the symptoms of the disease. Treatment is carried out individually, depending on the cause of the symptoms.

During the 1st week of the disease, the affected muscles need rest. In this period, the following are prescribed:

dehydrating agents
vasodilators
B vitamins
in the presence of an inflammatory process and pain syndrome, analgesics and anti-inflammatory drugs are indicated
short courses of treatment with hormonal drugs
– from physiotherapeutic procedures from physiotherapeutic procedures.

At the 2nd week, massage begins, exercise therapy with a gradually increasing load, adhesive plaster fixation of the affected muscles is carried out, paraffin applications are applied.From the end of the 2nd week, the use of anticholinesterase drugs and dibazol is advisable; more intense physical therapy. In some cases, electrostimulation is performed.

After 2-3 months with incomplete recovery, it is advisable to prescribe biostimulants. Reflexology should also be used. For neuritis of the facial nerve, a therapeutic facial massage is also useful.

Eye care for neuritis of the facial nerve includes:

instillation of artificial tear fluid or saline solution (every 1-2 hours)
wearing glasses
wearing a wet eye patch
at night you must apply a special eye lubricant and close your eyes medical paper
never use medical cotton products for contact with the eye, as cotton scratches the eyeball
in case of any discomfort in the eye, redness – you must consult an ophthalmologist.

In the conditions of the EXPERT Clinic, the attending physician can help the patient by prescribing treatment in the comfortable conditions of a day hospital.

Prognosis

The prognosis of facial nerve neuritis depends on its localization and the presence of concomitant pathology (otitis media, parotitis, herpes). In 75% of cases, complete recovery occurs, but with a disease duration of more than 3 months, complete restoration of the nerve is much less common. Recurrent neuritis has a favorable prognosis, but each subsequent relapse is more difficult and prolonged.

Severe forms can cause the following complications:

irreversible damage to the facial nerve
improper regrowth of nerve fibers, which leads to involuntary movement of some muscles when a person tries to use others – synkinesis (for example, when a person smiles, he may involuntarily close eyes)
Partial or complete loss of vision caused by the inability to lower the eyelids and, as a result, excessive dryness of the eyes.

In case of persistent residual effects in the long-term period (after 2 years), the issue of surgical treatment is resolved

Recommendations

, complex treatment, we recommend contacting a qualified neurologist.

Frequently asked questions

Is it possible to massage the face with neuritis of the facial nerve?

The usual classical massage is not indicated for neuritis, because this can lead to contractures of the facial muscles on the affected side. Shows a special “point” massage and exercise therapy.

I had neuritis of the facial nerve 3 times. Is there a preventative treatment to avoid it again?

It all depends on the causes of recurrent neuritis of the facial nerve.If it is provoked by a vasoneural conflict (of the facial nerve and blood vessels), then prompt elimination of this conflict is possible. In other cases, provoking factors (general and local hypothermia – the parotid region, etc.) should be avoided.

My mom has face asymmetry. Is it from neuritis?

The cause of facial asymmetry can be not only neuritis of the facial nerve, but also more serious diseases, for example, acute cerebrovascular accident, tumor (neuroma) of the auditory nerve, etc.To clarify the diagnosis, your mother should consult a neurologist.

Treatment histories

Story # 1

Patient T., 39 years old, suffered 2 relapses of neuritis of the left facial nerve within 3 years. The patient consulted a neurologist at the EXPERT Clinic when, against the background of hypothermia, facial asymmetry reappeared.

The patient underwent a course of hormone therapy, intravenous drip injections in the day hospital of the EXPERT Clinic and a course of restorative therapy, including acupressure and physiotherapy exercises.Facial movements have fully recovered.

During an additional examination, MRI of the cerebellopontine angle on the left revealed a vasoneural conflict of the left facial nerve. The patient was referred for planned neurosurgical treatment.

Requiem – Akhmatova. The full text of the poem – Requiem

No, and not under an alien firmament,
And not under the protection of alien wings, –
I was then with my people,
Where my people, unfortunately, was.

1961

Instead of a preface

During the terrible years of Yezhovshchina, I spent
seventeen months in prison lines
in Leningrad.Someone once “identified” me.
Then the woman standing behind me with blue lips,
who, of course, had never heard my name
in her life, woke up from the stupor we all had in
and asked me in my ear
(everyone was talking in a whisper there):
– And you can describe?
And I said
– I can.
Then something like a smile slid over the one
that had once been her face.

April 1, 1957
Leningrad

Dedication

Before this grief the mountains are bent,
The great river does not flow,
But the prison closures are strong,
And beyond them the “convict holes”
And deadly longing.
For someone a fresh wind is blowing,
For someone the sunset is basking –
We do not know, we are the same everywhere,
We only hear the hateful rattle of keys
Yes, heavy soldiers’ footsteps.
Ascended as to an early mass,
They walked wildly through the capital,
There they met, breathlessly dead,
The sun is lower, and the Neva is foggy,
And hope sings in the distance.
The verdict … And immediately tears will pour,
Oto all is already separated,
As if with pain the life from the heart was taken out,
As if rudely thrown backwards,
But it goes … Staggers … Alone.
Where are the involuntary friends now?
Two of my wretched years?
What do they see in the Siberian blizzard,
What do they see in the lunar circle?
I send them my farewell greetings.

March 1940

Entry

It was when he smiled
Only dead, glad to be calm.
And an unnecessary appendage dangled
Near its prisons Leningrad.
And when, mad with torment,
The already condemned regiments were walking,
And a short song of separation
The locomotives sang beeps,
The death stars stood above us,
And innocent Russia writhed
Under bloody boots
And under the tires of black marus.

They took you away at dawn,
Followed you, as if on a trip, followed,
In the dark room, children were crying,
At the goddess, the candle swam.
On your lips the coldness of the icon,
Mortal sweat on your brow … Do not forget!
I will, like the streltsy women,
Howl under the Kremlin towers.

1935
Moscow

The quiet Don flows quietly,
The yellow month enters the house.

Enters with a hat on one side.
Sees the shadow of the yellow moon.

This woman is sick,
This woman is alone.

Husband in the grave, son in prison,
Pray for me.

1938

III

No, it’s not me, it’s someone else suffering,
I couldn’t, but what happened,
Let the black cloth cover,
And let the lanterns carry away …
Night.

1939

Show you, the mocker
And the favorite of all friends,
The merry sinner of Tsarskoye Selo,
What will happen to your life –
Like a three hundredth, with a transfer,
Under the Crosses you will stand
And with your hot tear
Burn the New Year’s ice.
There is a prison poplar swaying,
And not a sound – and how many innocent lives are there … and my horror.
Everything is confused forever,
And I can’t make out
Now, who is the beast, who is the man,
And how long will the execution wait.
And only lush flowers,
And the ringing of a censer, and traces
Somewhere to nowhere.
And looks straight into my eyes
And the imminent death is threatening
A huge star.

1939

Light weeks fly.
What happened, I don’t understand,
How do you, son, go to prison
White nights looked,
How they look again
With a hot hawk eye,
About your high cross
And they talk about death.

Spring 1939

VII

Sentence

And the stone word
fell on my still living chest.
Nothing, because I was ready,
I can handle it somehow.

I have a lot to do today:
I must kill the memory to the end,
I must make my soul turn to stone,
I must learn to live again.

Otherwise … Hot rustle of summer
Like a holiday outside my window.
I have long had a presentiment of this
Bright day and empty house.

1939
Fountain House

VIII

To death

You will come anyway – why not now?
I’m waiting for you – it’s very difficult for me.
I put out the light and opened the door
For you, so simple and wonderful.
Take whatever form you like,
Break in with a poisoned shell
Or sneak up with a weight like an experienced bandit,
Or poison it with typhoid fumes.
Or a fairy tale invented by you
And everyone is sickly familiar –
So that I can see the top of the blue hat
And the house manager, pale with fear.
I don’t care now. The Yenisei is swirling,
The Polar Star is shining.
And the blue shine of beloved eyes
The last horror obscures.

August 19, 1939
Fountain House

Madness has already covered half of the Soul with a wing,
And gives fiery wine to drink,
And beckons to the black valley.

And I realized that to him
I must concede the victory,
Listening to my
Already, as it were, someone else’s delirium.

And will not allow anything
It will take me away with me
(No matter how you beg him
And no matter how you bother him with prayer):

Not a son, terrible eyes –
Petrified suffering,
Not a day when a thunderstorm came,
Not an hour of a prison meeting ,

Neither the sweet coolness of the hands,
Neither the agitated shadows of lime trees,
Neither a distant light sound –
Words of the last consolations.

May 4, 1940
Fountain House

Crucifixion

“Do not weep for Me, Mati, see in the grave”

Velikiy 1

Angels

hours the heavens melted in fire.
He said to his father: “Why did he leave me!”
A Mother: “Oh, do not cry for Me …”

1938

Magdalene fought and sobbed,
Beloved Disciple turned to stone,
And to where Mother stood silently,
So no one looked and did not dared.

1940
Fountain House

Epilogue

I learned how faces fall,
How fear peeps out from under my eyelids,
Like cuneiform hard pages
curls of ash and black
Silver turns suddenly,
The smile fades on the lips of the submissive,
And in a dry laugh, fear trembles.
And I do not pray for myself alone,
But for all who stood there with me
And in the fierce cold, and in the July heat
Under the red, blinded wall.

Again the funeral hour has approached.
I see, I hear, I feel you:

And the one that was barely brought to the window,
And the one that does not trample the ground for my dear,

And the one that, shaking her beautiful head,
Said: “I come here, like home. ”

I would like to name everyone by name,
Yes, they took away the list, and there is nowhere to find out.

For them I have woven a wide cover
Of the poor, they have overheard words.

I remember about them always and everywhere,
I will not forget about them even in a new trouble,

And if my exhausted mouth is clamped,
With which a hundred million people shout,

Let them remember me in the same way
On the eve of my memorial day.

And if someday in this country
They plan to erect a monument to me,

I give consent to this celebration,
But only on condition – not to put it

Not near the sea where I was born:
The last connection with the sea was broken,

Not in the royal garden at the treasured stump,
Where an inconsolable shadow is looking for me,

And here, where I stood for three hundred hours
And where the bolt was not opened for me.

Because I am afraid even in blissful death
Forget the rumbling of the black marus,

Forget how the hateful door slammed
And the old woman howled like a wounded animal.

And let from the motionless and bronze eyelids,
Like tears, melted snow flows,

And let the prison dove walk in the distance,
And the ships go quietly along the Neva.

March 1940
Fountain House

Why does a tooth react to cold, hot and sweet? Toothache from cold or hot?

Why are my teeth sensitive to sweets?

Not only cold and hot can cause pain with sensitive teeth.Teeth can be sensitive to candy and other sweets as well as sour foods and drinks. You may experience the familiar short-term sharp pain when you eat something sweet or sour. This is for the same reason teeth are sensitive to temperature changes: these foods (sweet / sour) can stimulate the nerve endings of the tooth.

There are also other reasons for teeth sensitivity to cold, hot, sweet or sour:

A crack in a tooth can affect a nerve within the tooth and cause tooth sensitivity
Teeth may be sensitive to heat and cold after filling
You may experience tooth sensitivity after a professional whitening procedure

If your teeth hurt when you eat cold, hot, sour or sweet foods, see your dentist to determine the cause of the discomfort.

Sensodyne Toothpaste is an effective way to relieve pain from sensitive teeth. It is # 1 brand for sensitive teeth as recommended by dentists *. For quick relief, try Sensodyne Instant Toothpaste. Clinically proven to reduce tooth sensitivity in just 60 seconds **, so you can enjoy your favorite food and drink again without worrying about discomfort.

* “Study of recommendations by dentists of various brands in the oral care segment”, Institute of Marketing Research GFK-Rus, November 2017 – January 2018
** Seong, J., Creeth, JE, Sufi, F. and West, NX ‘Short-term Efficacy of an Occluding Dentifrice on Dentinal Hypersensitivity’, J Dent Res, San Francisco, Calif, USA, Abstract 215.
207212 (2017) Synopsis Report, West, N., ‘A Clinical Study Investigating the Efficacy of an Occluding Dentifrice in Providing Relief from Dentinal Hypersensitivity’, GSK, GSK data on file.

90,000 Burning and tingling sensations in the ear – causes, symptoms and treatment | Infomedic.ru

Burning and tingling sensations in the ear are mainly associated with colds and otitis media.In fact, there are many other ENT conditions that can cause these symptoms. In addition, special care is required if there are certain accompanying symptoms associated with tingling in the ears, because in some cases this indicates the onset of hearing loss.

Definition

Burning sensation in the ears is one of the so-called forms of otalgia. The term describes various forms of pain in the ear, mainly the following nerves are responsible for the development of pain:

Glossopharyngeal nerve (Nervus glossopharyngeus) – this nerve is also called IX.Known as the cranial nerve, it is usually responsible for sensory perception in the middle ear.
Tympanic nerve (Nervus tympanicus) – branch IX. The cranial nerves are usually responsible for the sense of taste.
Vagus nerve (Nervus vagus) – cranial nerve X. is responsible not only for taste perception, but also for sensations of touch and motor processes in the ear and throat

Structure of the auditory organ

In order to understand why there is a burning sensation in the ears, you first need to carefully look at the structure of our hearing.Basically, the ear can be divided into five important main components. The outer ear ( Auris externa ) forms the visible part of the ear, consisting of:

– earlobes,

– auricle

– and the external auditory canal.

Burning sensation in the ear mainly occurs in the form of a tingling sensation in the earlobe. This is usually caused by insufficient blood circulation in the earlobe, for example due to a cold or vascular disease. If the circulatory disturbance is extensive, the burning sensation can spread from the earlobe to the external auditory canal.

The tympanic membrane is connected to the external auditory canal. It separates the outer ear from the inner ear canal and can also cause tingling in the ear area. This is mainly due to trauma or inflammation of the thin membrane. A blockage in the ear canal, such as caused by excessive earwax deposits, can also cause a burning sensation in the eardrum.

The eardrum received this name for a reason. Because all sounds that enter the ear canal from the outside are transmitted through the eardrum in the form of drum vibrations to the middle ear ( auris media ).It contains the tympanic cavity, bones, consisting of:

– hammer,

– anvils,

– and stirrup,

which handle noise vibrations. For example, otitis media can be very painful and dangerous. It is one of the most common ear conditions associated with burning in the ear.

The middle ear descends into the Eustachian tube (lat. Tuba audiva Eustachii) . On the one hand, the thin ear canal is used to ventilate the tympanic cavity, which prevents infections in the ear.On the other hand, the Eustachian tube, also known as the “ear tube,” balances pressure in the ears through body functions such as yawning, chewing, and swallowing, thus relieving pressure from the eardrum.

Unfortunately, the Eustachian tube does more than provide opportunities for air exchange and pressure equalization. Since the ventilation duct is a direct connection between the ear and the throat, pathogens from the ENT area can also easily migrate to the middle ear.Thus, ear disease occurs, which leads to acute pain. In addition, nerves along the ear canal often transmit pain stimuli from the throat, which are then mistaken for a burning sensation in the ears.

Sometimes the inner ear (inner Auris ) behind the tympanic cavity can be identified as a source of pain. In addition to the organ of balance, the inner ear also contains the cochlea, which is essential for the transmission of sound to the brain. In this case, the burning sensation often occurs in conjunction with imbalance and headache, for example in the context of an inner ear infection.

Cold as the main cause of tingling in the ears

Burning pain in the ears occurs especially often in autumn and winter. Wet and cold weather often causes painful circulatory problems in the outer ear. In addition, exposure to cold strains the immune system, which increases the risk of diseases such as runny nose (rhinitis), flu and colds (also flu infection). They affect all areas of the upper respiratory tract. Due to their proximity to the Eustachian tube, colds often penetrate the ear, as a result of which there is a burning sensation in the ears.

If a cold or flu is not properly cured during the course of the illness, there is also a further risk that infectious agents will enter the Eustachian tube. As a result, initially there is swelling and inflammation in the ventilation duct. The process of air exchange, as well as equalizing the pressure in the ear, is extremely difficult.

In addition to increased pressure in the area of the tympanic membrane, such a violation of ventilation contributes to the development of effusion in the tympanic cavity.This is followed by an accumulation of secretions in the middle ear, which can quickly develop into a focus of infection. If a subsequent infection occurs in this way, tingling in the ears is very likely. Common accompanying symptoms are cough, hoarseness, and runny nose, depending on the previous cold. Fever and chills may also occur, depending on the severity of the infection.

ENT diseases and tingling in the ear

Colds and flu are not the only diseases in the ear, nose and throat that can cause a burning sensation in the ear.In principle, diseases such as inflammation of the mucous membrane and lymphoid tissue of the pharynx – pharyngitis ( Pharyngitis ), inflammation of the tonsils – tonsillitis ( Tonsilitis ) and inflammatory disease of the mucous membrane of the paranasal sinuses – sinusitis ( Sinusitis in ) can spread ear through the eustachian tube.

Even diseases of the lower respiratory tract, such as pneumonia, can rise to the ear through the neck and throat. In the early stages of these diseases, it is often difficult to tell whether the symptoms of the disease are only spreading to the ear or the infection has already spread deep into the ear.

Attention: Infectious diseases always carry the risk of blood poisoning (sepsis)! This is all the more likely if infectious agents have already spread. Therefore, early treatment is extremely important!

Particularly severe pain in case of ear infections

A typical secondary infection when infectious microbes spread to the ear is otitis media. In this ear condition, the burning sensation in the ear usually occurs at regular intervals and with a certain intensity.Other accompanying symptoms may include difficulty swallowing, fever, dizziness, and nausea. A purulent discharge from the ear is also possible if the eardrum is affected during the course of the disease and thus inflammation of the eardrum (myringitis) occurs.

If otitis media is not treated for a long period of time, there is a risk of developing otitis media or labyrinthitis. This not only further increases the pain in the ears, but also increases the risk of permanent hearing damage and even deafness in the affected ear.

Otitis media can occur not only due to ENT diseases that rise in the ear. It is also possible that the disorder is caused outside the eardrum. The most likely scenario in this context is an external ear infection (otitis externa), which itself can lead to a burning sensation and tingling sensation in the ear.

Disease can be caused mainly by microbial contamination of the ear such as bacteria, mites or fungal infections. Infectious agents mainly enter the ear canal through non-sterile foreign bodies such as cotton swabs or microbial contaminated water.

In the latter case, staying in public baths is the classic route of infection. Swimming pool water often contains contaminated particles or urine residues that contribute to infection. Therefore, if inflammation of the outer or middle ear is acquired while swimming, they talk about the so-called swimmer otitis media. In childhood, in addition to colds, there is often a burning pain in the ears.

Speaking of water, residual water can also temporarily increase pressure in the ears, which can cause burning sensation.However, the symptom here is fairly harmless and disappears as soon as the water accumulation dissolves.

Tingling in the ear from trauma and high blood pressure

Burning ear pain is most dangerous if it is caused by hearing damage. As with an inner ear infection, hearing loss is possible, so a doctor should always diagnose this condition, due to the possibility of hearing impairment and problems.

There are various causes of hearing damage. For example, ear noise processing elements may be damaged due to improper treatment of ear infections.Likewise, eardrum injury cannot be ruled out, which is also possible in addition to untreated untreated infections, and severe trauma from an explosion or a foreign body trapped in the ear can also be a cause of hearing damage.

When it comes to injuries caused by high blood pressure, the intensity of the increase in pressure plays a major role. Burying your ears from diving to moderate depths while diving or increasing altitude during flight is generally harmless.But in the event of an extreme change in pressure, the picture changes dramatically. Abnormal pressure on the eardrum, which is caused by a lack of pressure compensation, can actually cause painful injury in the form of barotrauma.

Other causes of burning in the ears

With regard to the causes of the disease that cause burning pain in the ears, in addition to ENT diseases, it is necessary to mention allergies and childhood diseases such as mumps, measles, scarlet fever or rubella. Like the flu, these infectious agents can spread to the ears through the airways or bloodstream and further aggravate the stitching pains caused by ear infections.This shows once again why it is so important to completely get rid of infections and cure the disease, in order to avoid secondary infections.

In addition, various dental diseases associated with radiation pain in the ear should be mentioned, which, although they are not considered diseases of the ENT organs, also occur in the area of \ u200b \ u200bthe Eustachian tube and therefore can send pain signals to the ear. It is known that damage and inflammation of the root of the tooth, as well as problematic wisdom teeth, cause both ear pain and toothache.This can be explained by the close connection of the dental nerves with the nerves responsible for otalgia – pain in the auricle and external auditory canal in the absence of visible pathological changes in them.

Hearing or jaw malformations, skull fractures (eg, skull base fracture) and nerve inflammation should also not be ignored as the cause of pain. Tissue changes such as acne, eczema or boils in the ear can also cause burning problems in the ear.

Sometimes complaints are associated with the development of a tumor in the ear. The accompanying symptoms are mostly limited, so a burning sensation in the ears is often inexplicable at first.

Associated symptoms indicate early signs

The reasons can be very varied. Symptoms are similar to those of otalgia. The combination of tingling in the ears with various accompanying symptoms often provides the first indication of possible triggers:

Ringing in the ears

The most harmless variant of tingling in the ears is “ringing in the ears”, sometimes acute pain, arises from a cold in the outer ear or earlobes.In this case, it may be due to a decrease in blood flow to the blood vessels of the ear.

Pulsation in the ears

If burning sensation occurs in conjunction with tapping or throbbing in the ears, this is usually a sign of severely narrowed blood vessels. In this case, the pressure in the vessel is literally heard. In addition to the effects of the common cold, this form can also be based on an illness-related blood pressure disorder.

Burning pain from pressure

There are many reasons that lead to changes in pressure in the ears.Scenarios can range from sudden changes in altitude, such as when flying an airplane, to clogged ears, from effusion in the tympanic cavity to abnormal ventilation in the Eustachian tube (for example, inflammation associated with disease). Such pain when changing pressure is not always dangerous. However, if symptoms persist and do not go away, the doctor must diagnose these problems to keep the patient safe.

Burning and difficulty swallowing

Difficulty swallowing, combined with tingling in the ears, can also be caused by changes in hearing pressure.Otherwise, the accompanying complaint mainly occurs with colds, tonsillitis and throat infections. Other symptoms, such as coughing or congestion in the throat, are also possible with these underlying conditions, and during the swallowing process, there is usually a short-term intensification of burning pain.

This is due to the proximity of the throat region to the Eustachian tube and the involvement of swallowing in equalizing the pressure in the ear. In the worst case, painful swallowing problems indicate that the ventilation duct is already infected with an infection associated with the disease.Subsequent infection and inflammation of the middle ear due to the increase in the number of pathogens is also not excluded.

Burning in the ears and blockage of the airways

In addition to difficulty swallowing, the stabbing ear pain associated with multiple ENT conditions also occurs with a blocked throat, nose, or blocked frontal sinus. There are common accompanying symptoms, with the exception of colds and flu, especially with sinus infections, including frontal sinus infections. With such diseases, there is usually nothing to worry about if treatment is carried out on time.However, if left untreated, these conditions can spread far beyond the ear into sensitive areas of the meninges and cause meningitis.

Burning sensation in the ears, headache and dizziness

The inner ear is a key position, converting pressure waves into sound signals that eventually reach the brain, and there is also an organ of balance in the inner ear. It is located deep in the pyramid of the temporal bone, next to the cochlea of the inner ear.Since this part of the ear is involved in development, the symptom usually occurs along with related accompanying complaints such as dizziness, balance problems, or headache. In addition, skull fractures and meningitis can cause impaired perception and headaches. If in doubt, you should urgently consult your doctor if you have these combinations of symptoms.

Burning sensation in the ears in combination with hearing problems

In addition to a tingling sensation, colds can also cause hearing problems such as tinnitus.Eardrum trauma from rupture, impact injury, or extreme damage to other noise-processing elements of the ear, such as infections of the inner or middle ear, can be the cause. In any case, the joint occurrence of tingling and hearing problems should be diagnosed by a doctor.

Burning pain in the ears in combination with discharge

Tingling and burning in the ears is certainly a dangerous symptom if it occurs with bloody or purulent discharge from the ears.Hearing injuries and advanced ear infections can also be cited here as the main causes. If tingling in the ears occurs in combination with fluid in the ear, prompt treatment is urgently needed to prevent hearing damage.

Diagnostics

A medical diagnosis is usually made after examining the medical history. Asking the patient about existing comorbid symptoms and / or previous medical conditions usually allows the doctor to guess what and how.

This is followed by a medical examination.In addition to throat, pharyngeal and nose checks and blood tests, ear examinations are done. For example, complex audiometry can be used. Behind this is a series of standardized tests that test hearing function using various measured values. For example, the Weber test is common, in which hearing is assessed using a tuning fork.

Otoscopy is also common. The hearing is illuminated by an otoscope light source so that any existing hearing damage in the external auditory canal and on the eardrum can be detected.If there is a specific suspicion, assessment methods such as MRI, magnetic resonance imaging, or ultrasound may be used to assess the inner ear. This is especially true in cases where the cause of acute pain may be a fracture of the skull or malformation of the ear or jaw. It is also possible, for example, a blood test to diagnose infections.

During medical examination, otoscopy is often used. In this case, the ear is illuminated by the light source of the otoscope, so that any lesions in the external auditory canal and on the tympanic membrane can be detected.Photo: oldline2 / fotolia.com

Treatment for burning in the ears

There is not always a need to take medications. However, serious infections should not be ignored, and the right medication should be used in time so it is not too late. Numerous medicinal herbs that have analgesic effects and contain anti-infectious agents due to their disinfecting properties can provide the additional assistance needed during treatment. Below is an overview of the possible treatments.

Medicines

If the infection has already penetrated the ears, then the use of antibiotics in the form of ear drops or tablets is inevitable. There is a great risk that infectious agents can enter the ear through the Eustachian tube. Common medications include Amoxicillin, Azithromycin, Clarithromycin, and Penicillin.

However, there are now also herbal medicinal antibiotics such as Otoven, which offer a good alternative due to the high number of multidrug-resistant microbes.In particular, these drugs are milder than aggressive antibiotics.

If the burning sensation is accompanied by pus in the ear or mucus in the airways, depending on the underlying disease, drugs are also used to remove secretions, such as Acetylcysteine, Ambroxol, Bromelain or Papain. They can reduce pressure on the inner ear canal, which not only reduces pain, but also prevents pressure-related damage to the ear. You can also take pain relievers such as ibuprofen.In this matter, it is very important to consult with an ENT doctor in advance in order to correctly indicate the dosage of the medication.

Home remedies for burning in the ear

The so-called Valsalva method helps with burning pain in the ears while flying in an airplane, climbing or diving. To do this, you need to close your nose and mouth at the same time and make a strong exhalation. Symptoms during elevation changes can also be avoided by regularly swallowing.

When it comes to tingling in the ear caused by ear infections and other diseases of the ENT organs, targeted heat treatment is always of great benefit.For example, heating pads or a (not too hot) hot water bottle can relieve ear pain symptoms. Steam baths, in turn, clear the airways and help remove infectious secretions. Other proven home remedies for ear pain include treatment with an infrared lamp, a warm potato gruel compress placed in the ear, or proven warm tea.

Advice. A study in Finland in 1996 was able to prove that a sugar derivative, xylitol, works successfully against otitis media.Xylitol appears to contain compounds that successfully kill the infectious microbes responsible for otitis media. For prevention purposes, it is ideal to chew chewing gum that contains xylitol. On the one hand, xylitol reaches the middle ear faster through the throat. On the other hand, when combined with the chewing movement of the jaw, it also helps to strengthen the Eustachian tube and thus improve the ventilation of the middle ear.

Help on medicinal plants

Warming teas are well suited for tingling in the ear area for the therapeutic treatment of the underlying disease.List of recommended herbs:

– chamomile,
– garlic,
– mullein,
– lavender,
– lemon balm,
– parsley,
– peppermint,
– sage,
– thyme
– and onions.

Some of these herbs can also be used as a spice for warm broths and other fortifying dishes. A peeled clove of garlic wrapped in cotton can also be placed directly in the ear, so the antibacterial components of the garlic can quickly penetrate the infection.

Herbal supplements for steam or medicinal baths are also recommended. However, when bathing, please be careful not to get water into your ears to avoid exacerbating the infection due to residual water.

Hygiene measures

An important step in the treatment of ear infections, as well as in the elimination of the associated burning pains, is the professional cleaning of the ear canal. Blockages can be removed by flushing the ears. Ear disinfection with pure alcohol is also particularly effective against symptoms of illness and pain.To do this, wipes soaked with alcohol are inserted into the ear, which are then regularly changed until the inflammation subsides.

Important: It is advisable that the ear disinfection procedure with wipes is carried out by an experienced specialist. Otherwise, improper handling of the tweezers or penetration too deep can injure the ear canal, further exacerbating pain symptoms and the risk of inflammation. A similar situation with irrigation or ear washing, which should also be performed by a professional ENT doctor.

Operational measures

Ears clogged with foreign objects sometimes require surgery to clear the blockages. This method is very often used with children. Ears clogged with earwax may also require surgery if irrigation does not help.

Hearing trauma as a cause of burning pain in the ears usually must be treated with surgery. For example, a ruptured eardrum can only be repaired with an artificial seal.Sometimes the eardrum needs to be opened artificially, for example, to drain the secretion.

If the hearing loss is severe, a complete replacement of the affected hearing aid may be required. Surgery is usually limited to minimally invasive procedures.

Show sources

Author:

Nadezhda Pavlovna Timofeeva

Sources:

Jaffen B.W., Stark E.K. Secrets of otorhinolaryngology (translated from English) / ed. Yu.M. Ovchinnikov. Moscow: Binom, 2001.591 p.
Svistushkin V.M., Morozova S.V. Otalgia in the practice of an otorhinolaryngologist. Regular issues “RMZh” No. 9 dated 05.05.2014 p. 658, https://www.rmj.ru/
S.V. Morozova, A.M. Mityuk State of the upper respiratory tract in infectious and systemic diseasesrmj.ru/
Karneeva O.V., Polyakov D.P., Zelikovich E.I. Early diagnosis of retraction pockets of the tympanic membrane in children // Bulletin of otorhinolaryngology. 2012. No. 1. P. 24–27
Palchun V.T., Kryukov A.I., Kunelskaya N.L. and other Acute inflammation of the middle ear // Bulletin of otorhinolaryngology. 1997. No. 6. P. 7–11
Karneeva O.V., Polyakov D.P. Diagnostic and therapeutic tactics for acute otitis media in accordance with modern recommendation documents. Regular issues of “RMZh” No. 23 of 11.12.2015 p. 1373-1376, https://www.rmj.ru/
Zagainova N.S., Brodovskaya O.B. On the surgical treatment of chronic suppurative otitis media // Russian otorhinolaryngology.

Earache and Cold: Differentiating Acute Otitis Media from Upper Respiratory Infections

Understanding Acute Otitis Media: Prevalence and Risk Factors

Key Risk Factors for Acute Otitis Media

Differentiating Earache: Is It AOM or Something Else?

Common Causes of Earache in Children

Less Common Causes to Consider

Recognizing Alarm Symptoms and Signs in Earache Cases

Alarm Symptoms to Watch For

Alarm Signs During Examination

Clinical Examination: Key Components in Diagnosing AOM

Essential Elements of the Clinical Examination

Diagnostic Challenges: When AOM Isn’t Clear-Cut

Factors Complicating AOM Diagnosis

Treatment Approaches for Acute Otitis Media in Children

Key Considerations in AOM Treatment

Antibiotic Options for AOM

Preventing Acute Otitis Media: Strategies for Parents and Caregivers

Effective Prevention Strategies

The Role of Xylitol in AOM Prevention

When to Seek Medical Attention: Guidelines for Parents

Indications for Immediate Medical Attention

The Importance of Follow-Up Care

Acute earache

Epidemiology and population at risk

What else could it be?

Alarm symptoms

Alarm signs

Clinical examination

How sure of your diagnosis are you?

Table 1.

Is it likely to get worse?

Deciding on the best treatment

How many children do I have to treat for one to benefit?

How many children do I have to treat to harm one?

Which is the best antibiotic to use?

Is it safe to wait and see what happens?

Footnotes

References

Kids and Ear Infections – Children’s Health Orange County

Ear Infection Symptoms

Protect Little Ears

Hearing Loss Help

Is there an effective, preventative surgical treatment for children with frequent ear infections?

Fast Facts

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What are the symptoms of a cold?

What causes coughs and colds?

How can I prevent coughs and colds?

When should I seek medical help for a cough or a cold?

How are coughs and colds diagnosed?

How are coughs and colds treated?

What complications are linked to coughs and colds?

When might my child need antibiotics?

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How long will it last?

What about antibiotics?

Seek help

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References

Runny Nose, Sore Throat, Ear Pain & More During Cold Winter Weather in Tooele, UT: ENT Specialists: ENTs

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Why Does Flu Spread in Cold Winter Weather?

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