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Otitis Media

Otolaryngology

Otitis media is the inflammation of the middle ear (an air-filled space behind the eardrum). 

Symptoms

Acute Otitis Media symptoms include: 

Ear pain (Young children may hold, pull, or rub their ears to indicate discomfort)
Yellow or green discharge from the ear 
Hearing loss
Headache
Fever

Causes

Acute Otitis Media is typically also associated with respiratory diseases, the following are potential causes for acute Otitis Media: 

  • Upper respiratory tract infection A
  • Laryngitis or Tonsillitis
  • Ear 
  • Otitis
  • Difficulty in eustachian tube function

Otitis media with effusion is often associated with fluid accumulation in the middle ear. Here are some causes that can lead to otitis media with effusion:

  • A cholesteatoma occurs due to an infection, sensitivity or hypertrophy of proliferative glands, resulting in obstruction of the Eustachian tube, which makes the air pressure in the ear uncontrollable, and viscous fluid accumulates in the middle ear 
  • The effusion stays behind the eardrum, which is common in children aged two to six
     

Chronic otitis media is generally caused by incomplete recovery of acute otitis media. The following are common causes:

  • Insufficient healing from acute otitis media which leads to long-term inflammation of the tympanic mucosa of the patient's ear, which may easily lead to perforation of the tympanic membrane

High risk individuals

Children especially those under 6 years old, this is because their eustachian tube is shorter, more prone to acute otitis media.
People with immune system problems 
People with abnormal ear canal caused by congenital diseases, such as cleft lip and palate patients
People suffering from allergic rhinitis, sinusitis or adenoid hypertrophy

Diagnosis

OtoscopyCheck the inside of the ear through an otoscope to check for swelling or pus in the eardrum
Ear secretion test 
TympanogramMeasure the pressure in the middle ear and the vibration of the eardrum to check for fluid accumulation

Treatment

Acute Otitis Media
  • Antibiotics and the discretion of the doctor 
  • Analgesic and antipyretics

If serious the doctor may perform an invasive procedure to let out fluid in your ear.

Effusion Otitis Media
  • Allergy medication 
  • Steroidal nasal spray 

In severe cases, the eardrum will be pierced to allow the placement of a middle ear vent tube to drain the fluid.

Chronic Otitis Media
  • Antibiotics 
  • Tympanoplasty (To repair ruptured eardrums and middle ear bone damage)

Impact of Otitis Media

Typically, if acute Otitis Media is treated early on appropriately there will be no changes in hearing ability. However if left untreated acute Otitis Media can cause long-term inflammation accompanied by conductive hearing impairment, inner ear inflammation and even brain abscess and meningitis.

For example, if a child suffers from Otitis Media without timely treatment, it’s possible that it could cause hearing impairment which could subsequently impact language acquisition. Therefore timely treatment of otitis media is essential to preserve children's hearing and language development.
 

Prevention

  • Minimize or avoid secondhand smoke 
  • Receiving the appropriate vaccinations for the seasonal influenza viruses under the “Hong Kong Childhood Immunization Programme”
  • Smokers, diabetics and others with chronic diseases should receive the streptococcus pneumococcal vaccine and seasonal flu vaccines.
  • If you are using a milk bottle to feed your baby, keep the baby in a more upright position

Frequently Asked Questions

Swimmer’s ear is also known as Otitis externa. It is typically caused by fungal infection in the outer ear (in front of the eardrum) due to regularly getting water in your ear. However Otitis media with effusion is an infection positioned in the middle ear (behind the eardrum).
During the flight the pressure in the middle ear and the pressure in the atmosphere will differ slightly, furthermore the eustachian tubes of children are shorter and flat, with lymph nodes swelling if they get sick, these factors together make it easier to develop Otitis media.

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