Inflammation of the middle ear is one of the most common diseases in infancy and childhood. Inflammation of the middle ear is more common in children under five years of age, in men, in bottle-fed infants, in children going to kindergarten International Hospital Istanbul ENT Specialist Dr. Contact Mehmet directly tells the curious about the subject.
: Can you describe the otitis media?
Professor Dr. Mehmet Ada: Otitis media is a definition that fluid (effusion) accumulates in the middle ear cavity. Acute otitis media (AOM) is defined as recurrent acute otitis media (RAOM) in children who have had 3 episodes in the last 6 months, or 4 episodes of AOM in the last 1 month. The persistence of AOM symptoms within the first 72 hours despite antibiotic treatment is defined as “treatment failure.. The presence of fluid in the middle ear for more than three months is called Serous otitis media, which can be defined as chronic fluid accumulation in the middle ear. In this case, usually only hearing loss without a fever and pain is the main symptom.
: What Causes Disease?
Professor Dr. Mehmet Ada: The middle ear is a space behind the eardrum. The pressure inside is constantly changing and is equalized with the side of the membrane facing the outer ear canal. When the pressure on both sides of the membrane is equalized, the membrane becomes fully resilient and hearing normally occurs. However, problems occur if the pressure in the middle ear drops. This is usually associated with problems in the narrow canal, which we call the Eustachian tube, which connects the middle ear to the throat. In young children, this canal is both short and straight, but in a seven-year-old child, this canal has an anatomy that can fully function. Middle ear infections are usually caused by a bacterium or a virus. It may be related to a recent cold or accompanying allergic problems. Most patients were affected in both ears. In children, these agents are easily transported from the throat and nose to the middle ear through the shorter and horizontal eustachian canal. Once in the middle ear, germs settle and grow and this affects the eustachian canal, both in the middle ear and in close contact with it, causing the mucosa to swell in the tube. Due to the blocked tube, the pressure drops and the eardrum is pulled in. The sound transmission of the membrane, which loses its flexibility, falls. On the other hand, the liquid produced by the settled microbes accumulates in the middle ear and pushes the membrane outward and causes pain.
: Who is more common?
Professor Dr. Mehmet Ada: Children under five years of age, men, bottle-fed infants, children going to kindergarten middle ear inflammation is more common. Middle ear infections are less common in adolescence and adults, but usually occur after upper respiratory tract infections or when they are infectiously exposed to pressure changes (such as air travel, ascent or diving).
: What are the symptoms?
Professor Dr. Mehmet Ada: Middle ear infections are painful and result in insomnia. Your child is more red-skinned, sweaty and constantly crying in unrest all day long and playing with one ear constantly, one can say that one ear makes a continuous sound. Middle ear infections cause hearing loss in your child due to inflammation of the eardrum and middle ear. If the eardrum ruptures and this fluid does not flow out and the Eustachian canal remains blocked, the fluid here becomes chronic. If this fluid cannot be removed, the flexibility of the eardrum is reduced and hearing is affected. A large number of middle ear infections can delay your child's speech. Your child's learning ability may also be affected, depending on how long the hearing problem starts and how long it lasts. Your physician will decide by considering all these factors in the evaluation and timing and selection of the intervention. Some children have fluid accumulation in the middle ear after treatment after recurrent ear infections or after the upper respiratory tract (Serous Otitis Media). The characteristic feature of this type of middle ear inflammation is the only symptom of hearing loss without pain, as opposed to the symptoms of sudden middle ear inflammation mentioned above.
: How is the diagnosis made?
Professor Dr. Mehmet Ada: Your Otorhinolaryngology and Head & Neck Surgery specialist will perform the examination by using tools such as otoscope, forehead mirror and microscope when a middle ear problem is suspected. A short time is sufficient for the examination and does not cause pain. If you tell your child before you come to the examination, the examination will be more comfortable. If your child can sit calm for a few minutes, our audiometry specialist will perform middle ear tests and report with a special device measuring tympanometry and acoustic reflex. While tympanometry is used to determine the pressure in the middle ear, acoustic reflex measurement measures the function of the middle ear muscles at high sounds. The aim of these tests is to measure the elasticity of the eardrum and its response to loud sounds.
: What are the treatment options?
Professor Dr. Mehmet Ada: The factors that determine treatment are: frequency of infection and duration of infection. When the doctor determines the drugs, he / she determines the factors mentioned above and follows the healing process. In many children, medication and the elimination of risk factors are sufficient for treatment.
: Is drug-free treatment possible?
Professor Dr. Mehmet Ada: Some of the sudden otitis media can heal without using any antibiotics. Your doctor may sometimes choose such a treatment, but in this case, your child will follow and decide for three days.
: How is medication treated?
Professor Dr. Mehmet Ada: If a drug-free follow-up is not sufficient when a sudden developing middle ear infection is detected, treatment should be arranged according to your child's age and the severity of the infection. Your doctor's treatment plan may contain antibiotics and other medicines to prevent future infections. It may also contact your pediatrician for other diseases that may cause this condition to occur.
After the medication is prescribed, your doctor will monitor your child to determine the fate of the fluid in the middle ear. In most cases, the fluid accumulated in the middle ear disappears within 2 or 3 weeks following the middle ear infection. If the accumulated fluid becomes chronic, a follow-up of up to months may be necessary.
: What should be done to reduce risk factors?
Professor Dr. Mehmet Ada: If your child goes to kindergarten or daycare, there is a greater risk. Teach her to wash her hands and make her wash her hands more often during the day. Consult your doctor to determine what your child is allergic to. Protect your child from dust or other allergens if your child has a tendency to allergies. Make sure that there is no smoking inside the house and that it does not come into contact with cigarette smoke.