What causes otitis media and how is it treated?
Otitis is a name for the inflammation of the ear or both ears. Otitis media is the name of specific localization of the inflammation – in the middle ear. The eardrum, Eustachian tube, and, directly, the tympanic cavity in which the auditory ossicles are located make up the middle ear. These bones transmit vibrations of sound along the chain to the inner ear. Otitis can be one- or two-sided.
Children more commonly develop otitis media than adults.
Short information about otitis media
Types of otitis
Otitis can develop in the outer ear, inner ear, and middle ear. It can be also acute and chronic, viral, and bacterial.
Treatment of otitis depends on the causative agent. For instance, if inflammation is caused by a virus, it doesn’t require the use of antibiotics but bacterial otitis is treated with them.
Symptoms of acute otitis media
The symptoms appear sharply and grow very quickly - in a couple of hours. The first shooting pain appears, it can be throbbing or aching, it becomes stronger when swallowing, yawning, coughing, or sneezing. The pain often irradiates to the teeth, temple, and neck. In addition to pain, the following symptoms are characteristic:
- Noise in ears;
- Hearing impairment;
- Discharge from the ears;
- Decreased odor perception;
- Elevation of the body temperature;
- Fatigue, drowsiness.
Symptoms of chronic otitis media
Chronic otitis media can occur in untreated or insufficiently treated acute otitis. Besides, it can be caused by the head or ear injury. The symptoms of chronic otitis media include purulent discharges from the ear and impaired hearing. After the discharges disappear, there is usually no pain or fever. Other symptoms are:
- Hearing impairment;
- Noise in the ears;
- Coordination disorders.
What causes otitis?
The trigger factor for the occurrence of otitis media is infection. Most often it is caused by bacterial pathogens such as pneumococci, hemophilic bacillus, and staphylococci. They can penetrate the ear during various viral and general infectious diseases, especially, those that affect the nose and throat (flu, common cold, sinusitis, tonsillitis, etc.). Also, trauma to the head, eardrum often leads to the development of inflammation.
Flying in an airplane, intense diving and blowing your nose can cause otitis media, because this leads to a strong increase in pressure in the nasopharynx and microorganisms enter the tympanic cavity through the Eustachian tube.
The following factors also play a role in the onset of otitis media:
- Chronic tonsillitis;
- Lowered immunity;
- Vitamin deficiency;
- Diseases of the upper respiratory tract;
- Deviation of the nasal septum and other features of the anatomical structure of the nasal and ear cavities;
- Runny nose (including allergic rhinitis).
Diagnosis of otitis media
In order to detect an inflammatory process of the middle ear and its severity, an otolaryngologist visually examines the eardrum, pharynx, nasal cavity, and sinuses. Sometimes, a doctor also checks the indivdual's balance and coordination in order to promptly identify the possible complications of the disease, for example, labyrinthitis with toxic damage to the inner ear. In this case, such research methods as tympanometry, threshold audiometry, and sound audiometry are used.
Diagnostics also include hearing tests. Often an analysis of discharge from the ear is performed. If complications are suspected, for example, mastoiditis (inflammatory process in the mastoid of the temporal bone) or others, an X-ray examination is performed. With the help of an x-ray, the results of computed tomography of the temporal bone, or cranium, it is possible to timely determine the need for surgery.
Treatment of otitis media
Therapy of otitis media includes the use of symptomatic medicines, i.e. aimed at the reduction of inflammation and ache and broad-spectrum (effective against many bacteria) antibiotics such as Zithromax.
At the mild stage of the disease, it is recommended to use NSAIDs such as Diclofenac and Ibuprofen or Paracetamol for kids, and nasal sprays that reduce the swelling. Besides, painkiller eardrops can be used but only after visiting an otolaryngologist because if there is a rupture in the eardrum, ear drops are contraindicated.
The treatment with antibiotics is needed to prevent serious complications of the disease such as brain infection. It is crucial to follow the treatment course duration, dosage, and time of intake to avoid developing resistance to the antibiotic when the infection is harder to treat.
If during inflammation the eardrum isn’t ruptured and the purulent discharge accumulated above it cannot outflow freely, a doctor can make an incision to ensure the outflow. The surgery is made with local anesthesia for adults and general anesthesia for kids. The eardrum usually recovers without any intervention.
If otitis media in a child occurs frequently, it is advised to remove the tonsils or adenoids that are the primary sources of infection spreading then to the ears.
In adolescents with chronic or frequent inflammation of the nasal mucosa and sinuses, accompanied by otitis media, surgery is crucial especially if conservative drug treatment is not effective.
The prognosis for otitis media
Usually, when the disease is timely diagnosed and treated according to a doctor’s instructions, it is completely curable and doesn’t cause complications. Around 80% of patients experience relief on the 2-7 days of the therapy.
However, in some cases, the disease can cause complications the most common of which is mastoiditis (infection of the mastoid of the temporal bone). In the condition, bone tissue is often impacted and inflammation can go to the lining of the brain or brain itself.
Frequent otitis media in kids causes impaired hearing and speech development retardation so it is crucial to eliminate the potential risk factors such as chronically inflamed tonsils or adenoids.