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Does Your Child Have an Ear Infection?
By: Keith A. Jackson, MD & Glenn Kanamori, M.D., D.D.S.

Acute Otitis Media means an inflammatory process of the middle ear caused by infection. The middle ear is that portion of the ear that lies behind the tympanic membrane or eardrum. Acute Otitis media can occur in one or both ears. It is the most common cause of hearing loss in children. It tends to occur in the winter and early spring months.

Acute Otitis Media is a debilitating disease because not only does it cause hearing loss but also very painful earaches. In children especially in the formative years impairment of learning as well as delayed speech and language development can result. Fortunately early and appropriate treatment can almost always restore hearing to normal.

Parents should be aware of certain symptoms to look for. In infants and toddlers pulling or scratching at the ear, crying, irritability, fever, vomiting or ear drainage would warrant seeking medical attention. In young children be on the lookout for earaches, ear pressure, hearing problems, dizziness, vomiting, ear drainage or fever.

Acute Otitis Media is caused by blockage of the eustachian tube, which is a passage between the middle ear and back of the nose. When this tube becomes swollen during a cold, allergy or upper respiratory infection, any bacteria or viruses that are present in the middle ear will lead to accumulation of fluid (pus) in the middle ear. This buildup of pus causes pressure, pain and redness of the eardrum. It also interferes with the sound mechanism of the ear leading to hearing loss. Untreated Acute Otitis Media may cause the eardrum to rupture causing ear drainage, or turn into Serous Otitis Media where pus and mucus remain in the middle ear for weeks or months or even longer. Complications may occur at this stage. Acute Otitis Media may resolve on its' own but this is extremely unpredictable occurrence.

The mainstay of treatment for Acute Otitis Media is antibiotic therapy. If allergy or sinus infections are also present then additional types of medication may be prescribed to resolve these problems as well. Pain medication is also frequently necessary. A hearing test during or after the course of treatment may also be necessary to evaluate the presence or absence of a hearing loss. In a good number of cases the infection resolves with antibiotics.

There are two main groups of patients who may need further treatment- those with recurrent infections after stopping antibiotics, and those patients with persistent Serous Otitis Media that will not resolve despite medical therapy. In these two groups a small incision in the eardrum and placement of an extremely small tube called a tympanostomy tube into the eardrum will resolve the problem. This allows drainage of the fluid from the middle ear relieving the pain. It also allows liquid antibiotics to be placed directly into the middle ear to destroy the bacteria. The tubes will usually fall out of the ear in 6 to 12 months and the incision will heal on its own. The only real precaution with tympanostomy tubes is that ear plugs must be worn while swimming or bathing to protect the middle ear from water that has bacteria. Most patients that require tubes have immediate relief of their symptoms and are totally unaware that the tubes are in place.

Keith A. Jackson, MD & Glenn Kanamori, M.D., D.D.S.
Keith A. Jackson, MD & Glenn Kanamori, M.D., D.D.S.
The Desert Ear, Nose & Throat Group
Adult & Pediatric Otolaryngology