TL;DR:
- Otitis media affects the middle ear, mainly in children under 7, but also adults.
- Causes: Primarily bacteria (e.g., Streptococcus pneumoniae, Haemophilus influenzae), sometimes viruses responsible for respiratory infections.
- Risk factors: genetics, cochlear implants, passive smoking, vitamin deficiencies, allergies, weakened immunity.
- Symptoms: ear pain, congestion, decreased hearing, fever, discharge, irritability in toddlers, and feeding issues in infants.
- Diagnosis: History, otoscopy, and sometimes ear culture.
- Treatment: Antibiotics for bacterial infections, painkillers for viral cases. Chronic cases may need surgical drainage.
- Acute otitis: Quick onset, severe pain, fever; resolves with treatment.
- Chronic otitis: Persistent, mild symptoms, potential hearing loss if untreated.
- Complications: Hearing loss, meningitis, facial paralysis, abscesses.
- Prevention: Hygiene, avoiding smoke, proper nutrition, flu/pneumococcus vaccination, and immune-boosting measures.
Otitis media is a common ailment of the auditory system. Anatomically, the middle ear is connected to the throat, making inflammation within it often co-occur with respiratory infections. The disease is characterized by pain, a feeling of congestion and hearing impairment. It can affect both children and adults, but it is the youngest who are most susceptible to it. How to recognize otitis media, how to treat it and can the disease be prevented?
What is the middle ear and why does it get sick?
The middle ear is an air-filled space that is located behind the eardrum. Through the auditory trumpet, it connects to the nasal part of the throat. The function of this structure is to amplify sound vibrations and bring them to the inner ear. Inflammation of this part of the body is one of the so-called. childhood diseases. It is estimated that more than 90% of children under the age of 7 have faced it at least once in their lives. The peak incidence usually occurs in the first and second year of a toddler's life. At the same time, it is worth being aware that adults can also get sick.
The vast most cases of otitis internus in children are caused by bacteria, such as the pneumonia bacillus, the influenza bacillus or Moraxella catarrhalis. These are bacteria that are common in the human body and sometimes do not cause discomfort for a while. Slightly less common is viral otitis, which is usually caused by the same viruses that are responsible for upper respiratory infections. Recognizing the underlying cause of the disease before starting treatment is very important. The situation is similar when it comes to otitis media in adults.
Who is most at risk for ear infections?
Although otitis media is largely age-related, there are also other risk factors that increase the likelihood of developing the disease. These include:
- genetic load – if parents have been observed to have recurrent otitis media, there is a high risk that the child will also struggle with this problem,
- the presence of a cochlear implant, an electronic device implanted in people with severe hearing loss,
- frequent passive smoking – exposure to tobacco smoke is extremely harmful to children and adolescents,
- vitamin deficiencies – especially vitamin A, whose deficiency can lead to sclerosis of the mucous membrane,
- weakened immunity associated with other diseases,
- allergies – inflammation can be a consequence of an allergic reaction.
Inflammation of the middle ear in a child is a disease most often caused by bacteria or viruses. Although it is not contagious in itself, the microorganisms causing it can be transmitted to other people. When this happens, there is a risk of them developing ear or respiratory ailments. This is why it is so important to prevent sending sick toddlers to kindergartens and other educational institutions.
How to recognize otitis media in a child?
Symptoms that accompany this disease are quite specific, but can vary subtly depending on the age of the patient, the cause of the ailment and the individual case. The most commonly observed symptoms of otitis media are:
- ear pain or headache – usually very intense, throbbing in nature, increasing when lying down,
- a feeling of congestion and distension – may occur when purulent contents accumulate in the ear,
- hearing deterioration and tinnitus,
- itching in the area of the affected ear,
- elevated temperature,
- excessive leakage of secretions from the ear canal.
Fluid in the ear most often suggests exudative otitis media. This variant of the disease is not accompanied by acute symptoms, such as fever or severe pain. However, this does not mean that it can be trivialized. When it comes to infant otitis, symptoms can be not only local, but also systemic. Parents of toddlers often observe increased crying, irritability, frequent touching of the ears and difficulties with feeding. The infant may refuse food, as the act of eating intensifies the pain.
Middle ear diseases in adults
In people who are past childhood age, the disease is very rare, but it is not at all less troublesome. Suggestive symptoms of otitis in an adult are usually a dull, throbbing pain on the side of the head or inside the ear canal, significant hearing impairment and tinnitus. Symptoms can vary in severity and intensify and weaken over time. However, it is worth remembering that they usually do not go away on their own and a visit to the doctor will be necessary.
If the discomfort is accompanied by a watery-purulent discharge from the ear canal, it usually means that an exudative adult otitis has developed. The exudate in the ear can persist for weeks or even months. Past infections, allergies, as well as failure of the ear trumpet may be responsible for its appearance. As in children,** otitis media in adults can be acute or chronic.** Acute inflammation is accompanied by high fever and significant weakness. If inner ear inflammation develops, symptoms may additionally include balance disorders, dizziness and vomiting.
Diagnosis of otitis media.
When you observe any symptoms related to the functioning of the auditory system or upper respiratory tract, it is worth making an appointment for a medical consultation. A specialist who treats this region of the body is an orhinolaryngologist, commonly referred to as a laryngologist, and a primary care physician is also a good choice to suggest further treatment. Otitis media in adults and children is diagnosed in a similar way. The basis is a detailed history and an otoscopic examination. An otoscope is a simple tool that allows an accurate visual assessment of the inside of the ear canal and a check of the condition of the eardrum – otitis often causes it to swollen and reddened. Usually this examination is sufficient to make a diagnosis. If a child or adult is found to have an exudative otitis, an additional swab may be taken for culture. Determining what bacteria are responsible for the ailment allows the appropriate treatment to be selected.
As with other infections, the therapy is selected according to the type of infection. If bacteria are responsible for otitis in a child or adult, it is necessary to include antibiotics. Usually their effect begins to be felt after about two days after the start of use. It is important to remember that the drug should not be discontinued on its own, even if there is a significant improvement in well-being. Bringing the therapy to the end is very important. On the other hand, if the disease has a viral origin, symptomatic treatment in the form of painkillers and antipyretics is used.
Exudative otitis media is sometimes treated surgically. The procedure involves incising the eardrum, suctioning out the fluid inside and installing a drain. This treatment is done when chronic otitis media is diagnosed and the effusion persists for more than 3 months.
Chronic vs. acute otitis – how to recognize?
Acute otitis media develops very rapidly and is characterized by intense symptoms. It is often caused by viral infections, which can lead to bacterial superinfection. This variant of the disease is accompanied by severe pain and high fever. Usually acute conditions respond well to the implemented treatment and symptoms completely resolve within a few weeks. Chronic otitis, on the other hand, lasts much longer and has a milder course. It is accompanied by recurrent ear canal leaks, prolonged hearing impairment and dull headaches of moderate severity. It can be a consequence of an untreated acute infection or damage to the eardrum. Chronic exudative otitis gives relatively mild symptoms, but still bothersome. The discharge that appears often has an unpleasant odor. If symptoms indicate chronic otitis media, an ENT consultation is necessary, as neglected treatment can lead to complications such as abscesses and partial or permanent hearing loss. In both cases, prompt diagnosis and appropriate therapy are crucial.
Complications of otitis media.
Symptoms indicative of otitis media should prompt medical consultation as soon as possible. Neglecting therapy can lead to serious complications, so the patient should remain under the supervision of a specialist until fully cured. The consequences of the disease can be:
- zapalenie błędnika,
- facial nerve paresis or paralysis,
- mastoiditis,
- meningitis,
- epidural or subdural abscess,
- brain abscess,
- inflammation of the sigmoid sinus.
One of the most common complications of untreated disease is complete or partial hearing loss. Exudative otitis in children can lead to perforation of the eardrum, its atrophy or changes in its structure. That's why it's important not to underestimate the symptoms.
Can the disease be prevented?
In everyday life we are constantly exposed to pathogenic microorganisms. Most often, such situations do not cause any symptoms, and sometimes we do not even realize that we have been in contact with bacteria or viruses. It is impossible to completely prevent infections. However, there are certain steps that can be taken to reduce the risk of developing otitis media. The basis of prevention of any infection is to take care of hygiene. Regular hand washing with warm water and soap is extremely important. Children should be taught to blow their nose properly and keep their ears clean. During the fall and winter months, it is a good idea to protect your toddler's head from the cold. The cold does not cause disease, but it contributes to weakening of the immune system. It is important to strengthen the toddler's immunity. A big help in this regard is breastfeeding for the first months of life, and in later life a balanced diet and regular physical activity. Particularly important is avoiding exposure to cigarette smoke and vaccinating little ones against influenza and pneumococcus. Although it is impossible to eliminate all risk factors, appropriate prevention significantly reduces the risk of developing otitis media and can help ease the course of a possible infection.
Conclusion
Otitis media can disrupt daily life, especially in children. From recognizing symptoms like ear pain and hearing loss to understanding bacterial or viral causes, early attention is crucial. Proper diagnosis, effective treatment, and preventive measures—like good hygiene, avoiding smoke exposure, and vaccinations—can make a significant difference. Ignoring symptoms risks complications such as hearing loss or serious infections. If you notice any warning signs, don’t delay seeking medical care. With proper steps, this common condition can be managed and prevented effectively.
