OTITIS MEDIA

Definition

Otitis media is an illness characterized by inflammation of the area beyond the eardrum, or the middle ear. There are basically three types of otitis media: acute otitis media, otitis media with effusion, and chronic otitis media.

Acute otitis media (AOM) begins with infections caused by sore throats and colds that spread to the middle ear via the eustachian tube (see "Ear Function"). Seventy-five percent of children get otitis media before turning three years old, and half of these children will get it three times before turning four. In otitis media with effusion (OME), the middle ear fills up with a liquid that may or may not be infected with bacteria. Children and seniors typically catch OME. Hearing is impaired when the middle ear fills up with liquid because the middle ear cannot function properly. Most young children, however, are unable to say that they are having difficulty hearing; therefore, OME is often detected when children appear in bad moods or when speech and language development seems to be slow. CASE STUDY

Chronic otitis media is the repeated occurrence or failure to completely heal either AOM or OME. There is typically a rupture in the ear drum, intermittent oozing of fluid from the middle ear to the ear canal, and hearing impairment. If left untreated it may lead to even more serious conditions, such as inflammation of the brain or paralysis of the facial nerve.

Treatment

There are two steps in the treatment of AOM and chronic OM. The first is to try to eradicate the infection. The second is to prevent the ear from getting damp or moist. Antibiotics are required to suppress the bacterial infection and precaution is required when taking a bath to avoid moisture from entering the ear and allowing bacteria to regenerate. Closely fitting silicone ear plugs ensure that water stays out.

For OME, anti-inflammatory drugs and nasal sprays are used to open up the eustacian tube to allow the liquid trapped in the middle ear to flow through it. However, it is very common for the liquid to not drain out with medicine alone. Therefore, cutting a small slit in the ear drum and placing a small tube (also called a grommet) in it is often necessary to drain the middle ear. At this point the doctor will almost certainly say, "Be careful to not let water into the ear." This is especially important when bathing because it is so easy to get bath water filled with bacteria or sweat into your ear. In this situation you should always wear silicone ear plugs.

You can still enjoy water sports if you have a middle ear infection, as long as you protect your ears from water using silicone ear plugs. If there is a chance of bumping the ear plug out of place, then a head band in combination with the ear plugs is also advisable.

References

• Hajime Kanke, The Journal of Pediatric Practice, 1998, volume 8, issue 75, pp. 1447-1449.
• *Gates GA, Cost-effectiveness Considerations in Otitis Media Treatment, Otolaryngol Head Neck Surg, 114 (4), April 1996, 525-530.
• http://my.webmd.com/content/article/1680.51736
• McKinley Health Center, www.mckinley.uiuc.edu/info/dis-cond/misc/otitisme.html
• Miller-Keane Medical Dictionary, 2000.
• Practical Otology, Daniel J. Pender, J. B. Lippincott Company, 1992. 6. Audiology and Auditory Dysfunction, George T. Mencher, Sanford E. Gerber, Andrew McCombe, Allyn & Bacon, 1997.