Earaches and Otitis Media

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Insight into otitis media and treatments

• What is otitis media?
• How does the ear work?
• What are the symptoms?

Otitis media means “inflammation of the middle ear,” as a result of a middle ear infection. It can occur in one or both ears. Otitis media is the most frequent diagnosis for children who visit physicians for illness. It is also the most common cause of hearing loss in children. Although otitis media is most common in young children, it occasionally affects adults

Is it serious?

Yes, because of the severe earache and hearing loss it can cause. Hearing loss, especially in children, may impair learning capacity and even delay speech development. However, if it is treated promptly and effectively, hearing can almost always be restored to normal. Otitis media is also serious because the infection can spread to nearby structures in the head, especially the mastoid. (see the symptoms list) Immediate attention from your doctor is the best action.

How does the ear work?

The outer ear collects sounds. The middle ear is a pea-sized, air-filled cavity separated from the outer ear by the paper-thin eardrum. Inside the middle ear are three tiny ear bones. When sound waves strike the eardrum, it vibrates and sets the bones in motion that transmit to the inner ear. The inner ear converts vibrations to electrical signals and sends these signals to the brain. A healthy middle ear has the same atmospheric pressure as air outside of the ear, allowing freevibration. Air enters the middle ear through the narrow eustachian tube that connects the back of the nose to the ear.

What causes otitis media?

Blockage of the eustachian tube during a cold, allergy, or upper respiratory infection, and the presence of bacteria or viruses lead to a build-up of pus and mucusbehind the eardrum. This infection is called acute otitis media. The build-up of pressurized pus in the middle ear causes pain, swelling, and redness. Since the eardrum cannot vibrate properly,hearing problems may occur. Sometimes the eardrum ruptures, and pus drains out of the ear. More commonly, however, the pus and mucus remain in the middle ear due to the swollen and inflamed eustachian tube. This is called middle ear effusion or serous otitis media. Often after the acute infection has passed, the effusion remains lasting for weeks, months, or even years. This condition allows frequent recurrences of the acute infection and may cause difficulty in hearing.

What will happen at the doctor’s office?

 During an examination, the doctor will use an otoscope to look at and assess the ear. The doctor checks for redness in the ear, and/or fluid behind the eardrum,, and to see if the eardrum moves. These are the signs of an ear infection. Two other tests may also be performed:

• Audiogram—Tests if hearing loss has occurred by presenting tones at various pitches.

• Tympanogram—Measures the air pressure in the middle ear to see how well the eustachian tube is workingand how well the eardrum can move.

How should medication be taken?

It is important that all the medications be taken as directed and that you keep any follow-up visits. Often, antibiotics to fight the infection will make the earache go away rapidly, but the infection may need more time to clear up. Other medications that your doctor may prescribe include an antihistamine (for allergies), a decongestant (especially with a cold), or both. Sometimes the doctor may recommend a medication to reduce fever and/or pain. Special ear drops can ease the pain. Call your doctor if you have any questions about yours or your child’s medication, or if symptoms do not clear.

What other treatment may be necessary?

If your child experiences multiple episodes of acute otitis media within a short time, or hearing loss, or chronic otitis media lasts for more than three months, your physician may recommend referral to an otolaryngologist for placement of ventilation tubes, also called pressure-equalization (PE) tubes. This is a short surgical procedure in which a small incision is made in the eardrum, any fluid is suctioned out, and a tube is placed in the eardrum. This tube eventually will fall out on its own and the eardrum heals. There is usually an improvement in hearing and a decrease in further infections with PE tube placement.

Otitis media may recur as a result of chronically infected adenoids and tonsils. If this becomes a problem, your doctor may recommend removal of one or both. This can be done at the same time as ventilation tubes are inserted.

What are the symptoms?

In infants and toddlers, look for: Pulling or scratching at the ear, especially if accompanied by other symptoms; hearing problems; crying, irritability; fever; ear drainage. In young children, adolescents, and adults look for: earache; feeling of fullness or pressure; hearing problems; dizziness; loss of balance, nausea, vomiting, ear drainage, and/or  fever.

Remember, without proper treatment, damage from an ear infection can cause chronic or permanent hearing loss.

Updated: 3/23/11

http://www.infoplease.com/cig/dangerous-diseases-epidemics/ear-aches.html

Childhood Diseases

Ear Aches

Earaches are extremely common in young children. Although they are not themselves infectious, they are caused by upper respiratory infections, which are infectious. These infections are spread through contact with respiratory secretions—through coughing and sneezing.

The ear aches because of inflammation of the middle ear, caused by fluid that builds up behind the eardrum. Kids often cry, pull on their ears, have a fever, act irritable, and are unable to hear well. In more severe cases, there can be nausea, vomiting, and diarrhea. The developing anatomy of the ear canal in children make some children more susceptible to infection because the ear canal does not drain fluids properly, allowing bacteria to grow. Most children will grow out of this problem.

Read more: Childhood Diseases: Ear Aches — Infoplease.com http://www.infoplease.com/cig/dangerous-diseases-epidemics/ear-aches.html#ixzz1v4PP9GPg

Sometimes doctors give children antibiotics to cure these earaches, but they don't always work. Many of the organisms that cause the respiratory infections that lead to earaches are antibiotic resistant, and not all respiratory infections are bacterial (remember, antibiotics only help cure bacterial infections). Some children have chronic infections that only respond to surgery to insert a tube that drains fluid from the ear.

Read more: Childhood Diseases: Ear Aches — Infoplease.com http://www.infoplease.com/cig/dangerous-diseases-epidemics/ear-aches.html#ixzz1v4PYs3VB

http://www.lufthansa.com/us/en/Ear-aches

Possible causes of ear aches on board

The air pressure in commercial aircraft can drop to a level corresponding to an altitude of about 2,500meters above sea level. That can sometimes cause passengers to suffer ear aches. 

These occur above all when the balance of pressure between the middle ear and the ambient air pressure cannot function properly. Such complaints can arise in particular if a passenger has a cold with swelling of the nose and the passage between the back of the throat and the middle ear (the so-called Eustachian tube).

Takeoff is less of a problem An aircraft's takeoff and climb to cruising altitude is less of a problem because the cabin has a subpressure. For a passenger with a cold, the overpressure that arises in the middle ear can then even be balanced relatively easily via the Eustachian tube. 

Landing can be painful if you have a cold The landing presents problems more frequently, because during an aircraft's descent the cabin air pressure increases and the natural balance of pressure can be interfered with due to a cold-related swelling of the mucous membranes. This results in subpressure in the middle ear, with a burden on the eardrums which can be painful.

What you can do to prevent ear aches

The most important technique to enable a balance of pressure is the so-called Valsalva method. Take a breath, hold your nose, and with your mouth closed press the air forcefully to the back of your throat. That opens the Eustachian tube and enables a balance of pressure. 

For prevention, you can apply an anti-swelling nose spray to both nostrils about a half-hour before the aircraft begins to descend from cruising altitude. This will free the passages between the nasal sinuses and the middle ear and enable a balance between the ambient pressure and the middle ear. 

In addition, you can speed up the pressure balance by making chewing movements. Best of all, take a few bars of chewing gum with you. Deliberate yawning can also reinforce the pressure balance. 

In the case of serious inflammatory ailments of the nasal sinuses, you should certainly consult your doctor before your flight.