Most often, otitis occurs in children under 3-4 years of age. In fact mild inflammation middle ear is observed in most colds, but it usually occurs in mild form and is not accompanied by any symptoms.
A newborn and a child in the first months of life can only suffer from external otitis, i.e. inflammation (infectious disease) auricle or external auditory canal.
Causes of otitis media in children
Otitis is an inflammation of the middle ear caused by bacteria or viruses. The middle ear is a small cavity located behind the eardrum and connected to the nasopharynx by a canal called the Eustachian tube. When this tube is blocked for some reason, for example due to mucus formed during a cold, swelling due to allergies, or enlarged adenoids, it becomes difficult for the fluid that accumulates in the middle ear to drain out. Bacteria and viruses present in the larynx spread through the Eustachian tube and penetrate the fluid that has stagnated in the middle ear. Suppuration and painful inflammation form there.
In older children, it is already observed otitis media, commonly called otitis media. However, more precisely, it is an infectious disease eardrum, usually resulting from nasopharyngitis suffered by the baby. The infection penetrates through the pharynx and further through the Eustachian tube, designed to allow air to enter the tympanic cavity from the nasopharynx, due to which the eardrum can experience equal air pressure on both sides - outside and inside, which allows it to vibrate from noise, thereby giving opportunity to hear.
Symptoms and signs of otitis media in children
Usually, the ears begin to hurt a few days after the cold starts. A child over 2 years old can already explain and show what and where it hurts. Small children simply rub their ears with their hands or cry for hours on end. They may develop a fever.
If your child has ear pain, notify the doctor immediately, especially if the pain is accompanied by a fever. Antibiotics prescribed by a doctor are most effective at the early stage of the disease.
What to do if within a few hours you receive medical assistance fails? Do not put your child to bed because horizontal position the pain intensifies. Try to keep your baby's head upright. It is advisable to apply a warm compress or heating pad to the sore ear, but young children often do not have the patience for such procedures. (Do not allow your child to fall asleep with an electric heating pad applied to his ear, as this can cause burns.) Paracetamonium or ibuprofen may relieve pain somewhat. It is even better to use a cough suppressant containing codeine if the doctor prescribed it for that particular child. (A product prescribed for another child or adult may contain too much codeine. Codeine not only helps with coughs, but also relieves pain. If the ear pain is too severe, you can try all of these products at the same time, but never use more than one doses of a product containing codeine without consulting a doctor.
Sometimes the inflammation is already early stages breaks through the eardrum and pus comes out of the ear. You may notice traces of pus on the pillow in the morning, although the child did not complain of pain and his temperature was normal. More often this happens after several days of illness, accompanied by pain and fever. Since when the ear is inflamed, pressure is applied to the eardrum, the rupture of the abscess leads to a sharp decrease in pain. In this case, the pus drains and the infection sometimes goes away on its own. Thus, the flow of pus from the ears, on the one hand, is a sure sign of otitis media, and on the other hand, it indicates that the situation is already getting better. The eardrum usually recovers within a few days and does not cause further problems.
After the pus breaks out, the only thing you can do is insert a loose cotton swab into the auricle to absorb the pus, rinse outer surface ear with soap and water (avoiding water getting into the ear canal) and tell your doctor. Never insert cotton into the ear canal.
In case of inflammation due to swelling of the nasopharynx, the lumen eustachian tube closes, the flow of air into the tympanic cavity stops, and the ears become blocked. But that's not so bad. Otitis is an extremely painful and painful disease. When a newborn or infant cries desperately and reaches for his head with his hands, especially at night and especially if his temperature rises (sometimes all this was preceded by a runny nose, albeit a small one), you should immediately check the condition of the baby’s eardrums. It is urgent to show him to a doctor!
Exist different types otitis Congestive otitis (hyperemic) can go unnoticed. But when a child’s ears hurt, one can suspect the presence of such otitis media. If the diagnosis is confirmed, it is often enough to use anti-inflammatory drugs to achieve relief.
Treatment of otitis media in children
Otitis media requires treatment with properly selected antibiotics for a week (or even 2 weeks if we are talking about recurring otitis). After completing therapy, it is necessary to check the condition of the eardrum. And if improvement is not achieved within 2 days, you need to think about replacing the antibiotic with another one. With such otitis media, protrusion of the eardrum is often observed. In such cases, the otolaryngologist performs a paracentesis, i.e., cuts the damaged eardrum with a scalpel, making a hole for the accumulated pus to escape, and then removes this pus with cotton swabs. Sometimes the eardrum bursts by itself: at night the child screams shrilly, and in the morning the parents find traces of pus on the pillowcase that has leaked from the ear canal. In such cases, they talk about otorrhea - leakage from the ear.
With serous otitis, infiltrates appear on the eardrums: because of this, the child begins to hear worse. Such otitis requires vigorous anti-inflammatory treatment, which is most often accompanied by antibiotic therapy.
Thanks to wide application Antibiotic complications after otitis are usually avoided these days. Today, many of the formidable complications that arose due to the spread of infection directly from the ear throughout the body, which were previously considered almost inevitable, have practically disappeared. We are talking about ethmoiditis - an inflammatory process affecting the bones, and meningitis - inflammation of the membranes of the brain. However, otitis media are often recurrent, therefore, as soon as they begin to recur, you should immediately consult a doctor so that he can prescribe antibiotics of a different spectrum of action. In case of leakage from the ear, to identify the causative agent of the disease and select a medicine, it is necessary to do bacteriological analysis discharge from the ear.
With recurring otitis media, it is important to constantly contact your doctor and carry out restorative treatment to maintain the child’s body’s defenses. You need to discuss with your otolaryngologist whether the adenoids (papillomatous growths) are too large, especially in cases where otitis occurs against the background of recurrent nasopharyngitis. Removing adenoids is a fairly simple operation, but it can only be done after the child is one year old. Most often, after such an operation, the child almost completely ceases to “catch” infections, causing diseases ear, nose and throat, or at least gets sick much less often than before (especially for rhinopharyngitis and otitis media).
The most serious complication of otitis media is middle ear deafness. It can occur after recurrent inflammation of the middle ear or after a single serous otitis. This is why it is so important to have hearing tested in children who have not started speaking before age 2, as well as in babies who scream too loudly. If a child is diagnosed with middle ear deafness, sometimes it is enough to insert special small tubes into the eardrum to drain it. This operation allows you to constantly “ventilate” the middle ear and thus avoid many infections. It is considered the most radical treatment for ear diseases.
Finally, it must be said that often recurring otitis media in the first year of a child’s life may be a complication of... gastroesophageal reflux (see “Gastroesophageal reflux”),
In some children who spend a lot of time in children's groups, the otolaryngologist constantly discovers a flattened and hyperemic eardrum. But usually, once the child stops getting sick infectious diseases or just stop visiting kindergarten, the eardrum itself, and suddenly, returns to a completely normal state.
It is not at all necessary for an infant who has had otitis media for the first time too early, or for a child whose parents suffered from recurrent otitis media in childhood, to have frequent recurrences of otitis media.
If otitis media continues to be a very common disease, complications are due to the use of modern antibiotics- he calls less and less often.
One of the main goals in the treatment of otitis is to reduce pain, although you cannot completely get rid of it, and later, when the therapy is finished, to control the condition of the eardrum.
Chronic otitis in children
Sometimes children in the first year of life suffer from frequent ear infections. In this case, thick fluid accumulates behind the eardrum. If it is affecting your baby's hearing, your doctor may recommend three treatment options.
First, he may prescribe you antibiotics, which you will have to take every day and possibly for several months. The goal of this therapy is to prevent inflammation of the fluid in the middle ear. For some children this treatment is very effective, but for others it has less effect. (As we learn more about the risks associated with antibiotic use, this method is becoming less common.)
Second, the doctor may try to find the cause of the allergy that is causing fluid to accumulate in the middle ear.
Finally, he may refer the child to an otolaryngologist, who will insert tiny tubes that pass through the eardrums. This will equalize the air pressure on both sides of the membrane and thereby reduce the likelihood of further infection or fluid accumulation and normalize the child’s hearing. So-called “passive smoking” increases the likelihood of ear infections. This is another argument for parents to quit smoking.
Inflammation of the middle ear is the most common disease of the ENT organs. It occurs at any age, but more often – from six months to a year. And during the first three years Up to 90% of babies survive it.
If a child cries without apparent reason, refuses to eat, rubs his ears with his hands, shakes his head - there is reason to suspect that he is developing otitis media. Don't waste time - contact your doctor immediately!
What is otitis media?
Otitis media is an inflammatory process that involves various departments middle ear: tympanic cavity, auditory tube, mastoid process. Depending on the stage pathological changes in each of these departments, there are several types of otitis media:
- according to the nature of the course: acute and subacute;
- by etiology: infectious and non-infectious;
- by type of inflammation: purulent, catarrhal and exudative.
Causes
The middle ear is connected to the nasal cavity through the auditory (Eustachian) tube. With a runny nose, cold or acute respiratory viral infection, that is, when fluid accumulates in the nasal cavity, a blockage occurs auditory tube and air access to the eardrum stops. However, from the side of the auricle, the air continues to press on it, which causes painful sensations. And with the addition of a secondary bacterial infection acute occurs purulent otitis media.
Exactly at tympanic cavity and otitis media occurs
In infants, mucus formation in the nasal cavity occurs more actively than in adults. In addition, the anatomy of the structure inner ear they have a slightly different one - the Eustachian tube is short, narrow and located more horizontally. When crying or regurgitating after feeding, fluid immediately enters the auditory tube. And in newborns there may also be remnants of amniotic fluid.
In adolescents and adults, the main causes of otitis media include:
- water getting into the ear when swimming and diving;
- infections of the external auditory canal;
- complications after suffering from acute respiratory viral infection or sinusitis;
- decreased immunity due to other diseases - diabetes mellitus, kidney diseases, etc.
The causative agents of otitis media are viruses, pathogenic and opportunistic bacteria (streptococci and staphylococci, Pseudomonas aeruginosa, influenza viruses, parainfluenza and many others).
Symptoms
Otitis media begins with acute stage. It is characterized by the following symptoms:
- throbbing pain in the ear;
- hearing loss;
- hyperthermia (increased body temperature);
- general weakness;
- When the eardrum is perforated, pus leaks out of the ear.
With inadequate treatment or lack of medical intervention, the disease becomes chronic.
At chronic inflammation middle ear occurs: perforation of the eardrum, periodic suppuration from the ear, hearing loss leading to persistent hearing loss, destruction of bone tissue.
Depending on the location of inflammation, otitis media can be unilateral or bilateral. It should be remembered that unilateral otitis media, if left untreated, can affect the second ear and become bilateral.
Table: symptoms of otitis media, differing by type of inflammation
| Type | Symptoms |
| Exudative | This type develops as a result of the accumulation of fluid in the auditory tube. Over time, the fluid thickens, causing hearing loss. The pain is either absent or insignificant. |
| Purulent | When a bacterial infection occurs exudative otitis media turns into purulent. A hole appears in the eardrum - perforation. Appear purulent discharge, hearing decreases. |
| Catarrhal | Caused by an infection in the middle ear. Characterized by severe pain, fever, dizziness. As complications, purulent otitis and meningitis and complete hearing loss can develop. |
| Labyrinthitis | It is an inflammation of the inner ear. Rarely seen. Appears as a complication of acute or chronic otitis media. |
Diagnostics
Usually there are no difficulties in diagnosing otitis media. Ear pain, fever, decreased hearing - these are its characteristic symptoms.
U infants It is enough to press the tragus - the outer protrusion of the auricle - and if there is inflammation of the middle ear, the child will begin to cry from severe pain.
To make a differentiated diagnosis, an examination of the ear with an otoscope is necessary; it is performed by an otolaryngologist.
After an otoscopy, the doctor will determine whether the child has otitis media or not.
Treatment methods
Treatment for otitis media includes antibacterial therapy, vasoconstrictors and anti-inflammatory drugs, anesthetics – for severe pain, physical therapy.
Anti-inflammatory and analgesic ear drops can only be used if the eardrum is intact. Antihistamine drops are prescribed to reduce swelling. Vasoconstrictor drops are introduced into the nose to relieve swelling of the lining of the Eustachian tube.
If the eardrum is perforated, anti-inflammatory and analgesic ear drops are discontinued. Antibacterial drugs are prescribed instead. Sometimes the doctor will catheterize the eustachian tube.
Surgical intervention - paracentesis - is performed if within three days pain syndrome does not go away despite therapy. The doctor makes a small incision in the eardrum, allowing the pus to drain out.
Table: medications
| Name of the drug | Release form | Contraindications | Features of application |
| Antibacterial agents | |||
| Pills Syrup Suspension | Increased sensitivity to the components of the drug | Tablets – from 3 years Syrup – from 1 year Suspension – from 2 months. |
|
| Pills Capsules Suspension Injection solution | Increased sensitivity to penicillins | Tablets and capsules – from 10 years |
|
| Otofa (rifamycin) | Ear drops | Hypersensitivity | |
| Normax (norfloxacin) | Ear drops | Does not apply to under 18s | Does not apply to under 18s |
| Tsipromed (ciprofloxacin) | Ear drops | Does not apply under 15 years of age | Does not apply under 15 years of age |
| Anti-inflammatory drugs | |||
| Ear drops | Individual intolerance, ruptured eardrum | Use with caution children under 1 year old |
|
| Paracetamol | Pills | Kidney, liver failure | Tablets – from 3 years Syrup – from 3 months. Suppositories – from 1 month. |
Combination drugs |
|||
| Anauran (polymyxin, neomycin, lidocaine) | Ear drops | Hypersensitivity to the components of the drug | Not applicable to children under 1 year of age |
| Otipax (lidocaine, phenazone) | Ear drops Anti-inflammatory + anesthetic | Rupture of the eardrum | |
| Sofradex (gramicidin, dexamethasone, framecitin) | Ear drops Anti-inflammatory + antihistamine + antibiotic | Rupture of the eardrum Fungal, viral infections | |
Vasoconstrictors |
|||
| Naphthyzin | Nasal drops | Chronic rhinitis, diabetes, atherosclerosis, age up to 1 year | |
| Nasal drops | Atrophic rhinitis, diabetes, atherosclerosis, glaucoma | 0.05% solution – from 1 year to 15 years | |
| Nasal drops | Chronic rhinitis, diabetes, atherosclerosis, glaucoma | 0.05% solution – from 1 year to 15 years | |
Photo gallery: drugs for the treatment of otitis media
Features of treatment for children under one year old
In the treatment of otitis in newborns, a wait-and-see approach to antibiotic therapy is currently adopted. Infants are prescribed antibiotics from the first day of treatment, usually parenterally.
To give your child the opportunity to sleep and eat peacefully, it is necessary to relieve pain as soon as possible. Suitable ear drops for this are Otinum, Otipax, Sofradex and, of course, Paracetamol and Ibuprofen, which have not only an antipyretic but also an analgesic effect.
Physiotherapy
Physiotherapeutic procedures for otitis media include UHF, electrophoresis and ultraviolet radiation.
UHF therapy is a technique of influencing the body with a high-frequency magnetic field. At acute form disease, the duration of the procedure is initially 5 minutes. Every day the time is increased by 1 minute. The number of procedures is determined by the doctor, depending on the course of the disease.
Electrophoresis. The essence of electrophoresis is to supply a medicinal solution to the site of inflammation using an electric current. Irritation of tissues under the influence of current leads to an increase in their permeability and increased tissue metabolism, which accelerates the effect medicinal solutions. The dosage is determined by the strength of the current and the duration of the procedure. Duration – from 15 to 30 minutes. The course of treatment is from 10 procedures. Electrophoresis is not prescribed for children under 2 years of age.
Quartz ultraviolet irradiation - UVR. Through special tubes, simultaneous irradiation of the external auditory canal and nasal passages is carried out. The course of treatment is 5-6 procedures. The initial dose is 1 minute, daily increases by half a minute, reaching 3 minutes.
General contraindications: temperature above 38 degrees, poor blood clotting, cardiovascular failure, liver and renal failure, pustular skin lesions.
Traditional methods
What to do if a child gets sick, but there is no medicine at hand and you can’t get to the doctor? There are some traditional methods treatment of otitis, which traditional medicine does not reject.
- Insert the child into sore ear a cotton wick moistened with boric alcohol, alcohol tincture of calendula, propolis, or at least vodka and hold for 15-20 minutes.
- Perform dry heating using a blue lamp. If you don’t have a lamp, regular table salt will do - heat it in a frying pan, pour it into a bag of natural fabric and place the child with the sore ear on this bag. Attention - do not burn the child!
- Warming compresses made from camphor alcohol or vodka will also help relieve pain.
Remember that any heating is contraindicated when the body temperature is above 38 degrees and/or serous or purulent exudate is leaking from the ear!
Do not drop anything into the ears under any circumstances - if the eardrum is perforated, you can cause irreparable harm to the health of your child!
Prevention
To prevent otitis in infants you need:
- When feeding, hold the bottle at an angle of 45 degrees,
- after feeding, hold the baby upright so that he burps up air and excess food,
- regularly suck out mucus from the nose with a baby syringe,
- Make sure that water does not get into the ears while bathing.
At an older age it is worth:
- When you have a runny nose, blow your nose through the right and left nostrils alternately,
- at an older age, remove inflamed adenoids in a timely manner.
Video: Dr. Komarovsky about the causes of otitis media and methods of its treatment
Never self-medicate! Not received on time curative measures will lead to chronic otitis media, meningitis or complete hearing loss. All treatment methods proposed in this article are pre-medical. Take your child to an otolaryngologist as soon as possible. Only he is able to make a final diagnosis and develop a treatment regimen.
The information in the article will help to recognize and quickly treat otitis media in a child.
Otitis is one of the most common ENT diseases in children of early and preschool age. The incidence of middle ear inflammation in children of these age categories is due to immaturity immune system And anatomical features hearing organs. The disease is acute and causes a lot of trouble for both the child and his parents. The task of mom and dad is to recognize the disease in time and accept urgent measures on her treatment.
How to determine otitis media in a child? Signs of otitis media in children
Acute otitis media is an inflammatory process in the ear. Most often it is infectious in nature and is caused by bacteria (in most cases these are pneumococci or Haemophilus influenzae).
IMPORTANT: It is with otitis media that 95% of ENT patients under the age of 1 year and 40% of ENT patients under the age of 6 years go to medical institutions
In order to understand the mechanism of inflammation development, you need to have minimal knowledge about the structure of the human hearing organs. His ear consists of three sections (cavities):
- Outdoor. This is the visible part of the ear: the pinna and ear canal to the eardrum. Inflammation in this section usually occurs due to non-compliance with personal hygiene rules or improper hygiene procedures, for example, when a mother cleans her child’s ears too intensively
- Average. Its other name is the tympanic cavity, which is located behind the eardrum. Here are miniature sound bones with memorable names: hammer, anvil and stirrup. Inflammation of this particular section is diagnosed especially often in children.
- Internal. These are channels located in the roof temporal bone. They are called snail. Directly in this department, the conversion of sound vibrations into nerve impulses occurs. Inflammation of the inner ear rarely occurs on its own. Usually, it passes there from the middle section or organs of the nasopharynx
Depending on where exactly the inflammation is localized, acute otitis in children can be external, middle and internal, respectively.
Before we move on to describing the symptoms of acute otitis media, it is necessary to understand why it develops and why it affects young children so often.
- The cause of inflammation of the middle ear is often an infection that enters the tympanic cavity from the outside or “migrates” from the organs of the nasopharynx. Otitis media is one of the most common complications of ARVI, rhinitis, pharyngitis, tonsillitis, sinusitis, etc. Mucus containing the infection will travel through the Eustachian tubes into the middle ear
- Symptoms of the disease can also arise due to a sharp change in pressure in the tympanic cavity, which is normally atmospheric. This happens if small children fly on an airplane (altitude changes), dive
- The frequency of acute otitis in children is due to age-related feature the structure of the eustachian tubes: in babies they are short and wide, which facilitates the penetration of infection into them
- Unformed children's immunity not yet able to prevent the spread of infection throughout the body, localized in the organs of the nasopharynx
When a baby burps, the remaining milk or formula can end up in the Eustachian tubes, where they begin to rot. - Not all parents know how to properly “blow their nose” with young children and preschoolers. If both nostrils are closed when blowing your nose, mucus from the nose does not come out, but is thrown into the Eustachian tubes
Despite the fact that the symptoms of otitis media are characteristic, mothers and fathers do not always recognize the disease in time. This happens because in almost half of the cases in the first couple of cases the disease proceeds in hidden form. Immediately with the onset of inflammation, or when it already acquires purulent form, the following symptoms may appear:
- earache
- discharge from the ear is mucous or purulent (greenish, brownish, with a characteristic odor)
- hearing impairment
- headache
- temperature increase
- general ailments
- sleep and appetite disorders
- lethargy
- irritability
The main symptom of acute otitis media in a child is intense pain in the ear. An infant and a toddler who cannot yet speak are unable to describe how they feel. You can suspect he has acute otitis media if:
- the child is naughty for no apparent reason
- child refuses to eat
- baby crying in his sleep
IMPORTANT: There is a method by which you can determine the presence of inflammation in the ear cavities of a young child. It is necessary to press on the tragus of the baby's ear. If the baby twitches and screams, instinctively reaching for his ear, it means he has a lumbago. You need to see a doctor urgently
How many days does otitis media last in children?
Subject to timely diagnosis of acute otitis and adequate treatment, the disease will last 7-14 days, another two weeks will be needed for recovery
Video: Child's ear hurts. What to do at home?
First aid for a child with otitis?
Otitis media sometimes goes away on its own, but you shouldn’t rely on it! Firstly, the disease itself is very unpleasant, the child feels pain and discomfort. Secondly, catarrhal otitis media very quickly develops into purulent, and it will be more difficult to treat. Thirdly, complications of acute otitis are terrible, including:
- mastoiditis (inflammation of the temporal bone)
- meningeal syndrome (inflammation of the lining of the brain)
- encephalitis (inflammation of the brain)
Therefore, at the first suspicion of otitis media in a child, you should consult a doctor. It's better to call him at home. But if you have to go to the clinic, the child needs to put dry cotton wool in the sore ear and put on a headdress that covers the ears.
Acute otitis media in children treatment
Treatment of acute inflammation of the middle ear in children is complex and, if you managed to contact a medical institution on time, conservative. It includes:
- treatment of the underlying cause, if any
- antibacterial therapy for 5-7 days
- symptomatic therapy
- physiotherapy
- activities aimed at strengthening the immune system
Usually, antibiotics for acute otitis media are prescribed to children in early childhood and preschoolers in the form of a suspension, and to schoolchildren - already in tablets. This antibacterial drugs penicillins (Ospamox, Augmentin) and macrolides (Sumamed, Azimed).
Antibiotic Augmentin in suspension If the temperature rises to 38.5 °C, and it is almost always present in acute otitis media, the child is given antipyretics (Nurofen, Panadol, Paracetamol, Piaron).
If otitis is accompanied by rhinitis, vasoconstrictor drugs are dripped or sprayed into the nose (Pinosol, Nazo-spray Baby, others).
Practiced local treatment ear drops(Otipax, Otinum).
Otipax drops should definitely be in your home medicine cabinet. Turundas with antiseptics and anti-inflammatory drugs (hydrogen peroxide, boric alcohol, furatsilin) are also inserted into the child’s ears.
Physiotherapeutic treatment includes dry heating: UFO (ultraviolet irradiation), UHF, laser.
Particularly severe cases of acute inflammation of the middle ear require hospital treatment, including surgery.
How to cure otitis media without antibiotics?
Many parents are afraid to treat their children with antibiotics and believe that pediatricians, when prescribing such drugs, in most cases play it safe. Indeed, there is an opinion that it is not at all necessary to take them for otitis, at least until it turns into a purulent form.
But relying on a child’s fragile immunity is reckless. Few children are able to overcome the disease on their own. For the majority, the lack of antibiotic therapy in terms of treatment is fraught with complications and chronic inflammation.
IMPORTANT: It is still necessary to treat childhood otitis media with antibiotics. Modern drugs almost completely safe. The harm from taking them is much less than that which an advanced disease can cause.
Video: Otitis – School of Dr. Komarovsky
Secretory otitis in a child, treatment
Secretory otitis occurs in a child due to blockage of the Eustachian tubes and tympanic cavity with secretions (mucus) that enter them from the nasopharynx.
Treatment of this type of otitis is carried out in parallel with the treatment of diseases of the nasal cavity, throat or larynx, as a result of which hypersecretion of mucus occurs. Prescribed:
- vasoconstrictor drops
- nasal rinsing
- gargling
- inhalation
- antihistamines
All this will help relieve inflammation of the nasopharyngeal mucosa.
In rare cases, secretory otitis media requires surgical intervention in order to remove secretions from the Eustachian tubes and tympanic cavity.
Catarrhal otitis in children, treatment
Otitis in the catarrhal form occurs as soon as the disease starts. It is important to do everything so that it does not transform into purulent, and the eardrum does not perforate. That is, it is necessary to prevent pathogenic bacteria from multiplying on the inflamed mucous membrane of the middle ear. For this:
Chronic otitis in children, causes
Chronization inflammatory process in the middle ear occurs:
- in children with reduced immunity
- diabetics
- children who often suffer from ARVI
- children with a deviated nasal septum
Acute otitis media develops into chronic also due to untimely or improper treatment. In this case, the symptoms of the disease subside for a while, and then clearly appear again. There is a hole in the eardrum, which causes the baby's hearing to decrease.
Along with the treatment of middle ear inflammation itself, at the time of exacerbation of the disease, measures are taken to strengthen the child’s immunity.
Weakness of immunity in small child And incorrect treatment acute otitis media are the main causes of chronic inflammation in the middle ear Prevention of otitis in children
Parents need to know measures to prevent middle ear inflammation in children. These include:
- Timely and full treatment runny nose
- Education correct technique“blowing noses” of babies and teaching it to preschoolers and schoolchildren
- Preventing water from getting into children's ears when swimming in the bathtub and natural bodies of water
- Keeping your ear canals clean
- Removing wax plugs
- Careful cleansing of the ears (you can remove wax yourself from the outside, but if it has accumulated inside in large quantities, you need to visit a doctor)
- Feeding babies in an elevated (semi-upright) position
- Carrying in a column as a prevention of regurgitation
- General measures to strengthen the immune system
- Wearing hats according to the season
Even very attentive and responsible parents do not always manage to avoid otitis in their child. If it does occur, do not panic: if detected in time, the disease can be treated quickly and does not pose a threat to the life and health of the baby. To speed up his recovery, along with traditional treatment You can use traditional methods. But before doing this, you need to consult with the doctor treating the child.
Video: Ear pain in children Folk remedy - Our health
Otitis in children is the most common disease that is accompanied by inflammation of the middle ear. Children from 6 to 18 months, especially boys, are more susceptible to it. By the age of three, 80% of them experience this disease on average once a year. Otitis, as a rule, occurs in children in an acute form, but with timely diagnosis does not cause complications and is quickly cured.
Causes of development of acute otitis media up to 1.5 years
Acute otitis media in newborns has its own characteristics of course, diagnosis and treatment. It can occur from overheating or hypothermia, as a result of infectious and viral diseases, and improper feeding.
The following causes of otitis media in children can be identified:
- Anatomical and physiological features of the structure of the child’s ear . It turns out that children's eardrums are slightly thicker than adults'. also in infancy The eustachian tube is almost horizontal, wider and shorter in size. In the middle ear of infants, instead of a thin, smooth mucous membrane and air, there is myxoid tissue. It is a gelatinous, loose formation with a small number blood vessels, which contributes to the rapid proliferation of microbes trapped there.
- Reduced body resistance .
- The child is more often susceptible to infectious diseases (measles, scarlet fever, ARVI, diphtheria), fungal, viral and bacterial diseases, contributing to the development of complications.
- Quite often, adenoids are found in children , which contribute to the occurrence of a disease such as acute otitis media.
- Since babies lie down more, When regurgitated, milk passes through the auditory tube into the ear. , which also leads to an inflammatory process.
- Otitis media in a child may occur at birth, in early age and in utero . In the latter case, infection occurs due to inflammatory disease women in labor (endometritis, mastitis, pyelonephritis).
- The baby’s nutritional factor plays a big role , because at artificial feeding the risk increases by 2.5 times.
- The development of a disease such as otitis media can be facilitated by prolonged labor, fetal asphyxia and anhydrous period of more than 6 hours .
- The reason may also be allergies and exudative diathesis .
- Experts note that hereditary factor and pathology of the bronchopulmonary system are also of great importance.
- A less common case is introduction of infection from the external auditory canal . This is only possible if the eardrum is perforated or injured.
Features of diagnosing acute otitis media in children
Correctly selected treatment and early diagnosis symptoms are very important for the further course of the disease, since they can reduce the rapid development, as well as prevent hearing loss and intracranial complications. When diagnosing the disease “acute otitis media,” the mother’s medical history plays an important role for the specialist. During the interview, he clarifies the course of pregnancy, childbirth and pays attention to the full-term birth of the child. Are being found out general information about transferred viral diseases, reception medicines, administration of ototoxic drugs, mother’s ear disease, drinking alcohol and smoking.
Most often, ear disease is preceded by gastrointestinal disorders, respiratory infections, excessive nasal discharge, injury or allergies. Symptoms of inflammation appear spontaneously in the form of severe pain. Children's reaction to pain with a disease such as otitis media can be expressed in completely different ways and depend on their age. Up to six months, the child cannot independently determine the painful spot; he reacts with a pendulum-like shaking of the head and screaming, and refuses breastfeeding, because when sucking, jaw movements are transmitted to the walls of the external auditory canal and the tympanic cavity.
A fairly common way among pediatricians to study the reaction of children is to press on the tragus, but in in this case this action must be viewed critically as false-positive symptoms may often occur. It is best to diagnose otitis media while the baby is sleeping. General symptoms, accompanied by an active increase in body temperature and intoxication, may be absent in some cases. Here we can talk about the latent course of a disease such as otitis, in which there is a low-grade fever.
After the anamnesis has been clarified and general symptoms, specialists proceed to inspection. They carefully study the baby’s posture, condition abdominal wall, lymph nodes And skin, because acute otitis media is sometimes a consequence of gastrointestinal diseases, allergies or some kind of infection. Neurological symptoms are also noted, and basic meningeal reflexes and eyes are checked. Before moving on to palpation and endoscopy, the condition of the muscles is determined during an external examination of children. facial muscles, regions mastoid process, protruding ears, etc. And only then an otoscopy is performed. Diagnosis of ear inflammation in children under 1.5 years of age initial period quite difficult. However, it is at this time that an urgent determination of treatment tactics is required.
Symptoms and treatment
Otitis media in children usually begins quite unexpectedly and acutely. Symptoms can be different, but almost all of them are accompanied by an increase in temperature to 39°-40°. In newborns they dominate general reactions body:
- the baby sucks poorly;
- sleeps poorly;
- cries a lot;
- restless.
In this case, the baby lies more calmly on the unhealthy ear, and from 4 months he tries to reach the sore ear with his hand or rubs it on the pillow. Other symptoms are also common: nasal discharge, screaming and moaning at night, and it is quite difficult to calm him down. With each slight pressure on the ear canal, he begins to cry, and blood, greenish or yellowish discharge appears from the ear.
With the classic development of inflammation of the middle ear, experts distinguish 3 stages, each of which lasts about 7 days:
- initial development;
- perforation of the eardrum (pain and temperature decrease, discharge from the ear appears);
- recovery.
First aid for otitis in children can be alcohol-containing drops that are instilled into the ear. It is closed with a cotton swab and a warm compress is applied on top. If discharge begins from the ears, then it is not recommended to use alcohol to treat such an ailment as otitis media. Usually a vasoconstrictor is instilled into the nose to relieve swelling.
It should be noted that there is absolutely no need to fight a disease such as otitis media using non-traditional methods and self-medication, since only an ENT doctor is able to determine accurate diagnosis and prescribe a treatment procedure. At home, you try to protect your baby from colds, especially in the first year of life, because by eliminating the causes, you don’t have to worry about the consequences. If you are feeding your baby with a bottle, hold it at a 45° angle. Use an aspirator and later teach your children how to blow their nose correctly.
Acute otitis media occurs due to infection entering the middle ear cavity. The most common pathogens are bacteria - pneumococci and Haemophilus influenzae. They penetrate into the middle ear against the background of acute respiratory viral infections, adenoiditis, and frequently recurring runny nose, because the ear cavity is connected to the nasopharynx.
Important
Acute otitis media is especially common in children in the first years of life. It has been established that in the first three years of life, up to 90% of children experience acute otitis media at least once.
This is facilitated by the features anatomical structure in children, the Eustachian (auditory) tube connects the ear cavity to the nasopharynx. In children it is much wider and shorter than in adults; getting germs there is a couple of trifles.
The inflamed mucous membrane of the Eustachian tube sometimes swells to such an extent that it closes its lumen. Because of this, air exchange between the middle ear cavity and the nasopharynx is disrupted. An excellent environment is created for the proliferation of pathogenic bacteria, the formation of mucus, and often pus.
By acting on the eardrum, the thickness of which is only 0.1 mm, pus thins it, which can cause perforation to form in it. This threatens hearing loss, dizziness, paresis facial nerve, or even life-threatening meningitis. Therefore, it is important to treat otitis media in a timely manner.
Diagnostics
Unfortunately, parents may not immediately notice the problem, because in every second child, otitis media is initially asymptomatic. Visible causes for concern often appear only when a perforation occurs on the eardrum.
A signal of trouble can be ear pain, temperature, as well as a state of general anxiety, weakness, and lethargy.
The examination plan usually includes otoscopy(inspection of the membrane) and tympanometry(a method that allows you to determine the patency of the auditory tube and the condition of the tympanic cavity).
Treatment
The child is prescribed a course of oral antibiotics. The doctor decides which ones, taking into account the sensitivity of the drug to the pathogens of the disease. As a rule, treatment is started with penicillins or cephalosporins. If you are allergic to the components of these drugs, drugs from the macrolide group can be prescribed, but they are less effective.
- There is no point in using antibiotics in the form of ear drops in the early stages of the disease. During this period, only drops with analgesic and anti-edematous effects are used. Antibiotic drops are used for chronic otitis or acute otitis, if perforation has already appeared.
- In case of acute otitis media, it is necessary to instill vasoconstrictor drops into the nose. They help restore normal communication between the nasal cavity and the middle ear.
- If there is no pus, warm compresses can be applied. They are not placed on the ear itself, but around it. A hole is made for the auricle in a gauze napkin folded in several layers. Then the napkin is moistened in vodka or alcohol diluted in half with water and placed on the ear. Cover the top with wax paper or plastic film, then apply a small layer of cotton wool and secure the structure to the head with a bandage or scarf. The duration of the compress is at least two hours. If pus has already formed, drops and thermal procedures cannot be used.
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Keep in mind!
In most cases, a breached eardrum will heal on its own within a few weeks. But sometimes healing does not occur, and surgical manipulation is necessary to restore the integrity of the membrane.
They are low-traumatic, they are done under the control of a microscope, but without anesthesia and incisions - through the ear canal. Sometimes surgical intervention preceded by medication, laser or physiotherapeutic treatment.
