Otitis media is a disease of any part of the ear. The disease is inflammatory. Otitis media is considered one of the most common diseases in pediatrics. According to statistics, almost every child under the age of five has had otitis media at least once.
Classification of otitis media
There are three types of otitis media, depending on the location of the inflammation:
- Otitis externa.
- Otitis media.
- Labyrinthitis or internal otitis media.
Quite often, a picture is observed that initially the child had otitis externa. But as a result of improper or untimely treatment, otitis media passes into the middle ear. If left untreated, the inflammation spreads to the inner ear.
Otitis externa is an inflammation of the outer part of the ear canal and auricle of a child. Doctors divide otitis externa into two categories: when the inflammatory process of the external ear is observed throughout the entire course of the disease, it is diffuse, and when the inflammation is localized in one place where the formation of a boil is observed, it is limited.
Otitis media is the most common type of otitis media in children. In babies under the age of 1 year, among all types of otitis media, inflammation of the middle ear is diagnosed in 90%. By the nature of the course of the disease, otitis media can be chronic, acute or recurrent. Also, there are two types of acute otitis media: purulent and catarrhal. During the development of otitis media in a child, five stages of the disease occur:
- Acute inflammation of the auditory tube - eustachitis. An increase in a child's body temperature can only occur as a result of an infection. There are complaints of a feeling of stuffiness and noise in the ear.
- Inflammation of the mucous membrane of the middle ear - catarrhal inflammation. The child develops sharp pains in the inflamed ear. The feeling of noise and congestion increases.
- Pre-perforative stage of ear inflammation of a purulent character. At this stage, the child experiences the strongest pain sensations. They can give pain in the eyes, cheeks, neck, teeth. Body temperature can rise to 38-39 ° C. As a result of a blood examination, an inflammatory process is diagnosed.
- Postperforative stage of inflammation. There is a release of pus from the ear canal as a result of a ruptured eardrum (perforation). At this stage, pain in the patient decreases, but the restoration of hearing is not yet taking place. The temperature usually returns to normal.
The chronic course of otitis media can be divided into three categories:
- Purulent otitis media.
- Exudative otitis media.
- Adhesive otitis media.
Inner ear inflammation can be acute or chronic, localized, or diffuse. The inflammation itself can be characterized by its form: serous, necrotic, or purulent.
It is possible to classify otitis media by quantity. There is unilateral otitis media, when only one ear is inflamed, or bilateral otitis media, when the patient complains of symptoms in both ears.
What are the causes of otitis media in children?
Otitis media in a child, depending on the method of occurrence, is divided into three types:
- Allergic.
- Traumatic.
- Infectious.
If otitis media in an adult is quite rare, then in a child it is a fairly common disease. This is due to the special structure of the Eustachian tube. In childhood, the ear tube has practically no bends. With its shorter length, it has a greater width. In adults, the Eustachian tube changes and looks completely different. As a result of this feature, mucus formed in the nasopharynx can easily enter the ear and cause a change in pressure in the eardrum as a result of impaired ventilation. In this case, the occurrence of an inflammatory process is observed.
The formation of otitis externa most often occurs in the case of improper hygiene procedures. Due to the violation of the integrity of the skin on the ear and the ingress of infection into the wound, inflammation of the auricle occurs. Otitis externa can be provoked even by ordinary brushing with a stiff brush. Inflammation of the outer part of the ear canal is possible as a result of ingress and stagnation of water after water procedures and swimming in the pool.
In a child and an adult, otitis media can develop for many reasons. The most common are allergic reactions that cause swelling of the mucous membranes, infection through trauma in the ear, and inflammation in the nasopharynx. Ordinary snot that is not treated in time can easily lead to otitis media. Also, the reasons for the formation of otitis media can be:
- Chronic sinusitis, tonsillitis, pharyngitis, or rhinitis.
- Hypothermia of the body.
- Tonsil enlargement and chronic adenoiditis.
- Decreased immunity as a result of the presence of certain diseases (AIDS, leukemia, rickets, decreased hemoglobin concentration in the blood, weight deficiency).
The onset of otitis media is most often a complication after incorrect or untimely treatment of otitis externa or otitis media. But the appearance of internal otitis media as a result of injury or an infectious disease in the body is also characteristic. In the second case, the infection enters the inner ear through the blood or the meninges.
Symptoms of otitis externa in children
Each type of otitis media in a child has its own symptoms. Otitis externa in a baby is diagnosed by the presence of edema of the auricle. The child may complain of itching and soreness. And parents may notice that the ear is red. If you measure the temperature, it is very likely that it will be elevated. When a child opens his mouth or tries to chew, the pain only gets worse. An increase in pain is also observed when pulling on the auricle.
Doctors distinguish two types of external otitis media: diffuse and limited.
With diffuse otitis media in a child, the ear canal is completely inflamed. Blisters are very common on the ear skin. If the cause of otitis media is a fungus, then you can notice peeling of the skin on the ear. In addition, the child will experience quite severe itching.
The manifestation of limited external otitis media is characteristic only if inflammation of the sebaceous gland or hair follicle occurs within the external auditory canal or auricle. After redness, a furuncle appears on the skin. At the same time, an increase in lymph nodes behind the auricle is noticeable. The pain decreases only after the boil breaks out. In no case should you pierce the abscess yourself. Thus, you can only exacerbate the situation. After all the pus is gone, a small depression remains, which will subsequently heal.
Symptoms of otitis media in children
Catarrhal otitis media has the following symptoms:
- Feeling weak and lethargic.
- The child has restless sleep. During the waking period, he is capricious and does not eat well.
- A small child complains of ear pain, which can be pulsating, sharp and shooting. If otitis media is suspected in infants, then you can press the ear tragus. If the baby responds with a screeching and an attempt to move away from the finger, then most likely he has otitis media.
- The temperature can rise sharply up to 40 ° C.
- Decreased hearing, sensation of tinnitus.
- Sometimes the child may have a loose stool or diarrhea.
If you do not start treatment in a timely manner, then within a day the catarrhal form of otitis media can turn into purulent. Pathogenic bacteria multiply very quickly in the ear exudate. The characteristic symptoms of a purulent form of otitis media are acute and very severe pain in the ear and a feeling of congestion. The pain is stronger, the higher the pressure on the eardrum. If a perforation of the tympanic membrane occurs inside the ear, then the feeling of pain diminishes sharply.
Serous otitis media has a sluggish process. The fluid accumulated in the ear is not purulent. It can last from several weeks to several months.
The chronic form of otitis media is characterized by the periodic appearance of pus in the ear. Perforation of the tympanic membrane does not heal for a very long time. The child complains of tinnitus and hearing loss.
Symptoms of labyrinthitis in children
Inner ear inflammation is acute and chronic. Signs of acute otitis media include noise in an inflamed ear, hearing loss, dizziness and imbalance, nausea and vomiting. Also, the patient's skin color on the face changes. If the otitis media is of the serous type, then after 14-21 days the symptoms disappear and hearing is restored. If the labyrinthitis has a purulent character, then the dysfunction of the ear is persistent.
If the labyrinthitis has become chronic, then the patient can observe a fistular symptom, a violation of the correct functioning of the inner ear, periodic dizziness and nausea. Among all the listed symptoms, the most important is a fistular symptom or spontaneous nystagmus towards the sore ear. It occurs as a result of thickening and rarefaction of air in the ear as a result of the formation of a fistula.
How to treat otitis media in children?
Treatment of otitis media must necessarily be carried out under the supervision of a physician. Self-medication can lead to adverse effects.
Otitis externa can be treated at home. Until the boil matures and an abscess forms, only alcohol compresses and anti-inflammatory drugs are used. The doctor can open the boil on his own. As a result, the cavity is drained and cleaned with chlorhexidine, miramistin or another antiseptic drug. Then a bandage with ointment is applied, which will need to be changed periodically. If the child has a fever or inflamed lymph nodes, then the doctor will prescribe antibiotics.
If otitis media is formed as a result of fungal infection, then antimycotic drugs for external and internal use are prescribed.
Otitis media is also most often treated at home. If the cause of otitis media is allergy, then antihistamines are used. If otitis media is viral, then antiviral drugs are used. In the presence of an elevated temperature, the patient should be given antipyretic drugs.
In some cases, for children over two years old, doctors use expectant tactics with the use of painkillers and antipyretic drugs. Depending on whether unilateral or bilateral otitis media, physiotherapy is performed on one or both ears.
If the patient has severe pain and a purulent form of otitis media, then surgical intervention for artificial perforation of the tympanic membrane is possible.
Treatment of labyrinthitis is carried out only in a hospital setting. If you do not go to a medical institution in time and treat the child with folk remedies, then the baby may completely or partially lose hearing. In addition, cerebral circulation may be impaired and the transition of the disease to meningitis or sepsis.
