If the little one complains of ear pain, it is very likely that he has an ear infection, children are more prone to ear infections, but otitis also occurs in adults.
Among the common symptoms of otitis in adults and children are:
- Earache (the most common symptom of otitis)
- Sensation of pressure in the ear or “clogged ear”
- Auricular secretions – discharge from the ear, watery or purulent
- Hearing impairment – mild or severe hearing loss, can affect one ear or both.
In children, especially those who cannot speak yet, parents can watch for other signs:
- Fever
- State of nervousness, increased irritability
- The child often touches his ear, shows itching at the level of the ear (itching)
- He has difficulty sleeping.
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Acute otitis – inflammation or infection of the ear Types
There are three large groups of otitis, corresponding to the location of the inflammation:
- Otitis externa it represents the inflammation of the auricle and/or the external auditory canal (the canal leading to the eardrum). Otitis externa is also known as “swimmer’s ear”
- Otitis media represents the inflammation of the eardrum and the tympanic cavity. The tympanic cavity is a small chamber, located behind the eardrum, normally filled with air, which in otitis media is filled with liquid (serum, mucus or pus). Viruses, such as those that cause the common cold and bacteria (Streptococcus pneumoniae, Haemophilus influenzae) are responsible for most middle ear infections.
- Otitis internaless common, includes inflammation of the cochlear and vestibular labyrinth.
Acute diffuse otitis externa
It occurs most frequently in the summer, especially due to microbial contamination in the water of swimming pools and pools.
Another cause is the frequent use of ear sticks, which should be avoided. Learn more about ear plugs and how they can be removed.
Basically, in acute otitis externa, the skin of the external auditory canal becomes inflamed. The most common microbes encountered are Pseudomonas aeruginosa and Staphylococcus aureus.
Symptoms and treatment in acute otitis externa
The most common symptoms in acute external otitis, which are not related to the cold, are:
- Pain when pressing on the ear or posterior traction of the pavilion
- The skin at the entrance to the auditory canal appears swollen, narrowing the canal
- As a rule, the hearing is normal or only slightly reduced (unlike otitis media).
The treatment is mainly local and consists in the application by the doctor of a gauze table soaked with an antibiotic solution. The table is changed every 24-48 hours by the doctor, who will practice aspiration of any secretions from the ear. The patient will put drops of the antibiotic solution on his table, 2-3 times a day, for 5-7 days. In the first days, oral painkillers will also be administered. In more severe cases, oral antibiotics are also needed.
Acute otitis media
Acute otitis media is the most common form of the disease and is found mainly in children. This is an infectious process identified in the middle ear and is triggered by various pathogens – such as bacteria, rarely viruses.
Acute otitis media has a high incidence in children. Thus, approximately 80% of children aged up to three years have at least one episode of the diseasewhile in almost half of themacute otitis media recurs several times a year until the age of 7 years.
Otitis media occupies a large part of the most frequently encountered pathologies and is divided into three categories:
- Acute sero-mucosal otitis media
- Acute congestive otitis media
- Acute bacterial otitis media.
Contact the ORList doctor for a specialist consultation, diagnosis and treatment. Watch if the little one has a fever over 39 grade C, presents auricular secretions, worsening symptoms and/or the child complains of loss or decrease in hearing.
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Acute sero-mucosal otitis media Symptoms and treatment
It occurs frequently in nasopharyngitis, that is, in common colds. Acute sero-mucous otitis media is caused by inflammation and obstruction of the Eustachian tube, the channel that connects the middle ear and pharynx, due to nasal obstruction, nasal and pharyngeal secretions and pharyngeal inflammation. The middle ear is filled with mucus, without bacterial infection.
Symptoms and treatment in acute sero-mucosal otitis media:
- Sensation of clogging, auricular fullness
- Mild and transient pains in the ear
- Loud ringing in the ears may occur
- The patient hears his own voice in the ear (autophony)
- Context of cold or context of sudden variation in atmospheric pressure (example: la plane landing).
Learn more about Traveling by plane when the child has a cold
The treatment in acute sero-mucosal otitis media is represented by the treatment of the common cold:
- Oral anti-inflammatories
- Deblocking
- Nasal disinfectants
- Mucolitice.
Antibiotics are not needed. Acute sero-mucosal otitis media subsides in a variable time, from a few days to a few weeks, often persisting even after the cold is cured.
Acute congestive otitis media Symptoms and treatment
In 4 out of 5 cases, acute congestive otitis media has a viral etiology. And in one out of five cases, it represents the first stage of bacterial otitis.
Acute congestive otitis media appears during colds (nasopharyngitis), but also during direct exposure to cold or air conditioning, against a background of even a mild cold.
Symptoms and treatment in acute congestive otitis media:
- Moderate or intense ear pain
- Mild hearing loss
- Cold symptoms (sore throat, stuffy nose). There are also congestive otitis without clear cold symptoms (example: only mild pain in the throat)
- There is no pain when pressing on the ear or when chewing
- The pain gives way quite easily to oral analgesics or anti-algesic otic drops.
Treatment in acute congestive otitis media contains ear drops with anti-inflammatory, disinfectant and anesthetic solutions, oral anti-inflammatory, unobstructive and nasal disinfectants. Acute congestive otitis media requires supervision and consultation every 24-48 hours, considering the possibility of progression to bacterial (suppurative) otitis. Antibiotics are not necessary (except in the case of progression to bacterial otitis).
Acute bacterial otitis media Symptoms and treatment
It also appears in the context of a cold (nasopharyngitis). The symptomatology for acute bacterial otitis media is, however, much more serious.
The etiology is bacterial: mainly Streptococcus pneumoniae (40%), then Haemophilus influenzae and Moraxella catarrhalis.
Symptoms and treatment in acute bacterial otitis media:
- Intense, deep, often throbbing earache
- The pain subsides with difficulty or only for a short time with analgesics (sometimes not at all)
- Hypoacusis (significantly clogged ear)
- Fever is frequently present (it always occurs in children)
- The eardrum is intensely red and bulging – if appropriate treatment is instituted, the eardrum heals without perforating and there is no discharge from the ear. If the treatment is postponed, the eardrum is perforated, there is a discharge of secretions from the ear (otorrhea) and the pain at this moment subsides, but this does not mean that the infection subsides.
Treatment in acute bacterial otitis media it is both general and local. General treatment includes:
- Antibiotics administered locally, orally or by injection (10 days)
- Oral anti-inflammatories
- Nasal decongestants and disinfectants.
Local treatment in acute bacterial otitis media
- Aspiration of otic secretions (in case they appear through eardrum perforation)
- Gauze cloth in the ear canal (with rivanol or non-ototoxic antibiotic solution).
It is necessary to check every 24-48 hours in the first days to monitor the effect of the treatment. If there are no signs of improvement, a small surgical intervention is performed, timpanotomia, through which a small incision is made in the eardrum in order to evacuate the purulent secretions. It is also possible to practice taking cultures from the otic secretion for finding out the type of microbe and the sensitivity to antibiotics.
Otitis interna
Internal otitis is characterized by inflammation of the inner ear, of the labyrinth of the ear (for this reason it is also known as labyrinthine). It is a form of otitis that heals itself with the help of the immune system.
Symptoms and treatment in internal otitis
Although it is a form of otitis that can disappear by itself, without treatment, there are some symptoms:
- Dizziness, vertigo
- Ringing in the ears
Once the symptoms are identified, a specialist consultation and monitoring of the infection is still necessary. If internal otitis does not show signs of healing by itself, as happens in more than 80% of cases, the doctor will recommend a treatment.
Diagnosis of otitis
The diagnosis in the case of acute otitis can be made by the ENT doctor, sometimes also by the family doctor. For this, some detailed investigations are necessary:
- Patient history
- Otoscopy (visualization of the external auditory canal, the tympanic membrane and the tympanic cavity)
- Laboratory tests (hemoleukogram and C-reactive protein)
- Imaging investigations (MRI or CT type).
Depending on the clinical characteristics of each case, the ENT specialist may also recommend an ENT fiberoscopy.
ENT fiberoscopy allows the doctor to evaluate the degree of inflammation and the severity of the infection, but also to identify the presence of complications.
Complications of untreated otitis
Not treated at the right time and with the appropriate treatment, otitis is the main cause of hearing loss. Aggravated, otitis can also lead to complications such as:
- Perforation of the eardrum
- Facial paresis
- Meningitis
- Otomastoid.
To prevent ear infections, it is important to avoid inserting various objects into the ear (sticks, paper clips) to clean the ear, maintain ear hygiene and make sure that after bathing they are completely dry, avoid exposure to cigarette smoke and do not use dirty hands at ear.
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2024-02-20 23:05:14
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