Ear infections are the most common illness  that affects children. They often begin with a cold, which may cause fluid to accumulate behind the eardrum and become infected. Treatment centers on relief of ear pain and fever, and antibiotics are often prescribed for bacterial infections

PEDIATRIC EAR INFECTIONS (OTITIS MEDIA)

Ear Infections

Ear infections (otitis media) occur when fluid accumulates behind the eardrum and becomes infected. This area is called the middle ear. Ear infections are the most common illness affecting children.

The eustachian tube is a narrow tube running from the air pocket behind the tympanic membrane to the back of the nose. In children, the Eustachian tube is shorter than in adults and allows bacteria and viruses to enter the middle ear. In young children, the eustachian tube is almost horizontal. This positioning interferes with drainage. In addition, the muscles of the palate, which open the eustachian tube with swallowing or jaw movement, are less well-developed. The eustachian tube is also physically small in young children. All these factors may lead to eustachian tube blockage. As a child grows, the eustachian tube enlarges, angles down, and reaches adult development at approximately age six.

Many ear infections may begin with a cold. The nasal membranes and eustachian tube come swollen and congested. This results in obstruction of the eustachian tube. Fluid accumulates in the middle ear space. Bacteria then contaminate the fluid in the middle ear, causing the infection.

Children suffering from an ear infection may display some or many of a constellation of these symptoms:

  • Ear pain
  • Tugging or pulling at the ear
  • Fever
  • Hearing loss
  • Poor sleeping or crankiness
  • Runny nose


Older children may explain ear pain, ear fullness or hearing loss, while younger children may be irritable, fussy, sleep poorly, or have trouble hearing. After treatment of an ear infection, if the middle ear fluid does not clear and the fluid remains, a sensation of plugging or fullness, as well as hearing loss, may be the only symptoms that your child experiences.

Therapy for otitis media is centered around antibiotic therapy, as well as relief of ear pain and fever. There is some debate as to how often antibiotics are needed as many ear infections resolve spontaneously, and viral infections are nor improved ay antibiotic treatment.

In a certain number of children, ear infections become chronic. Either the infections occur with very little well time between flares (back-to-back) or the middle ear fluid never clears, resulting in prolonged hearing impairment.  In these instances, your doctor may recommend “ventilation tubes”. This prevents the accumulation of fluid behind the eardrum and equalizes air pressure. Placement of a ventilation tube usually restores a child’s hearing to normal.

 
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