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Otitis Media

It is a middle ear infection. Sometimes ear infections can be painful and may even need antibiotics. It is very common in childhood. Most ear infections occur in infants between the age of 6-18 months, though anyone can get an ear infection. For reasons that are unclear they are more common in boys than girls.

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Main symptoms of otitis media include:

  • Earache
  • A high temperature (fever) of 38°C (100.4°F) or higher
  • Lack of energy
  • Slight deafness
  • Often accompanied with nasal discharge and cough

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Otitis media (middle ear infection) is caused when a bacterial or viral infection, such as a cold, spreads into a part of the ear known as the Eustachian tube.

The Eustachian tube is a thin tube that runs from the middle ear to the back of the nose. It has two main functions:
  1. To ventilate the middle ear, helping to maintain normal air pressure.
  2. To help drain away mucus and other debris from the ear.

An infection in another part of the body can cause the Eustachian tube to become blocked, leading to an infection.

Enlarged tonsils or adenoids (small lumps of tissue at the back of the throat, above the tonsils) may block the Eustachian tube. Adenoids and tonsils can be removed if they cause a persistent or frequently reoccurring ear infection, this is more common in children than in adults.

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Tests to be conducted are described below:

Tympanometry
It helps to measures, how the ear drum reacts to changes in air pressure. A healthy ear drum should move easily if there is a change in air pressure. In tympanometry test, a probe placed into ear changes the air pressure at regular intervals while transmitting a sound into the ear. The probe measures how sound reflects back from the ear, and how changes in air pressure affect these measurements. If less sound is reflected back when the air pressure is high, it usually indicates an infection.

Tympanocentesis
It involves draining fluid out of the middle ear using a small needle. The fluid can then be tested for bacteria or viruses that could be responsible for the infection.

CT scans
A computer tomography (CT) scan may be used if it is thought the infection may have spread out of the middle ear. A CT scan takes a series of X-rays and uses a computer to assemble the scans into a more detailed, ‘3D’ image of the skull.

NHP provides an indicative information. For further diagnosis and treatmwnt one should consult your physician. 

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Antibiotics:
The first line antibiotic treatment is amoxicillin . Among short-course antibiotics, long-acting azithromycin is found more likely to be successful than short-acting alternatives . If there is no improvement after 2–3 days of treatment a change in therapy may be considered.

Tympanostomy tube:
In chronic cases with effusions, insertion of tympanostomy tube (also called a "grommet") into the eardrum reduces recurrence rates in the 6 months after placement. Thus tubes are recommended in those who have more than 3 episodes of acute otitis media in 6 month or 4 in a year associated with an effusion.

NHP provides an indicative information. For further diagnosis and treatmwnt one should consult your physician. 

Reference: 

Most commonly reported complications are detailed below.

Mastoiditis
Mastoiditis is one of the most common complications of otitis media and is caused when the infection spreads out of the middle ear and into the area of bone underneath the ear (the mastoids).

Cholesteatoma
Cholesteatoma is an abnormal pocket of skin (cyst) that can sometimes develop as a complication of reoccurring or persistent middle ear infections.

Labyrinthitis
In some cases the infection can move into the inner ear causing a delicate structure deep inside the ear, called the labyrinth, to become inflamed. This is known as labyrinthitis.

Meningitis
A rare and serious complication of otitis media is that the infection spreads to the protective outer layer of the brain and spinal cord (the meninges) leading a serious infection known as meningitis.

Brain abscess
Another rare and serious complication of otitis media is a brain abscess. A brain abscess is a pus filled swelling that develops inside the brain.

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  • CREATED / VALIDATED BY : NHP CC DC
  • LAST UPDATED ON : Feb 04, 2016

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