According to statistics, otitis media is one of the most common diseases that affects newborns, is accompanied by acute pain in the ear and can have serious consequences. It affects up to 60% of infants aged 6-11 months, some experience the disease 2 or more times.
How does otitis media progress in a baby? What are the main causes of otitis media? How to recognize the disease in time and begin treatment?
How does otitis media develop?
The human ear is divided into three sections: outer, inner and middle. The main part of the hearing aid is the Eustachian tube, which is connected to the nasal cavity. It equalizes the pressure on both sides of the eardrum and protects the middle ear by periodically opening and closing to allow buildup of germs and unwanted fluids to escape.
As a result of a cold or allergy, mucus accumulates in the nasopharynx. These secretions pass through the Eustachian tube into the middle ear and accumulate there. The mucus that fills a baby's nose during a cold ends up behind the eardrums.
It puts pressure on the eardrum, causing severe pain, especially if the newborn is lying down.
When pus ruptures the eardrum, you can see purulent discharge coming from the hearing aid. After a rupture, the child feels relief as the pressure and pain in the ear subsides.
Treatment
Treatment of inflammatory diseases of the hearing organs in children should be carried out immediately to avoid possible complications. In otolaryngological practice, there are two main methods of treating purulent otitis:
- conservative - medications are prescribed;
- surgical - the ear membrane is dissected to drain purulent contents.
The choice of technique is carried out exclusively by a specialist after carrying out the necessary diagnostic procedures, determining the severity and stage of the disease.
Antibacterial therapy and other medications
Despite the ambiguous attitude of parents towards antibiotics, it is antibacterial therapy that is considered today the most effective way to treat purulent otitis media in children.
The most common causative agent of otitis (about 30%) is pneumococci, so doctors usually prescribe Amoxicillin for children, an antibiotic effective against this group of bacteria.
The drugs of choice are antibacterial agents such as:
- Augmentin;
- Sumamed;
- Flemoxin;
- Cefuroxime.
For purulent otitis media, treatment with antibiotics is mandatory. One of the most commonly prescribed drugs is Amoxicillin.
When treating with antibiotics, you should remember that these drugs have a cumulative effect, so you will have to take them for quite a long time. For young children, the minimum duration of therapy is 10 days.
It is necessary to give an antibiotic to a child even if the severity of symptoms decreases. Premature withdrawal may result in bacteria developing resistance to a particular drug.
In addition to antibacterial drugs, the doctor prescribes other medications for the child that are aimed at relieving inflammation and reducing pain.
Medicines for the treatment of the disease - table
| Group of drugs | Specific drugs | What is it prescribed for? |
| Vasoconstrictor nasal drops |
|
|
| Antipyretics |
|
|
| Ear drops |
|
|
| Vitamin and mineral complexes |
|
|
Medicines for babies - gallery
Paracetamol is an analgesic and antipyretic drug
Otofa - antibacterial ear drops
Otipax - ear drops with a powerful anti-inflammatory and analgesic effect
Nazol Baby - vasoconstrictor nasal drops
Multi-tabs - vitamin and mineral complex
General recommendations
Treatment with medications must be accompanied by regular hygiene measures. If purulent contents leak out, the baby's ear canals should be carefully cleaned using cotton swabs pre-moistened in an antiseptic solution. After removing the exudate, you can use ear drops.
To speed up recovery, it is recommended to refrain from water procedures for a while. Moisture getting into the ear can activate the inflammatory process. Instead of bathing, doctors advise drying babies with napkins or towels soaked in water.
Surgical intervention
In children, the eardrum is much thicker than in adults, so in some cases pus cannot rupture it on its own. To relieve the child of severe pain and improve the outflow of exudate, forced perforation of the ear membrane is performed - paracentesis (tympanotomy).
Other indications for immediate surgical intervention include:
- high body temperature that does not subside for several days;
- constant vomiting;
- throbbing pain in the ear;
- transfer of infection to the inner ear and suspicion of inflammation of the membranes of the brain.
Perforation of the membrane is done with a special spear-shaped needle under local anesthesia. After the purulent contents are released, a sterile turunda is inserted into the ear canal.
Acute purulent otitis media poses a serious danger to the child’s health, so if the otolaryngologist suggests puncture of the eardrum to alleviate the baby’s condition, one should not refuse.
For a speedy recovery, it is necessary to clean the passages several times a day with Furacilin or boric alcohol.
Types of otitis
Otitis media in infants can be of two types: catarrhal and purulent. With catarrh, the child feels only severe pain, and discharge from the ear is evidence of the development of purulent otitis media.
Therefore, if there is any type of discharge from the ear, the baby should be immediately shown to a specialist.
There are three types of otitis: internal, middle and external. Hearing impairment, pain, and purulent discharge from the ear are usually observed with otitis media.
Based on the above, it is clear that otitis media is rarely an independent disease. It acts as a complication after acute respiratory viral infection or an inflammatory process occurring in the nasopharynx.
Symptoms of pathology
Acute otitis media begins with inflammation of the mucous membranes of the auditory tube and tympanic cavity. In this case, swelling of the mucous membranes is observed and infiltration occurs. The mucous membranes of the cavity are quite thin. As a result of dysfunction of the auditory tube, the cavity is filled with pathogenic exudate, which at the beginning of the inflammatory process is serous, and then becomes more viscous and acquires a purulent texture.
The mucous membrane thickens several times. At the final stage of development of the pathology, suppuration stops completely. A perforated eardrum heals on its own in most cases, but restoration of hearing function takes some time.
In a newborn
Among the characteristic manifestations of purulent otitis in a newborn are:
- anxiety, the child becomes more whiny;
- the baby refuses food;
- regurgitation occurs, vomiting appears after eating;
- the child often shakes his head when eating;
- mucus is discharged from the ear.
In children over two years of age
Children over 2 years of age can rarely clearly describe how they feel. They have otitis media:
- increased fatigue;
- constant drowsiness;
- weakness;
- pale skin;
- increase in body temperature up to 40 degrees;
- ear congestion;
- discharge of pus mixed with blood from the ear cavity.
Diagnosis of pathology usually does not cause difficulties. The doctor performs an otoscopic examination and listens to the complaints of the baby’s parents. To determine the direction of therapy, tests are indicated, usually a general blood and urine test.
Causes of otitis media in children
The main causes of otitis media include:
- colds and complications from infections in the nasopharynx;
- household injuries caused by careless cleaning with cotton swabs;
- penetration of formula or breast milk into the ear;
- presence of adenoids;
- hereditary predisposition caused by the peculiarities of the internal structure of the ear;
- allergic reaction;
- weak immunity of the child;
- congenital anomalies of the lungs and bronchi;
- increased pressure on the eardrum (possibly during air travel).
There are a number of objective reasons for the development of the disease in newborns.
These include:
- Formation of mucus in the nasal cavity due to frequent daily crying. With strong crying, fluid immediately forms in the nasal cavity.
- Frequent regurgitation, due to which milk residues can easily penetrate the Eustachian tube. And since this organ in a baby is much shorter and narrower than in an adult, fluid accumulates here very quickly.
- Inability to blow your nose well. The presence of an assertive mother, grandmother or nanny nearby only aggravates the situation. When they, tightly covering their nose with a handkerchief, ask the child to blow his nose and blow “as hard as he can,” the accumulated secretions rush into the middle ear, thereby provoking the onset of otitis media.
Main signs of the disease
In order to promptly detect the inflammatory process, parents need to know the main signs of otitis media in an infant. It is not difficult to find out about the development of the disease in a three-year-old child, since he can tell what is bothering him.
But how to recognize otitis media in a baby who cannot speak? Diagnosis of inflammation occurring in the middle ear is difficult at this age, and it is quite difficult to notice it in the early stages.
Mom should be alert to the following signs:
- the baby turns his head, is capricious for no reason, refuses to breastfeed;
- temperature rise to 38-40°C;
- the appearance of insomnia and changes in routine;
- vomiting, lack of appetite;
- the appearance of swelling in the parotid area;
- presence of nasal congestion, redness;
- the appearance of discharge from the ear.
Symptoms of otitis media in infants appear suddenly. Even in the evening the child was in a cheerful and joyful mood, and in the morning he woke up lethargic and capricious. An obvious sign that indicates the presence of the disease is pain when you press your index finger on the cartilage near the auricle.
If the baby cries and reaches for his ear, this indicates the development of acute otitis media, you should immediately consult a doctor.
About otitis...
Newborn health
Otitis in a baby! What to do?
What should parents always remember? What to fear and what to pay attention to when the disease begins? Today you are being advised by the chief pediatric otolaryngologist in Moscow, Doctor of Medical Sciences, Professor Tatyana Ilyinichna Garashchenko.
About the main reasons
The main cause of otitis media in children is, of course, acute respiratory viral diseases.
American specialists once conducted an extensive study, which showed that against the background of a common acute respiratory viral infection, 65% of children experience damage to the middle ear, that is, the entire clinical picture of acute otitis media is present.
Approximately the same picture is observed in our country: every fourth child affected by a viral infection is diagnosed with otitis upon a more thorough examination.
Very often, the cause of otitis is a bacterial infection, which joins an already started viral one. It is not for nothing that the French say that viruses pass judgment, but bacteria carry it out. It is those bacteria that settle in the middle ear and cause inflammation.
And, please note, it can cause meningitis, especially in children of the first year of life. Therefore, compulsory vaccination against Haemophilus influenzae has been introduced into the vaccination calendar all over the world, and from the new year in our country, and vaccination against pneumococcus is introduced from the age of two.
These vaccinations will help protect children from meningitis, especially of ear origin. In addition, elementary hypothermia can provoke inflammation of the middle ear: the child has caught a cold, the ears have blown out. And another common cause of otitis is excessively enlarged adenoids and their chronic inflammation (adenoiditis).
It must be taken into account that children prone to allergies have allergic otitis media. Following improper feeding, the child develops skin rashes, the tympanic cavity opens and fluid leaks from the ear. Allergic otitis media may not be accompanied by fever.
Throwing food into the middle ear is also a fairly common cause of otitis media, especially in newborns and infants.
About the onset of the disease
Otitis caused by infection usually develops following damage to the nasal cavity, that is, a runny nose and respiratory symptoms from the upper and lower respiratory tract.
The mother may note that after ARVI, the child’s temperature sharply increased again, he became more restless, and refuses to eat. The baby develops a pendulum-like movement of the head, and some children even try to look at the sore ear with their eyes. The first signs of otitis media can most often be recognized during breastfeeding.
When a baby attaches to the breast, negative pressure is created in the nasopharynx, and this increases pain. As a result, the baby's attempt to eat becomes very painful, and the baby bursts into loud crying.
He kicks his legs, screams, and his mother gets the feeling that it’s intestinal colic. If the baby lies down on his sore ear, he suddenly begins to suck better. In this position, with the sore ear pressed, it’s easier for him, it doesn’t hurt so much.
And when turned the other way, the baby will still refuse the breast with a cry.
How else can a mother recognize the signs of otitis media?
When the child is sleeping, she can gently press the tragus - the part of the ear lobe that protrudes above the earlobe.
If a child winces and moves his head away, this can also be considered one of the symptoms of middle ear disease.
Any otitis occurs either in catarrhal or purulent form (when the eardrum is opened). The mother can determine whether purulent discharge has appeared from the ear herself by cleaning her ears every day. In addition, oddly enough, when the eardrum is perforated (ruptured), a visible improvement in the child’s condition occurs.
The membrane is torn, which means the pressure drops, the temperature immediately drops, and the baby’s appetite returns. All symptoms disappear except one - purulent or bloody discharge.
About complications
Otitis media is dangerous due to its complications. The fact is that recognizing otitis media is not always easy.
For example, it is not always accompanied by severe pain in the ear. Symptoms of this disease often include disturbances in the gastrointestinal tract. This is due to the fact that the middle ear and abdominal cavity are innervated by the same nerve (that is, they have common nervous regulation).
Therefore, when the ear gets sick, intestinal symptoms may prevail in young children: bloating, regurgitation, vomiting, stool retention.
That is, external manifestations may resemble, say, appendicitis. Often infants with similar symptoms end up not in the ENT department of the hospital, but in the surgical department. But surgeons are literate people, so they begin examining such children by inviting an ENT doctor.
Only after excluding the diagnosis of “acute otitis” do they engage in further diagnostics. If a mother undertakes self-treatment of a gastrointestinal disorder, ignoring other symptoms, then otitis media can develop into such a formidable complication as otoanthritis.
The infection from the middle ear spreads to the area behind the ear and affects another air cavity of the middle ear. Protrusion of the auricle, redness, swelling appears, and an increase in temperature is noted again. The timing in which this process can develop is unpredictable - it occurs both immediately after acute otitis media and a month later.
If the mother does not notice these symptoms, then the child will most likely be admitted to the hospital in 2-3 months, but with meningitis: the structure of the child’s ear is such that an infection from the tympanic cavity can directly come into contact with the meninges.
So parents should be more vigilant and monitor the course of any, even the mildest viral disease. Other complications of acute otitis include paresis of the facial nerve, chronic otitis media, hearing loss, damage to the vestibular system and meningitis, which we have already mentioned.
About errors
It often happens that middle ear diseases are provoked by parents themselves. For example, a child has a severe runny nose, and the mother incorrectly blows off nasal secretions. She pinches both nostrils and forces the child to blow his nose violently. This should never be done - your ears instantly become clogged. You cannot blow your nose into both nostrils at once - only one at a time.
Why do otitis occur so often in young children and very rarely in adults?
Because the middle ear is connected to the nasal cavity by an airway - the auditory tube. In children it is very wide, short and open. And if a child blows his nose into pinched nostrils, then all the pus from the nose is immediately thrown into the middle ear. Often the cause of otitis media is improper feeding.
The mother fed the child and immediately puts him in the crib on his side, that is, on some ear. And during feeding, children swallow a lot of air, which must be removed later, holding the baby in an upright position.
If regurgitation occurs while the baby is lying horizontally, then the milk is immediately thrown into the auditory tube. Another common mistake is improperly suctioning mucus from the nasal cavity using a bulb. This must be done very gently, slowly.
If the mother abruptly releases the pear, then negative pressure arises in the nasal cavity, hemorrhage occurs in the tympanic cavity and peeling of the mucous membrane occurs.
About treatment
Otitis in children under two years of age must be treated with antibiotics. If an older child has a mild form of otitis media, then you can do without them. But in any case, before purchasing ear drops, you must read the instructions.
There are drops such as Sofradex and other gentamicin-containing drugs that are used only for external and catarrhal otitis. And if the eardrum is opened, then this group of antibiotics, penetrating through the hole into the ear canal, can cause damage to the auditory nerve.
But for any form of otitis, you must first treat the nasopharynx and put drops in the nose twice as often as in the ears, since it is very important that the nose breathes well. These can be vasoconstrictor or anti-inflammatory drops.
For children with allergies, special drops have appeared containing both antihistamine and vasoconstrictor components.
All children with otitis media benefit from warm compresses, inhalations, quartz treatment, and expectorant therapy.
For catarrhal otitis, you can drip warming oil drops of calendula, belladonna or camphor, which help relieve pain, as well as drops with a special anesthetic component, such as Otipax. But the oil must be warm, heated to about 40 degrees. In case of suppuration, the above drops cannot be used.
Source: https://www.BabyBlog.ru/community/post/01medicina/536032
How to treat otitis
If you find otitis in an infant whose symptoms are rapidly developing, you must immediately begin treatment, which should be prescribed by a qualified doctor.
Incorrect, untimely therapy can lead to hearing loss and dangerous complications. You should not experiment, blindly following the advice of traditional medicine.
Typically, treatment for ear pain involves prescribing:
- Antibiotics, the duration of which is 5-7 days.
- Ear drops, which are instilled three times a day, 4 drops in each ear. The medicine must first be heated by holding it in the palms of your hands or in warm water. The duration of treatment is no more than 10 days.
- Vasoconstrictor drops, which are used immediately before feeding and at night. They are instilled 3 times during the day to narrow the blood vessels and maintain the patency of the Eustachian tube. Their use allows you to relieve discomfort caused by a runny nose in your baby.
- Children's antipyretics.
- Antihistamines that eliminate intoxication of the body.
Usually, treatment of otitis occurs at home, but if complications arise, it is better to stay with the child in the hospital.
If the baby's ears hurt and otitis is suspected, alcohol compresses, homemade drops and ear warming should not be used.
For example, the use of an alcohol compress can relieve pain in some small patients, while in others it can cause exacerbation of otitis media and rupture of the eardrum.
Diagnostics
In addition to determining the presence of purulent otitis in children by symptoms, there are, of course, medical diagnostic methods, based on which they determine how to treat the disease. First of all, the doctor interviews the baby (if possible) and his parents. Next, he examines the ears using an otoscope to determine the stage of the disease.
The specialist may also refer the child for a blood test to determine the presence of inflammation. Sometimes a bacteriological examination of samples of contents from the ears of a small patient may be necessary. This is necessary to assess the level of susceptibility of bacteria to a specific group of antibiotics.
Why is otitis media dangerous in infants?
If the disease is not identified in time and effective treatment is not prescribed, this can lead to such negative consequences as:
- Hearing impairment. Typically, middle ear disease is accompanied by a slight deterioration in hearing, which recovers in 1-3 months. Ineffective treatment can cause long-term problems, and advanced otitis media, which causes damage to the ear bones and auditory nerve, often leads to irreversible deafness.
- Spread of infection to other organs. An advanced disease can spread to nearby tissues and cause other ailments. Otitis media can cause inflammation of the process of the temporal bone, located directly behind the ear, or damage to the bones of the skull. Sometimes the infection spreads to brain tissue.
Prevention
As preventative measures, it is necessary to follow completely simple recommendations.
Namely:
- Continue breastfeeding for as long as possible.
- When eating, the child should be in an almost vertical position.
- When bathing, to prevent water from flowing into the ear, use a rubber cap. If liquid gets into the ear, carefully blot it up.
- Carry out hardening procedures that strengthen the baby’s body and strengthen the immune system.
- Teach your child to blow his nose correctly when one nostril is closed and the mouth is slightly open.
- Perform hygiene procedures once a week, since a healthy ear cleans itself, and a small amount of wax will not harm.
