Otitis Media in kids

Area behind the eardrum is known as middle ear and inflammation of middle ear is known as otitis media. It is very common in young children. A recent onset inflammation is known as acute otitis media (AOM) and repeated inflammation for longer durations is known as chronic otitis media.

Risk factors for OM include –

  • Age between 6 months to 36 months

  • Use of pacifier

  • Attending daycare

  • Bottle-fed

  • Drinking while lying down

  • Being exposed to air pollution or passive smoking

  • Experiencing changing altitude or climate

  • Recent flu, cold, fever

  • Being in cold climate

  • Infected adenoids

Causes –

The eustachian tube is the tube that runs from the middle of the ear to the back of the throat. An acute otitis media occurs when your child’s eustachian tube becomes swollen or blocked and traps fluid in the middle ear leading to infection. In young children, the eustachian tube is shorter and more horizontal than it is in older children and adults. This makes it more likely to become infected.

Symptoms of otitis media are-

  • Extreme fussiness/crying in child

  • Clutching ear while wincing in pain

  • Sleeplessness due to ear pain

  • Headache/neck pain

  • Fluid discharge from the ear

  • Fever

  • nausea/vomiting

  • Hearing loss

  • Loss of balance

Diagnosis –

The pediatrician may use one or more of these methods to diagnose otitis media in your child.

  • Otoscope- It is an instrument  to look into your child’s ear and detect any redness, swelling, pus, air bubbles, fluid or perforation of middle ear.

  • During a tympanometry test, your child’s doctor uses a small instrument to measure the air pressure in your child’s ear and determine if the eardrum is ruptured.

  • Reflectometry-  An ENT specialist uses a small instrument that makes a sound near your child’s ear. Your child’s doctor can determine if there’s fluid in the ear by listening to the sound reflected back from the ear.

  • Hearing test- To determine if there is any hearing loss.

Treatment –

The majority of middle ear infections resolve without antibiotic treatment. Home treatment and pain medications are usually recommended before antibiotics.

You may be advised these measures to relieve the symptoms-

  • applying a warm, moist washcloth over the infected ear

  • using over-the-counter (OTC) ear drops for pain relief

  • taking OTC pain relievers such as ibuprofen and acetaminophen

Antibiotics are provided if the symptoms does not get better in few days with supportive care.

Surgery may be advised if your child’s infection doesn’t respond to treatment or if your child has recurrent ear infections.

Sometimes, AOM infections can lead to recurrent ear infection, enlarged adenoids, enlarged tonsils, ruptured eardrum, growth in middle ear and speech delay in recurrent infection.

Otitis media generally get better without any complications, but the infection may occur again. Your child may also experience temporary hearing loss for a short time. But it should return quickly after treatment.

Reducing the risk of middle ear infection by washing hands and toys, getting seasonal flu shots, breastfeeding instead of bottle feed, avoiding pacifiers and avoiding passive smoking is recommended.


Dr Prerna Gaur






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