Usually, otitis media affects the middle ear, the space between the eardrum and the air. The eustachian tube, which connects the middle ear to the back of the throat, is usually infected with viruses or bacteria from the nose or throat. In addition to causing ear pain, fever, fluid drainage, hearing loss, and reduced balance, otitis media can be treated with pain relievers, antibiotics, or surgery. You can prevent otitis media by getting vaccinated, avoiding tobacco smoke, and treating allergies and colds.
Causes
It occurs when the Eustachian tube becomes swollen or blocked and traps fluid in the middle ear. This trapped fluid can become infected by viruses or bacteria that enter the ear through the nose or throat.
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Nasal and throat allergies can cause inflammation and mucus production
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A cold, flu, or sinus infection can cause congestion and swelling in the nose and throat
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An infection or enlargement of the adenoids, which can block the eustachian tube
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As a result of smoking or exposure to secondhand smoke, the nose and throat lining can become irritated
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Drinking while lying down can cause fluid to flow back into the Eustachian tube
Symptoms
Depending on the severity and duration of the infection, otitis media symptoms may vary. The most common symptoms are:
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Movement, pressure, or noise can aggravate ear pain, which may be mild or severe
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A fever may be low or high, and may indicate a systemic infection
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There may be a foul odor to the discharge, which may be clear, yellow, green, or bloody.
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One or both ears may suffer from hearing loss, which may be temporary or permanent
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There is a ringing, buzzing, or hissing sound in the ear that may be constant or intermittent called tinnitus
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Nausea, vomiting, or loss of balance may occur with vertigo, which is a sensation of spinning or moving
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It may cause drooping of the eyelid, mouth, or cheek, or difficulty smiling, blinking, or chewing on one or both sides of the face
Diagnosis
Medical history, physical examination, laboratory testing, and imaging tests are used to diagnose otitis media. The doctor will ask about the symptoms, the onset and duration of the symptoms, the medical history, and the family history of the patient. A physical examination will also take place, which will include:
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Examining the ear for signs of discharge, swelling, redness, or foreign objects
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Checking the ear for pain, tenderness, or warmth
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Checking the ear for signs of pain, reduced movement, or crepitus (a crackling sound).
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Hearing and balance tests are performed on the patient
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Patient's facial nerve function is tested
Some laboratory and imaging tests may also be ordered by the doctor, including:
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Samples of ear discharge can be collected and tested for bacteria, fungi, and viruses with an ear swab
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A blood test can measure the level of white blood cells, inflammation markers, or antibodies, and indicate whether an infection or inflammation exists
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An X-ray can reveal the bone structure and the presence and location of fluid, air, or foreign objects in the ear
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An MRI can show the soft tissues and blood vessels around the ear and rule out any malignant transformation or complications
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An ear CT scan can show cross-sectional images of the ear and the surrounding structures, and detect any abnormalities or complications.
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Detects multiple or hidden infections in the bone and ear with a bone scan, which shows the metabolism of the bone and ear
Treatment
The treatment of otitis media depends on the cause and severity of the infection, as well as the overall health and preference of the patient. The treatment aims to eliminate the infection, relieve the pain, and restore hearing and balance. There are a number of treatment options available, including:
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Medications include:
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The use of antibiotics can kill or stop the growth of bacteria that cause ear infections. They can be administered orally, via injection, or via ear drops, depending on the type of infection and its location.
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Depending on the type and location of the infection, antifungals can be administered orally, by injection, or by ear drops.
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Depending on the type and severity of the infection, antivirals can kill or stop the growth of viruses that cause the ear infection.
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Inflammatory medications, such as anti-inflammatories, can reduce swelling and pain in the ear. They can be administered orally, via injection, or by ear drops, based on the type and location of the inflammation.
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Depending on the type and severity of the pain, analgesics can be given orally, intravenously, or through ear drops to relieve the pain.
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Depending on the type and severity of the allergy, antihistamines can reduce the allergic reaction that causes the inflammation of the ears.
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Depending on the type and severity of the congestion, nasal decongestants can reduce the congestion and pressure in the ears.
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As a result of surgery, you can:
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This procedure involves making a small incision in the eardrum, or inserting a small tube into the eardrum, depending on the type of fluid and the location of the pus in the ear.
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The foreign object or tumor must be removed from the ear, and the ear's normal function must be restored. Depending on the type and location of the foreign object or tumor, the procedure may involve using a small instrument or a microscope, or by making a small incision in the ear canal or earlobe.
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In order to treat the damage or defect of the ear, and prevent the recurrence of the infection, a graft, flap, or prosthesis is used, depending on the type and extent of the damage.
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Prevention
Although otitis media is not always preventable, some measures can be taken to reduce the risk or severity, such as:
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The influenza vaccine or pneumococcal vaccine can prevent or reduce the severity of some ear infections
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Tobacco smoke can irritate the nose and throat lining, increasing the risk of ear infections
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Treatment of allergies and colds, which can cause inflammation and congestion in the nose and throat and increase the risk of ear infections
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Maintaining good hygiene, such as washing hands frequently, cleaning ears gently, and not sharing earphones or earplugs
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Preventing or limiting exposure to water, trauma, or foreign objects that can enter or irritate the ear
