Ear problems in children – Acute otitis media
Ear problems in children
- Otitis media is an ear infection of the middle ear that causes pain, fever and hearing loss
- Otitis media is one of the commonest ear problems in children – by the age of five, nearly every child has experienced at least one episode of otitis media, so otitis media is one the commonest children’s ear problems
- Most ear infections either resolve on their own (viral) or are effectively treated by antibiotics (bacterial)
- Fluid in the middle ear may remain for months after the infection resolves
- Ear infections and/or fluid in the middle ear may become a chronic problem leading to other issues such as hearing loss, behavior, and speech problems
Recurrent otitis media
- Situations where middle-ear infections are likely to recur:
- Children prone to upper respiratory infections
- When fluid in the middle ear is present from previous infections
- Children’s day care
- Where the Eustachian tube does not function
Chronic otitis media (Glue ear)
- Otitis media with middle ear fluid that has been present for three months or more is called glue ear
- The middle ear fluid is often thick like glue
- Risk factors for glue ear include:
- Poor Eustachian tube function
- Children under the age of three
- A recent ear infection
- Colder weather
- Other children’s problems such as cleft palate
The Eustachian tube
- The Eustachian tube connects the middle ear to the throat
- Its purpose is to equalize middle ear pressure
- When the ear “pops” the reason is that the Eustachian tube has opened and equalized pressure
- If the Eustachian tube does not function properly then middle ear fluid cannot drain and fluid in the middle ear interferes with hearing
- Children tend to grow out of otitis media and glue ear with development of the Eustachian tube and accordingly, children older than seven or eight years are less prone to middle ear problems
Complications of persistent glue ear
- Glue ear can cause the ear drum to thin and fall in – called a retraction pocket
- This can lead to further complications and hearing loss
- If the ear drum is severely retracted chronic middle ear disease and cholesteatoma may develop
- A cholesteatoma is an abnormal growth of skin misplaced in the middle ear
Who needs ear grommets?
- Grommets are often recommended when a person experiences repeated middle ear infection (acute otitis media) or has hearing loss caused by the persistent presence of middle ear fluid (otitis media with effusion)
- These conditions most commonly occur in children, but can also be present in teens and adults and can lead to speech and balance problems, hearing loss, or changes in the structure of the ear drum
- Other less common conditions that may warrant the placement of grommets are malformation of the ear drum or Eustachian tube, Down Syndrome, cleft palate, and barotrauma (injury to the middle ear caused by a sudden change in air pressure), usually seen with altitude changes such as flying and scuba diving
- In children, where there are problems associated with glue ear and hearing loss including delay in speech development, learning difficulties, behavioural problems, frequent ear aches or balance
Childrens ear grommets
Ear grommet placement aims to:
- Treat children’s ear problems and restore hearing loss caused by middle ear fluid
- Improve speech problems and balance problems
- Improve behavior and sleep problems caused by chronic ear infections
- Reduce the risk of future ear infection
- Treat ear drum retraction and chronic middle ear disease