Middle Ear Inflammation

WHAT IS MIDDLE EAR INFECTION?

The middle ear can become infected as a result of allergies, colds, sore throat or respiratory infection. Blockage of the eustachian tube, which connects with the middle ear, paves the way for otitis media. Although middle ear infection, also known as otitis media, can also be seen in adults, it occurs more often in children and is painful.

WHAT ARE THE SYMPTOMS OF MIDDLE EAR INFECTION?

Middle ear infection is more common in children. The symptoms of middle ear infection in adults may differ from those in children. Middle ear infection, which is mostly seen in autumn and winter months, can heal spontaneously or have a bad course.

Symptoms of Middle Ear Infection in Children

Symptoms of middle ear infection in children are usually sudden onset of ear pain and fever after a cold. In babies, symptoms are more common in the form of restlessness, fever, rubbing one's ear against the pillow, or putting one's hand to one's ear.

In general, symptoms of middle ear infection in children are as follows:

Earache
sleep problem
Weakness
Restlessness and crying
Hearing problems
loss of balance
High fever
discharge from ear
Loss of appetite
Itching and irritation in and around the ear

Symptoms of Middle Ear Infection in Adults

Symptoms of middle ear infection may differ in adults. Usually the first symptom is pain and a feeling of stuffy ears. In general, symptoms of middle ear infection in adults are as follows:

Earache
Clogged ear feeling
ear discharge
Hearing problems
tinnitus
Fire

WHAT ARE THE CAUSES OF MIDDLE EAR INFECTION?

The causes of middle ear infection may be of different origins.

Originated from the Eustachian tube: Middle ear infection, that is, otitis media, is mostly seen in children. Although otitis media is less common in adults, it can lead to more serious problems. The most important reason why middle ear infection is more common in children is due to the Eustachian tube. The Eustachian tube, which helps regulate the air pressure in the middle ear, renew the air in the ear, and evacuate normal secretions from the middle ear, is shorter, more horizontal, and wider in children. This makes it difficult to remove the fluid accumulated inside, increasing the possibility of clogging.
Originated from adenoid: Adenoid, i.e. adenoid It is located near the opening of the Eustachian canal. Swelling of the adenoid, which is larger in children than in adults, due to various reasons, increases the risk of ear infection.
Age: middle ear infection is more common between 6 months and 2 years of age.
Premature birth or low birth weight
Personal risk factors such as cleft palate, head-facial anomalies or Down syndrome
Frequent upper respiratory tract infections in autumn and winter
nurseries
exposure to cigarette smoke
Environmental factors such as low breast milk intake or bottle feeding are also among the causes of otitis media.

HOW TO UNDERSTAND MIDDLE EAR INFECTION? WHAT IS THE DIAGNOSIS?

An Ear Nose and Throat doctor can diagnose a middle ear infection based on the symptoms of the disease and examination. During the examination, the doctor will look at the ears, throat and nose with a lighted device to check whether there is a problem in the passageways. In acute otitis media, the eardrum usually appears red and bulged. In chronic otitis media, perforation, collapse, or adhesion of the eardrum to the middle ear may occur. In cases where the eardrum is perforated and there is discharge, a culture sample can be taken from the discharge to understand which bacteria causes otitis media.

A number of additional tests and examinations may be performed to confirm the diagnosis of otitis media.

Pneumatic otoscope: It is a tool used to diagnose otitis media. While very light air is blown into the eardrum with a pneumatic otoscope, the doctor examines whether there is fluid accumulation behind the eardrum.
Tympanometer: With this test, eardrum movement is measured to get an idea about the pressure in the middle ear.
Acoustic reflectometry: This test measures how much sound is reflected from the eardrum. The eardrum, which should absorb most of the sound, reflects the sound back if there is fluid in the middle ear.

MIDDLE EAR INFECTION TREATMENT

Middle ear infection can usually get better on its own. It is necessary to consult a doctor in case of middle ear infections whose complaints continue to increase. Otitis media is a health problem all over the world due to its prevalence and possible complications and sequelae. Antibiotics are given very frequently for acute otitis media, and this situation can also reach high economic costs. Ear tubes can be used in cases where drug treatment is insufficient for otitis media. Otitis media surgery may vary depending on the condition of the disease.

FREQUENTLY ASKED QUESTIONS ABOUT MIDDLE EAR INFECTION

How Does Middle Ear Inflammation Happen?

The middle ear is connected to the throat through a canal called the eustachian tube. Allergies, a cold, a throat infection, or a respiratory infection can cause the area around the eustachian tube to swell. This may prevent fluid from draining from the middle ear into the nasal passages. The fluid that cannot be discharged into the nasal cavity collects behind the eardrum. Bacteria and viruses that grow in this fluid may predispose to middle ear infection.

Which Doctor Should You See for Middle Ear Infection?

Ear, Nose and Throat doctors diagnose and treat middle ear infections. If symptoms persist for more than a day, if a child younger than 6 months has symptoms of middle ear infection, if severe ear pain, if the baby or child is restless after an upper respiratory tract infection, if fluid or pus flows from the ear, an ear, nose and throat doctor should be consulted without delay. Since middle ear infection treatment also includes surgical methods, choosing an experienced doctor and a hospital with the infrastructure can prevent more serious problems that may arise in the future.

What are the Types of Middle Ear Inflammation?

Acute otitis media: Occurs suddenly. It causes swelling and redness. There may be fever and earache.

Middle ear infection with effusion (fluid): It is the presence of fluid in the middle ear cavity. It is usually seen after previous acute middle ear infections. This situation is mostly seen in preschool age children. Since its symptoms are extremely insidious, the disease may not be noticed and therefore it is known as the most common cause of hearing loss. Children with fluid in their middle ears may not be able to hear sounds because they often have poor hearing. These children may turn up the volume on the television or watch it more closely, repeat conversations, show behavioral disorders, become withdrawn, or fail in school. It is important to correct the underlying risk factors in patients and normalize eustachian tube functions. Thus, the fluid in the middle ear cavity gradually decreases and the ear can return to normal. In these patients, spontaneous improvement occurs within three months. Surgical options are considered in patients with hearing loss and no improvement after three months. In this case, the adenoids are evaluated and, if necessary, a tube can be placed in the ears. Cleft palate, autismIn cases such as language and speech retardation, intellectual retardation or school failure, surgical treatments may be considered without delay. As surgical treatment, patients may undergo eardrum ventilation tube, adenoid surgery, or tonsillectomy.

Chronic Otitis Media: The pathological course of chronic otitis media in the ear is different. It is a condition characterized by a permanent hole in the eardrum. Chronic otitis media is chronic inflammation of the mucosa in the middle ear cavity, eustachian tube and mastoid cell spaces associated with the middle ear. Symptoms of chronic middle ear infection; It occurs with ear discharge, perforated eardrum and usually conductive hearing loss. Ear discharge sometimes improves. Then it starts again. If these symptoms persist for more than three months, the disease is considered chronic. The disease can progress beyond the mucosa lining the middle ear, causing damage to adjacent tissues and more serious problems. This condition mostly manifests itself with earache and fever. Therefore, one should be very careful. Chronic otitis media in itself; It is divided into classes as collapse in the eardrum, adhesion to the middle ear, without cholesteatoma and with cholesteatoma.

How to Cure Middle Ear Inflammation?

Symptoms of middle ear infections usually begin to improve within the first few days. Most middle ear infections can clear up completely within 1-2 weeks without any treatment. Antibiotics are often used in the treatment of otitis media. Since frequent and unnecessary use of antibiotics can increase the resistance of bacteria to drugs, antibiotics should not be used without consulting a doctor.

Simple painkillers recommended by the doctor can be used.
A hot press can be applied to the ear to relieve pain.
Ear discharge should be wiped with cotton.
Ear buds or fingers should never be inserted into the ear.
Care should be taken to prevent water or shampoo from getting into the ear.

What Medications Are Used in the Treatment of Middle Ear Inflammation?

Middle ear infection medications are used to relieve pain and clear up infection.
Over-the-counter medications containing acetaminophen or ibuprofen can be taken to relieve the pain.
If there is no hole or rupture in the eardrum as a result of middle ear infection, anesthetic drops can be used to relieve pain.
Otitis media drops can be ready-made, or handmade drops prepared in pharmacies can also be used.
Antibiotics used orally or as ear drops are among the medications used to treat middle ear inflammation.
The benefits of decongestants used for nasal congestion and antihistamines used for allergies in the treatment of otitis media are controversial.

Tube Insertion Surgery

Fluid accumulated in the middle ear may not improve despite medication or antibiotics. Otitis media tube insertion surgery can be performed in cases of constantly recurring middle ear infections, middle ear infections that do not heal on their own or with medical treatment, and eardrum collapses.

During middle ear tube insertion, the ear, nose and throat surgeon makes a small hole in the eardrum. A small tube (tympanostomy tube) is inserted into the opening to help ventilate the middle ear and prevent further fluid accumulation. Some ear tubes are intended to stay in place for six months and then fall out on their own. Other tubes are designed to stay in longer and may need to be removed surgically. The eardrum usually closes on its own after the tube is removed.

Middle Ear Inflammation Surgery

Surgical treatment is recommended in cases where medications used to treat chronic otitis media do not respond. In surgical treatment, surgeries are performed depending on the extent of the disease.
Eardrum repair surgeries (Tympanoplasty) are performed in patients who have a hole in the eardrum and do not have any other pathology. An ear microscope is usually used in these surgeries. For this, in the majority of patients, surgery is performed by making an incision behind the ear or in the upper front part of the auricle.
In cases with more advanced disease, the bone behind the ear should be treated.
Cholesteatoma is the most important ear disease and its treatment should be done without delay. Cholesteatoma is the presence of skin inside the middle ear, which should not normally be present. In this case, the cholesteatoma gradually grows and damages all the neighboring tissues around it. Thus, it causes complications ranging from facial paralysis to brain damage.
In the treatment of chronic otitis media with cholesteatoma, surgery should be performed without delay, diseased tissues within the bone should be removed and necessary rehabilitation should be performed.

Middle Ear Infection Endoscopic Surgeries

Recently, surgery is performed using endoscopic instruments instead of ear microscopes in suitable patients. In this case, it is easier to reach the disease.
Thanks to endoscopic surgery, no incision is made behind the ear, and patients undergo a procedure that requires less tissue removal by entering through the ear canal.
In endoscopic ear surgeries, the short duration of surgery, the removal of less healthy tissue during the interventions, and the absence of any incisions are advantages for patients.
In these patients, the post-operative period is much more painless and comfortable, and recovery occurs earlier.

What Happens If Middle Ear Inflammation Is Untreated?

Most middle ear infections do not cause any problems. However, frequently recurring and untreated middle ear infections can lead to more serious problems.

Infection in other parts of the head
Rupture of eardrum
Hearing impairment or permanent hearing loss
If hearing problems occur in babies or children, there may be delays in speech and social development skills.
Facial nerve paralysis and meningitis may occur.

What Should Be Done to Avoid Otitis Media?

Middle ear infection usually occurs after upper respiratory tract infections. Taking precautions against upper respiratory tract infections is important to avoid middle ear infection.
Exposure to cigarette smoke should be avoided.
Babies should be breastfed as much as possible. Breast milk contains antibodies that may provide protection from ear infections.
If you are feeding your baby with a bottle, try to keep it as upright as possible.

Is Acute Middle Ear Infection Common?

Middle ear infection is a very common condition, especially among children. It is known that up to 80% of children have had at least one otitis media before the age of 3.

Is Middle Ear Infection Contagious?

Middle ear infection is not contagious. It is not possible for children or adults to transmit otitis media to each other. However, middle ear infection usually occurs following a viral infection. These viral infections are contagious.

Why Do Babies and Young Children Get Ear Infections?

The Eustachian tube, a canal that runs from the middle ear to the back of the nose and throat, is shorter and horizontal in babies and young children. This causes the eustachian tube to become blocked more easily. However, young children have low immune systems.