When Mayukhi Kumar, a six-year-old from Guwahati suffered from an upper respiratory infection, little did she and her parents know that it would lead to unbearable ear pain. “She had a bad cold and a cough, but after a week she started complaining about ear ache and tugging on her ears,” recalls her mother Moni Kumar. On examining, the doctor diagnosed her with acute otitis media in the right ear.
Otitis media is a medical term for middle ear infection. The middle ear is an air-filled space behind the ear drum. It is connected to the nose through the eustachian tube, and to the bone behind the ear called the mastoid bone, says Dr Ria Emmanuel, consultant ENT at Narayana Multispeciality, Bengaluru.
Read More: Anatomy of the human ear
Symptoms
Dr Girish Anand M S, consultant ENT surgeon, Aster CMI Hospital, Bengaluru lists out the symptoms:
- Itching in the ears
- Decreased hearing
- Ear pain
- Ear discharge
- Fever
- Giddiness
- Ear pulling
Causes
Otitis media can be caused due to viral or bacterial infection. It usually starts with upper respiratory infections, and spreads to the middle ear through the eustachian tube.
It is quite common among children because their eustachian tube is more horizontal than adults, says Dr Emmanuel. “The anatomy of these tubes in children makes them more susceptible to blockages and less efficient in draining fluids,” she adds. When fluids get trapped, they can get infected by viruses or bacteria, resulting in pain. If neglected, it can lead to chronic otitis media in children and adults.
Types
Acute otitis media (AOM): It lasts from a few days to a few weeks. The common symptoms of acute otitis media are ear pain and ear block, says Dr Emmanuel. “Sometimes, the symptoms could be pus or mucus discharge and we call it acute suppurative otitis media om (ASOM),” she adds. The eardrum is red and swollen.
Chronic otitis media: It lasts more than three months. “The pain would not be as bad as AOM. But an individual can experience decreased hearing, on and off ear pain and pus discharge,” says Dr Emmanuel. Small/middle/large perforations or holes in the ear drums can also be seen along with the discharge.
Otitis media with effusion: This may occur after an episode of acute otitis media, where the symptoms of the infection may subside, but fluid remains trapped in the ear. It can result in temporary and mild hearing impairment and increase the risk of another ear infections.
According to Dr Emmanuel, this infection can cause holes in the ear drum and tissue changes in the middle ear.
“In some cases, it starts involving the bones and it gets difficult to treat it with medicines. Infection can spread around the middle ear and the bone behind it and can cause complication in other parts of the body,” she adds.
Diagnosis
“A good history of exposure factors followed by a detailed ear, nose and throat examination is necessary to diagnose the condition,” says Dr Anand. An examination of the ear drum will reveal a congested ear drum, a bulge in the ear drum, ear bubbles behind it, fluid levels in the middle ear, blood stains or pus discharge from the ear drum or a hole in it with pus discharge, he adds.
Treatment
For Kumar, taking a course of antibiotics prescribed by the doctor for about a week helped relieve her symptoms and discomfort.
Dr Anand says that it is important to treat the underlying infections if any.
“A course of appropriate medicines mostly antibiotics, anti-allergy or anti-inflammatory medicines as a medical management, is given to the individual,” says Dr Anand.
“If it is chronic and severe and medications do not work, surgery as a procedure is advised,” adds Dr Emmanuel.
Prevention
Here are a few prevention steps advised by Dr Anand and Dr Emmanuel:
- Treat the upper respiratory infections like cold, cough or sinusitis at the earliest to prevent it from spreading to the ear
- Do not blow or clean the nose forcefully
- Avoid swimming or diving when you have a cold. It can lead to middle ear infection
- Maintain good hygiene of the ear
- Avoid oily and cold food
