Otitis

There are two types of otitis in children, otitis media and otitis externa. By their second birthday, the vast majority of children (90%) will have experienced one episode of otitis media.

Otitis media  is an infection of the middle ear cavity.

The eustachian tube brings the nasal cavity into communication with the middle ear. When the normal patency of the eustachian tube is blocked, due to upper airway infection or adenoid hypertrophy, bacteria gain access to the middle ear causing otitis media.

Most common etiology is a co-infection of both bacteria and viruses.

In infants the symptoms are non specific and include irritability (fussiness), fever and poor feeding. In older children the main manifestations are otalgia (ear pain), fever or otorrhea (ear drainage), after spontaneous rupture of the tympanic membrane. Symptoms of common cold may also be present.

Otitis media is diagnosed by examination of the ear by a paediatrician (otoscopy).

Treatment depends on the age of the child and the severity of the symptoms. Initially, the child may be given anti-inflammatory drugs (e.g. ibuprofen) for one to two days, and in certain cases the pediatrician may decide to prescribe antibiotics.

Otitis externa, also known as swimmer’s ear, is an inflammation of the external auditory canal .

It is usually caused by bacteria that may be present in swimming pools or lakes.

Symptoms include ear pain (typically reproduced by moving the earlobe with the hand) and purulent drainage from the ear. Fever is not usually present.

Diagnosis is also made by examination of the ear by the pediatrician with otoscopy.

Treatment consists of topical ear drops (containing antimicrobial and anti-inflammatory agents). Common analgesics (e.g. paracetamol, ibuprofen) are also administered.

Author: Ioannis Chastas