Definition
Inflammation of the middle ear (Otitis media) is not uncommon in children. Most children contract it once during the first three to six years of life. The middle ear is an air-filled cavity in the skull bone, where the ossicles are located. These are important for the transmission of sound to the inner ear, where sound is then perceived. Inflammation of the mucous membranes of the middle ear can be caused by a bacterial or viral infection, which then leads to earache, fever and, due to accumulating secretions, to temporary hearing loss.
Causes
To the outside, the middle ear is limited only by the thin eardrum. There is also a connection to the nasopharynx. This connection is the tube (Eustachian tube).
It ventilates the middle ear and provides pressure equalization. Since it is still quite short and narrow in small children, germs can migrate better into the ear and cause an inflammation. In addition, the mucous membrane of the ear trumpet swells more quickly as a result (like the nose in the case of a cold, for example), so that drainage and pressure equalization are no longer guaranteed.
Above all, the lack of drainage is problematic, since a backlog of secretions promotes the growth of bacteria. The cause is often another infectious disease. For example, in the case of a cold, flu or tonsillitis, the pathogens can migrate via the auditory tube from the nasopharynx to the middle ear, where they then trigger an inflammation.
This irritates the mucous membranes and can lead to severe, stabbing earaches. During birth, amniotic fluid can also enter the middle ear via this route, where it can also lead to an inflammation. Further risk factors are, if the child is exposed to cigarette smoke, lack of breastfeeding in the first months and also contact with other children (for example siblings or in kindergarten).
Diagnosis
In order for middle ear infection to be diagnosed and because children are still too young to be able to speak for themselves, parents should be able to answer some questions from the doctor. On the one hand, the doctor needs to know how long the child has had the complaints and pain symptoms and whether the child has had middle ear infection or similar complaints before. On the other hand, it is important to know whether the child has or has been ill with a cold, flu, tonsillitis or similar symptoms.
Parents should observe whether pus is coming out of the ear and, if possible, check whether the child’s hearing is worse in one ear. During the examination, the doctor looks into the ear with an otoscope, a device with a magnifying glass and light, and examines the condition of the eardrum. In the case of an inflammation of the middle ear, it is often dull (not shiny as usual), strongly supplied with blood and bulging. In severe cases, the eardrum is torn and pus emerges.
