Declaration
Inflammation of the middle ear (otitis media) is a common disease in young children. Almost every child falls ill with middle ear inflammation once up to the age of 4. This disease causes inflammation of the part of the ear located behind the eardrum (= middle part).
From here there is a connection to the throat, the so-called Eustachian tube. It is normally responsible for the ventilation of the ear and also for the pressure equalization between the outside world and the tympanic cavity. In children, this trumpet is still very small and relatively narrow, which means that if the mucosa swells, this passage can easily be blocked. Then secretion accumulates there and an inflammation can develop.
Symptoms
Signs of otitis media in infants may include frequent rubbing of the ear, constant touching of the ear, indication of pain, especially when touching in the ear region, and frequent crying/crying. Unspecific symptoms of the disease can also be present. For example, general weakness or restlessness, vomiting and diarrhoea, fever and chills or even loss of appetite are possible.
If the children are already a little older (4 years or older), they can often localize the pain precisely and also indicate that they hear less well on one side. In addition, the development of a fever is less frequent here than in younger children. Fever is a possible symptom of middle ear infection (otitis media) in young children.
It does not necessarily occur, but is often a concomitant symptom. A fever is defined as a temperature of 38.5 °C or higher. Temperatures between 37.6-38.5 °C are called subfebrile.
In small children, an attempt can first be made to control the fever with calf compresses. The child should also drink a lot. If the fever does not go down within a few hours, the treating pediatrician should be consulted.
He or she can then decide whether a drug treatment is necessary to reduce the fever and whether the middle ear inflammation also requires drug treatment. Pus develops during an inflammation, usually in response to contact with bacterial pathogens. These pathogens often rise up to the ear after an infection of the respiratory tract or tonsils.
Due to the anatomical conditions in children, inflammation of the middle ear is more common in this case. This has to do with the fact that the outflow from the middle ear (the Eustachian tube or ear trumpet) is often relatively narrow, secretion accumulates and bacterial colonization is favored. If pus forms in the middle ear, this leads to increased pressure on the eardrum and pain increases.
During an ear examination, the doctor can see whether pus is located in the middle ear, i.e. behind the eardrum. In some cases, the pressure the pus exerts on the eardrum can be so great that the eardrum ruptures. Clinically, this perforation causes the earache to subside very suddenly because the pressure on the eardrum is gone.
The pus then runs out of the ear as a yellowish liquid. Pain is probably the most typical symptom of an inflammation of the middle ear and will be all too familiar to most parents. This pain is caused by the inflammatory reaction in the middle ear and the accumulation of secretions that exert pressure on the eardrum.
The children are often in great pain and cry a lot. The pediatrician can prescribe mild painkillers to make the pain more bearable for the duration of the disease. Here, for example, paracetamol or ibuprofen come into question.
Paracetamol is available as suppositories or tablets, ibuprofen is available as juice or in tablet form. An inflammation in the area of the middle ear leads to swelling of the affected areas. There is often secretion in the ear, which cannot drain off sufficiently due to the swelling.
The inflammation and the congestion of secretion often lead to the children’s hearing in the affected ear being impaired. The hearing loss usually disappears completely once the acute inflammation of the middle ear has subsided. Inflammation of the middle ear in small children does not necessarily have to be treated with antibiotics.
Only about half of middle ear infections are caused by bacteria, the other half by viruses. However, antibiotics do not help against viruses and not every bacterium can be fought by every antibiotic. Usually, the children receive adequate fever and pain treatment, e.g.B.
with paracetamol or ibuprofen and if necessary decongestant nose drops. These can relieve nasal breathing in the short term, but probably have no influence on the actual course of the disease. They should also not be used regularly over a longer period of time.
If purulent secretion runs out of the ear or if the symptoms do not improve within a few days, it may still be necessary to use an antibiotic. Children often find warmth pleasant. This can be provided by irradiation with red light or by a warmed pad, for example.
If the inflammation of the middle ear persists over a longer period of time, it is possible to insert small tympanic tubes into the eardrum and thus ensure adequate ventilation of the middle ear. They also help with the drainage of secretions so that the pressure in the middle ear is reduced. In addition, so-called adenoids can often be responsible for chronic middle ear inflammation.
These are growths of the tissue on the palatal tonsil that swell when there is an inflammation of the airways and thus block the ear trumpet so that the secretion can no longer flow from the ear into the throat. An operation in which these polyps are removed can be helpful here. Home remedies for middle ear infectionsOnion and chamomile bags, for example, are proven home remedies for relieving symptoms of middle ear infections.
Chopped pieces of onion or chamomile flowers are placed in a thin cloth bag and placed on the aching ear several times a day for about half an hour. A red light lamp that warms the affected ear is also good for many children. Calf compresses are considered a household remedy for high fever.
Here towels are given, wrung out and then wrapped around the calves with water that is somewhat cooler than body temperature. The warm towels can be renewed 2-3 times. These products are used to alleviate symptoms, but are no substitute for medical treatment.
A child with otitis media should always be presented to the treating pediatrician. In the past, most middle ear infections were treated with antibiotics. Nowadays, this is somewhat different, but the use of antibiotics for middle ear infection varies greatly from country to country.
While in the USA almost all children with a middle ear infection are treated with antibiotics, in Germany it is only about 1/3. The general use of antibiotics is no longer common here. This is mainly because studies have shown that the disease heals spontaneously (i.e. without antibiotics) as quickly as with antibiotics.
In special cases, however, antibiotic therapy should be started early on. For example, studies show that the administration of antibiotics can be useful in children under 2 years of age with bilateral middle ear inflammation and high fever, as well as in children in poor general condition and children who have had previous middle ear inflammation with complications. In most uncomplicated cases, however, the middle ear infection heals completely within a few days, even without antibiotics.
If the symptoms do not improve after 48 hours of treatment with symptomatic measures such as painkillers and nose drops, antibiotic therapy should be started. Of course only after consultation with the treating pediatrician. Amoxicillin is the first choice for the antibiotic treatment of middle ear inflammation in children.
For children with a known allergy to penicillin, so-called macrolides such as erythromycin can be used as an alternative. Nowadays, there are pathogens that can cause inflammation of the middle ear but are resistant to amoxicillin. Here, for example, a combination therapy of amoxicillin and clavulanic acid helps.
The antibiotic therapy should – after consultation with the doctor – usually be carried out over at least 5 days. There are various homeopathic remedies that are intended to help relieve the symptoms of middle ear inflammation: Aconitum napellus (blue wolfsbane), Belladonna (deadly nightshade), Chamomilla (chamomile), Ferrum phosphoricum (iron phosphate), Pulsatilla pratensis (meadow cow pellet), Dulcamara (bittersweet), Hepar sulfuris (calcified sulphur liver), Potassium bichronicum (potassium bichromate). Of Aconitum napellus, Belladonna, Chamomilla, Ferrum phosphoricum, Pulsatilla pratensis and Dulcamara three globules or one tablet can be taken every half hour. Hepar sulfuris and potassium bichronicum should not be taken more than three times a day.The homoeopath of confidence should be asked more precisely which of the remedies should be used best in each individual case. A homeopathic treatment does not replace a medical consultation in any case.