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There are two basic types of ear infections:
- Middle ear infection (otitis
media) are caused by infected fluid in the small space deep
behind the ear drum.
- Swimmer's ear (otitis externa)
is an irritation of the outer ear canal, and does not involve
the middle ear cavity.
WHY DO SOME CHILDREN
GET MORE MIDDLE EAR INFECTIONS THAN OTHERS?
Almost every child will have at least
one middle ear infection in their childhood. About 15% of children
experience recurrent infections. Children at highest risk for ear
infections are:
- children under 2 years of age
- those with a family history of
frequent ear infections
- daycare attendees
- children exposed to cigarette smoke
Children who are breastfed generally
have fewer ear infections than others. Water in your ears, or
exposure to cold winds and drafts, does not cause ear infections!
SYMPTOMS OF MIDDLE
EAR INFECTIONS
Ear infections typically occur during
the course of head colds. Several days after the onset of a cold, your
child may suddenly complain of excruciating ear pain, and have a new
fever. Symptoms often appear at night.
Not all children complaining of an
earache have an ear infection! Air pressure built up behind the ear
drum, foreign objects in the ear canal, and sore throats often cause
children to complain about and earache.
We cannot diagnose ear infections
over the phone. An office visit is always necessary for us to determine
what is wrong.
TREATMENT
Approximately 70% of all ear infections
will go away on their own (without treatment) within 3 days.
- Control the pain. Although the
infected area is quite small, pressure building up behind the ear
drum can be very painful! Children can be given Acetaminophen
(Tylenol), or Ibuprofen (Advil or Motrin) for the pain. We often
recommend anesthetic ear drops or warmed mineral oil dropped into
the ear canal.
- Antibiotics. Some middle ear
infections require the use of an antibiotic for treatment. Remember
that it takes up to 2 days for an antibiotic to start relieving pain
and pressure.
POSSIBLE
COMPLICATIONS OF MIDDLE EAR INFECTIONS
- Recurrent infection: Some
children whose ear infections respond easily to antibiotics get
recurrent episodes of infection. We may
choose to place these children on a low dose antibiotic throughout
the winter months ("antibiotic prophylaxis"). Children
treated in this way may have dramatically fewer and less severe
infections.
- Persistent middle ear fluid: After
an infection is treated, a non-infected thick fluid often persists.
This fluid may last up to 3 - 4 months. Sometimes, despite
antibiotics and time, middle ear fluid will not go away. Children
with persistent middle ear fluid beyond 3 - 4 months are generally
referred to an ear/nose/throat surgeon (otolaryngologist) who will
consider surgically draining the fluid, and placing
"ventilation tubes" through the ear drum to prevent future
accumulation of middle ear fluid.
- Ruptured ear drums: About 5%
of all ear infections involve a spontaneous rupture of the ear drum.
Pus and bloody fluid will leak out of the ear canal. Ruptured ear
drums usually heal during the course of treatment, make the pain go
away, and are not considered a serious complication.
- Hearing loss: Ear infections
or fluid in the middle ear cavity may cause temporary hearing loss.
This will resolve as the middle ear fluid resolves. Permanent
hearing loss is extremely rare with any ear infection.
SWIMMER'S EAR (OTITIS
EXTERNA)
Frequent swimming often washes
protective wax out of the ear canal, making the canal dry, cracked,
irritated, and prone to infection. Swimmer's ear is almost always seen
in the summer, is not associated with head colds, and occurs in the
older school-aged child. Gently tugging on the outer ear worsens the ear
pain.
Swimmer's ear can be treated by using a
mixture of one part white vinegar, one part tap water. Put 4-6 drops of
this mixture in the ear canal 4 times a day for one week. To help
prevent repeated infections, 2 drops of the vinegar/water solution can
be instilled in the ear canals after swimming is done for the day. WEB
LINK
Learn more about earaches in children.
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