Acute otitis media

Acute otitis media is an infected middle ear filled with pus accompanied by pain when the fluid presses against the eardrum and redness around the eardrum and sometimes a fever. Children are more prone to ear infections than adults for a number of reasons. Their eustachian tubes are shorter and more horizontal than in adults, which mean that any bacteria find the tube easier to access. The tubes are also narrower and are not as stiff which means that they are easier to block. Children’s adenoids are larger and as they are near to the entrance of the Eustachian tube, they can obstruct the entrance and cause them to block. As if all of those factors are not sufficient to conspire against a child then the fact they do not have developed immune systems before the age of seven does not help. That means that they are more prone to external pollutants such as cigarette smoke.

Even after antibiotics the fluid can remain in the ears for several months and that means there is no single treatment. The doctor will take into account the severity of the case, how often it occurs, and how long the infection has lasted for and whether the hearing has been affected. It is not unusual for a doctor to recommend that no treatment is appropriate. There are many reasons for this not least of which is that antibiotics have only minimal effect on the pain, and will not have any impact in the first twenty four hours. They do not eliminate the fluid and if a virus has caused the infection then they will have no impact. The use of antibiotics leads to bacteria becoming resistant to antibiotics and future treatment is then placed in jeopardy. In extreme cases tympanostomy tubes or grommets may be inserted in the tympanic membrane. This equalizes the pressure and allows the fluid to drain.

Glue ear

Glue ear is prosaically named; it is a condition whereby the middle ear is filled with a fluid that looks like glue. It may affect one or both ears, but it dampens any vibration from the eardrum which means that the cochlea cannot hear the full sound, and it appears that a volume control has been turned to very low in the ears. Glue ear usually occurs in young children, seven out of every ten children before the age of four have suffered from it. However it can develop at any age. It is more common in children that live in homes that have a smoker, where children have frequent ear infections, and also when their siblings have had the condition. There is evidence that there is an increase of the incidence of glue ear when a child has not been breast-fed.

Medicines rarely work, though in some cases a child blowing up a balloon using the air from the nose helps the condition. Unfortunately this can be hard for small children to do. In extreme cases a grommet or ventilation tube is inserted they normally stay in position for about six months and then they fall out. Normally the fluid has drained by the time they fall out, but in rare cases the operation has to be performed again.