Otitis media: the causes and manifestations

Otitis media

What is otitis media

Otitis media — is an inflammatory disease of the middle ear associated with the ingress of infection. Can manifest pain in the ear, a rise in temperature, temporary hearing loss and general symptoms such as loss of appetite and irritability. The most frequent otitis media affects children due to the nature of their anatomy. Most often, the process begins with one ear, but then it can adhere to the second.

Otitis media in children by frequency of occurrence is in second place after the ARD. About 50% of the children to their first birthday has already suffered at least one episode of the disease. Many children recover without any treatment, others require antibiotics.


Acute otitis media must be distinguished from exudative otitis media, wherein the primary factor is the accumulation of fluid in the middle ear cavity. This leads to temporary hearing loss, which can last for quite a long time and lead to a delay in a child's development, problems with speech.


Factors contributing to the emergence and development of the disease:

  • Deficient immune system of children
  • Genetic and familial predisposition
  • Anatomical features of the structure of the ear and the nose
  • Malnutrition, vitamin A deficiency

Bacteria and viruses:

  • Three types of bacteria causing otitis media in 95% of cases: Streptococcus pneumoniae — Streptococcus (More often) Haemophilus influenzae — Haemophilus influenzae and Moraxella catarrhalis — moraksella.
  • Viruses are most commonly associated with otitis media: respiratory syncytial virus, influenza viruses, parainfluenza, rhinoviruses and adenoviruses.

Allergic diseases:

  • Many children with frequent ear infections also suffer from allergic rhinitis and bronchial asthma.

The influence of the environment:

  • Many studies report a reduction in the risk of otitis media during breastfeeding. According to the last of them, breastfeeding protects against otitis media, subject to continued feeding for 3 months. This reduces the risk of otitis media by 13%, and the protective effect lasts for several months, even after weaning.
  • The use of pacifiers — increases the risk of otitis media. It is assumed that this is due to a slight intake of bacteria in the Eustachian tube with frequent swallowing.
  • The role of passive smoking — Numerous studies support the fact that smoking adults with the child dramatically increases his risk of otitis media.
  • Visiting kindergartens — in close contact with other children increases the risk of infection by bacteria that are resistant to antibiotics.
  • Low levels of family life — combines many independent risk factors usually associated with smoking, artificial feeding, visiting a kindergarten, crowded living conditions.

The mechanism of development:

The human ear is divided into three sections: the outer (pinna), middle (the eardrum, hammer, anvil) and internal (the cochlea, auditory canals). Otitis media is called otitis media caused by any infection penetrated into it.

Inflammation often develops after suffering a cold or flu, because of which the local immunity is weakened nasal cavity and increases the amount of bacteria. The important role played by swelling of auditory tube, which connects the nasal cavity and average ear, thereby equalizing the pressure in them. Impaired function of the Eustachian tube leads to increased pressure in the middle ear (just as happens when you fly on an airplane), the accumulation of fluid and microorganisms, causing inflammation begins. As a result of accumulation of fluid (exudate) eardrum bulges out why there is pain and anxiety.

As the amplification process may form pus, which subsequently breaks through the eardrum and come out. Immediately after a patient's condition improves, the pain subsides and the temperature decreases. Eardrum tad worse hearing, but soon grows almost completely independently.

Complications of otitis media occurs when the pus gets into the cells of the temporal bone to the inner ear or under the lining of the brain, which is very rare.


Symptoms of otitis media in older children and adolescents usually appear suddenly and include ear pain and temporary hearing loss. Pain may be different intensity its amplification characteristic hours.
In young children, the average otitis may show the following symptoms:

  • High temperatures — more than 38 ° C
  • Baby missing or pulling at his ear
  • Discharge from the ear
  • Irritability, nervousness
  • Decreased activity and appetite, refusal to eat
  • Vomiting or diarrhea

Similar symptoms are observed:

Foreign bodies. Ear pain can be in contact with a foreign body, such as small items or parts of toys. Thus there is no rise in temperature, and precipitates out of the ear.

Water ear. Water may cause temporary hearing loss and discomfort. This can happen, for example, when bathing the child in the pool or pond. The temperature is normal, there is no pain.

Aural calculus. In the formation of cerumen reduced hearing in one ear. ENT doctor makes the diagnosis, remove the plug as it should.

Glue ear. Manifest hearing loss, discomfort in the ear. More common in older children and adults. Distinguish it from acute otitis media may only doctor after inspection.

The blood from the ear. There is never a symptom of otitis media. If the ear of the child's blood appeared, you should think about the injury — or scratch the ear canal, or serious head injury.

Complications of otitis media

Perforation (tear) of the eardrum — A common complication of otitis media. The gap associated with an increased pressure in the cavity of the middle ear and tympanic membrane thinning. After the rupture of the ear starts to pus, the pressure in the middle ear is reduced and most patients feel significant relief. Fortunately, the eardrum heals quickly — from several hours to several days. Pus from the ear is always an indication for antibiotics.
Hearing loss — The liquid that collects in the middle ear inflammation (exudate), difficult to see and hold sounds, thereby reducing the hearing. In many cases, the fluid remains in the ear for a few weeks after the disappearance of the main symptoms — of pain and temperature. In most cases, hearing loss is temporary, but often it can not last long, and the main danger here — the difficulty the child's communication and language learning.
In this regard, every child who has had otitis media, to show the ENT doctor after 4 — 6 weeks after recovery. If the doctor finds the presence of a liquid, it may recommend its removal — myringotomy and timpanostomiyu.
Suppurative complications — Develop very rarely when germs get inside the ear of the temporal bone, under the lining of the brain and the brain itself. These include mastoiditis, labyrinthitis, epidural abscess, brain abscess, thrombosis of the lateral and sigmoid sinus. Signs, which may be suspected, these complications are very high fever, deterioration, severe headache, confusion, vomiting.
With all kinds of suppurative complications need urgent hospitalization, additional examination and surgical treatment.

Prevention of complications

Prevention of complications of otitis media is the early detection and treatment of it early on. In the majority of cases it is possible to avoid perforation of the eardrum, not to mention the more serious consequences. For the early detection of otitis media should call the doctor at the first sign (rubbing baby ear, anxiety, temperature).


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