Otitis Media 

Brief History Of The Disease:-

Otitis media is one of the most common diseases among children, and it often occurs due to a bacterial or viral infection, and it may cause some secretions to come out of the ear as an advanced symptom of the disease that requires going to the doctor immediately, A child who suffers from persistent ear infections may need tests for both hearing and speech skills And It is considered one of the most important risk factors that lead to the infection of the infant with otitis media is to breastfeed him in a lying position.

Introduction:-

Otitis media is most often caused by a bacterial or viral infection affecting the middle ear, which leads to the accumulation of fluid behind the eardrum, This disease is one of the most common diseases among children, as they are affected more than adults, and the cause is due to several factors, including:

·         The shortness of the Eustachian tube (a thin tube that runs from the middle ear to the back of the nose) and thus easy transmission of viruses and bacteria from the nose or pharynx to the middle ear and the occurrence of inflammation.

·         Immunodeficiency in children compared to adults makes them generally more susceptible to infectious diseases.

Types of otitis media:

Type I: acute otitis media:

It is caused by a bacterial or viral infection in most cases, and it may be a complication of an upper respiratory or sinus infection, and these symptoms usually disappear with treatment of the infection causing the disease.

Type II: otitis media accompanied by a cold:

It occurs as a result of the accumulation of fluids and mucous secretions inside the ear as a result of several reasons, including obstruction of the eustachian tube after infection in the upper respiratory tract, the occurrence of cold, the accumulation of mucous secretions inside the ear, as well as the poor performance of the Eustachian tube for its function; This is usually due to cleft palate, frequent colds, or barometric shock.

Type III: Chronic otitis media:

This type occurs as a result of delayed treatment of acute ear infections, which leads to the accumulation of fluids and secretions for two weeks or more, and consequently, waxy gatherings that may reach the eardrum, and their large number may lead to secretions from the ear.

The causes of disease :

·         Respiratory infection, such as a cold or the flu.
·         Allergy.
·         Exposure to cigarette smoke.
·         Adenoiditis or tonsillitis.
·         For infants, it is because milk leaks into the baby's ears during feeding.

Symptoms of the disease:

Children:

·         Earache, especially when lying down.
·         difficulty sleeping
·         Crying more than usual and pulling the ear.
·         Not responding to sounds.
·         loss of balance
·         High temperature ( ℃ 38 degrees Celsius or higher.
·         secretions from the ear;
·         Anorexia.

Symptoms of the disease in adults:

·         pain in the ear.
·         difficulty sleeping
·         secretions from the ear.
·         Hearing impairment.

When should you go to the doctor:

·         If symptoms persist for more than one day.
·         The presence of severe pain in the ear.
·         Exudate or blood from the ear.
·         The presence of symptoms in a child less than 6 months old.
·         Difficulty sleeping when a child has a cold or other upper respiratory infection.

Diagnosis:

• An ear infection is diagnosed based on the symptoms described. Your doctor will likely use an otoscope in addition to:
•  Middle ear efficiency test.
•          Acoustic reflexometry (sound response).
•          Perforation of the eardrum with a small syringe to extract a sample of the inflammatory fluid in the inner ear.
• If a child has persistent ear infections or a persistent buildup of fluid in the middle ear, the doctor may refer him or her to an audiologist, speech therapist or developmental therapist to test hearing, speech skills or language comprehension.

Risk factors:

·         Children between the ages of six months and two years.
·         Breastfeed the baby while he is lying down.
·         Seasonal illnesses such as colds and influenza.
·         People with seasonal allergies.
·         Exposure to tobacco smoke and polluted air.

Complications:

Repeated infection and persistent fluid buildup can lead to some serious complications:
·         Hearing impairment.
·         Delayed speech or developmental skills in children.
·         Spread of untreated inflammation to nearby tissues.

treatment:

·         If the infection is simple or viral, it is recommended to monitor the child and see the doctor regularly until the infection clears.
·         If the infection is recurring and worsens with time, and the symptoms are severe, the patient needs treatment in this case, and the doctor will dispense antibiotics if the cause of the infection is bacterial, and they are oral or as an injection, and it must be ensured that the child takes the antibiotic daily and not stop it before complete Duration of treatment, even if there is an improvement in the condition.
·         If it's due to an allergy, decongestant or antihistamine ear drops may help relieve symptoms.
·         If the condition is difficult and does not respond to antibiotic treatment, the doctor may have to make a hole in the eardrum to allow the pus fluid collected from the ear.

protection:

·         When colds occur, it is preferable to treat the infected, especially children, and not neglect their treatment so as not to develop into an infection of the middle ear.
·         When a child has recurrent middle ear infections (four or more times a year), he may need to take an antibiotic.
·         Care must be taken to monitor the child's health constantly, especially if he is exposed to frequent infections in the middle ear.
·         Ensure that the child has his or her routine vaccinations.
·         Not exposing the child to cigarette smoke, shisha and others (passive smoking).
·         Keep the child away from the injured.
·         Always keep the baby's head slightly elevated while feeding.
·         Breastfeeding for at least 6 months strengthens immunity and makes the baby less susceptible to ear infections.