Zellers

Otitis media is a middle ear infection that is most common in infants and young children. By the age of one year, most children will have had one or more middle ear infections. Although a middle ear infection can occur at any age, it's much less common in older children and adults.

The middle ear is connected to the throat by a small tube called the eustachian tube. It's protected from the outside by a thin shield called a membrane. Viruses and bacteria that normally live in the throat can sometimes cross into the middle ear - through the eustachian tube - causing an infection.

Winter is high season for ear infections. They often follow a cold. Some factors that increase a child's risk for middle ear infections include:

• crowded living or daycare conditions
• exposure to secondhand smoke
• respiratory illnesses
• close contact with siblings who have colds or ear infections
• having a cleft palate
• allergies that cause congestion on a chronic basis

Barometric trauma is another risk factor for a middle ear infection. The pressure in the middle ear rises when the airplane you are travelling on descends or when you ascend while scuba diving. If the eustachian tube is not open, the pressure in the middle ear cannot be equalized, and thus, may cause injury, which increases the risk of an acute ear infection.

Middle ear infections can be categorized as acute, serous, or chronic.

Common symptoms of acute otitis media are fever, pain, and irritability. In children, the ear infection often begins after the child has had a cold for several days. You may notice your child tugging at their ears.

It's more difficult to detect signs of ear infection in young babies. You may notice a change in mood or feeding, and the infant will most likely have a fever. Because ear infections are usually painful, many babies will be irritable.

If fluid builds up in the ear, the infection is called serous otitis media. This occurs when the eustachian tube becomes blocked, and pressure in the middle ear drops. Under these circumstances, the child might experience hearing loss or impairment in the infected ear. This is usually only temporary. While this is usually no cause for alarm, anyone who experiences hearing loss or impairment should consult their doctor (and expect a follow-up).

Chronic otitis media refers to a long-lasting ear infection. This is often complicated by (or caused by) a hole in the eardrum (perforation) from any one of the following:

• acute infection
• blocked eustachian tube
• heat or chemical burns
• injury from sudden air pressure changes
• injury from an object entering the ear

Chronic ear infections often flare up after a cold, or, if perforated, when water enters the ear during swimming or bathing. Repeated or long-lasting infections can destroy the small bones in the middle ear, leading to long-term hearing loss. More serious complications include spread to nearby organs, appearing as inflammation of the inner ear, facial paralysis, and brain infections.

Based on a visual examination and description of the symptoms, your doctor can diagnose otitis media. In an infected ear, the eardrum usually appears red and swollen. If pus is draining from the ear, a sample can be sent for lab analysis, to identify which type of bacteria is causing the infection.

When fluid builds up in the middle ear, the doctor can perform a tympanometry. This is a simple hearing test that measures the pressure on both sides of the eardrums.

Otitis media is often treated with antibiotics. To lower the chances of the infection returning, it's very important to take the antibiotics regularly and finish the entire course of treatment even if the symptoms improve quickly. Many of the infections are actually caused by viruses and, in some cases, a short period of watchful waiting rather than antibiotics may be appropriate for children who neither have recurrent infections nor structural differences in their ears.

For adults and children over the age of 6, cold medications (such as decongestants) may be useful for keeping the eustachian tube from becoming blocked. Antihistamines may help people who have allergies. But neither of these medications will cure the ear infection. Pain relievers can be used to ease the pain of the infection and to lower a child's fever. Holding warm cloths over the sore ear may also provide some relief.

Fluid buildup in the middle ear can be drained. In a procedure called a myringotomy, a tiny tube is inserted into an opening of the eardrum that drains fluid away and allows air to reach the middle ear which equalizes the pressure and often allows drainage down the eustachian tube. The cause of fluid accumulation must also be treated. For instance, if allergic reactions are to blame for blocking the eustachian tube, then antihistamines can be given to relieve allergies.

If the child has a permanent hole in his or her eardrum that's causing chronic otitis media, the eardrum itself may be repaired by a procedure called a tympanoplasty.

It's hard to prevent ear infections since many children, especially those who attend daycare, are susceptible to colds. Careful hand-washing regimens can help reduce the chance of catching colds, so it's important to remind your kids to wash up as often as possible.

Breast-feeding seems to lower the chances of developing ear infections among infants and children by helping to boost their immunity. Another good preventative measure is to keep your home smokefree as smoking increases the risk of middle ear infections. Immunization with the pneumococcal vaccine can lessen the likelihood of getting ear infections caused by certain types of bacteria.