It seems there’s nothing more frustrating to parents than a child who suffers from ear infections, especially recurrent ear infections. Their questions are usually the same – how did my child get an ear infection, what can we do to treat it, will it come back, or when will these frequent ear infections go away?
Ear infections, specifically otitis media, are most commonly due to a malfunction in the eustachian tube which is a small canal that connects the middle ear cavity. An upper respiratory infection may cause the eustachian tube to become plugged and fluid to accumulate in the middle ear space.
When fluid is present, the eardrum doesn’t move properly resulting in a hearing decrease. Also, fluid is a prime breeding ground for bacteria to grow. Bacteria often travel to eustachian tube from the back of the throat and as they multiply, the body’s own defenses begin to fight the infection. This can cause more fluid to accumulate and pressure to build against the eardrum. The end result is an ear infection complete with fever, pain, excessive crankiness, decreased appetite and poor sleeping.
Now here’s where the confusion and frustration may set in. A child may have more subtle symptoms, yet still have an ear infection. “If a patient suspects his or her child isn’t acting quite right, or the child’s hearing seems somewhat affected, it is important to check the middle ear for fluid,” says Dr. Melanie Goodell. “Ear infections can happen so quickly. Within a matter of hours, a happy, seemingly healthy child can have a raging infection in one or both ears.”
So what is the best treatment for an ear infection? Up to fifty percent of ear infections will resolve without antibiotics. If self resolution does not occur, an appropriate antibiotic will kill the bacteria and should prevent additional fluid buildup. When an antibiotic is given by mouth, it is absorbed in the blood stream and carried to all areas of the body, including the infected middle ear. Repeated daily doses eventually eliminate all the bacteria, however the fluid may still remain for as long as three months.
Over time, the fluid usually drains out of the middle ear through the now healing eustachian tube. As it drains, the air returns, the eardrum begins to move properly and normal hearings resumes. Here’s the catch, though: the ears may be clean for awhile, but the onset of another cold may cause the infection cycle to repeat. Also, blood flow is minimal in this area and occasionally, repeated doses of antibiotic may be necessary over a period of time.
“If your child has repeated episodes of otitis media, we may recommend low doses of antibiotics daily, especially during the cold season, ” says Dr. Diane Fondriest. “This type of antibiotic maintenance may prevent bacteria from multiplying, even though the ear may have fluid in it.”
If fluid remains in the ear, usually for three months or more, or if a child does not respond well to long-term, low-dose antibiotic therapy, tympanostomy tubes may be indicated. These tubes are surgically implanted and allow the fluid to drain, the eardrum to operate normally and help restore hearing.
“Because ear infections are so typical in young children and occur when a child is starting to learn words and understand language, attention to ear infections is very important,” adds Dr. Sheri Ross. “There’s no question that an ear infection can be a frustrating experience. But, today we know more about them and we’re using this research to try to combat ear infections in a caring, effective way.”
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