Mr Nigam ENT Treatments - Otitis Media
Otitis media means inflammation of the middle ear (the space behind the ear drum). Many different conditions are lumped together under the term otitis media - including infections due to a number of different viruses or bacteria, or the presence of different types of uninfected fluid.
The presence of middle ear fluid and redness or inflammation of the ear drum is usually referred to as acute otitis media, is typically due to bacterial infection, and is usually treated with antibiotics. Chronic otitis media means long-standing middle ear fluid (with or without infection). Fluid in the ear, without signs of infection or inflammation, is usually called otitis media with effusion or serous otitis media.
Symptoms
Many families reach the conclusion that allergies play a major role in their child's ear or nose/sinus problems. While the answer to this is controversial, we feel that the evidence for this is very weak. The symptoms (especially nasal drainage) looks like it may be allergic, but biochemical and immunologic analyses usually suggests infectious causes (viruses and bacteria) as opposed to allergy, especially in the child less than 3 years of age.
The role of inhalant allergies in precipitating ear infections, we feel, has NOT been supported by sound studies and the role of "food allergies" is even more difficult. Obviously, there are occasional exceptions. More obviously, the biggest proponents of an allergic cause are those individuals and groups who make their living off of allergy diagnosis or therapy.
What about resistance to antibiotics?
This is one of the major challenges facing those of us treating otitis media. Interestingly, the problem is not as visible to many families and clinicians as it might be because most of the infections (unfortunately, not all) improve regardless of whether antibiotics are used and whether antibiotics really work well or not. Amoxicillin is still considered the most appropriate initial choice, even though it does not work in all cases. The pneumococcus, which can be a very dangerous bacteria, remains relatively more susceptible to amoxicillin than most of the other choices; and amoxicillin has a long record of safety. Finally, many parents feel like antibiotics aren't working when the child suffers several different infections within a short time. This may not reflect a treatment failure at all; just a new infection - often as a result of increased exposure to other children and the viral infections that set the child up for an ear infection.
When will my child outgrow the problem?
The majority of children with otitis media outgrow the problem sometime between two and three years old. Well over 90% improve by school age. Only a
very small percent of children continue to have problems into adolescence. The presence of other problems - such a a history of cleft palate or adenoid
disease may prolong middle ear disease.