Otitis in children: causes of the disease and ways to prevent it. Probable causes and symptoms of otitis media in young children

Otitis in children - causes and treatment

Inflammation of the middle ear, in addition to pain, may be accompanied by fever, general lethargy, runny nose. In some cases, acute otitis media quickly turns into a purulent form, affecting the eardrum, which increases the risk of this disease becoming chronic. Minor injuries of the ear and manipulation of sharp objects in it can cause traumatic otitis media. Another common cause of this disease is chronic foci of infection in the paranasal sinuses, nasopharynx, or tonsils.

Can otitis media be treated on its own?

You can only suspect a disease, but a pediatrician should examine the child, make a diagnosis and choose the appropriate treatment. Modern therapy for otitis media includes antibacterial and anti-inflammatory drugs, compresses and physiotherapy, nasal irrigation and general therapy. For a person without a medical education, the appointment of such treatment is an impossible task. If the child is observed by a homeopath, his advice can also be very helpful. In chronic otitis, removal of the adenoids is sometimes recommended. The solution to this issue does not depend on the wishes of the parents, but on an objective necessity.

What can not be done with otitis?

If the child's temperature rises above 38ºС, warming compresses are contraindicated for the baby (as well as other physiotherapy procedures - for example, inhalations). This may worsen his condition. Boric alcohol, previously widely used to treat otitis media, can cause burns to the skin of the ear canal and eardrum, so it is better to refuse its use.

Why is otitis media dangerous for a child?

Lack of treatment, inadequate or incomplete therapy can cause complications: hearing loss, chronic otitis media, facial nerve paresis, acute mastoiditis (inflammation of the mastoid process of the temporal bone), irritation of the meninges.

How does otitis media usually progress in children?

The disease usually begins as a common ARVI. Ear damage can be one- and two-sided and occurs from the first day of illness or on the second or third day. Ear pain - the main symptom of acute otitis media - is often accompanied by fever, general lethargy of the child, runny nose. In some cases, acute otitis media can turn into a purulent form, affecting the eardrum. This increases the risk of developing a chronic form of otitis media, the signs of which are an open hole in the eardrum, hearing loss and pus from the ear.

How to recognize otitis in young children?

Otitis in children under the age of one year often occurs in a latent form. While the child is small, it can be difficult to establish the correct diagnosis. A baby can turn its head, refuse to eat, turn away from the mother's breast. If the baby rubs and pulls on the ear, this can be either a sign of pain or just a habit. To determine pain, you can click on the protrusion near the auricle (tragus). If the ear does not hurt, then the child most likely will not respond to this pressing.

What is the cause of frequent otitis media?

The Eustachian tube, which connects the throat with the tympanic cavity, is still very short in young children, and its wide opening is located in close proximity to the adenoids. If the baby has a runny nose or sore throat, then the discharge easily penetrates into the middle ear area, infecting the eardrum. Chronic foci of infection in the paranasal sinuses, nasopharynx or tonsils, nasopharyngitis, enlarged adenoids, recurring colds contribute to the frequent penetration of infection from the pharynx into the ear. In addition, a constant horizontal position in children who are not yet able to crawl and walk interferes with the outflow of mucus from the nasopharynx. No less dangerous and too intense blowing your nose.

Video. Otitis in a child - what to do?

How to protect your child from a cold:

Otitis (inflammation of the ear) is a fairly common disease in children, especially at an early age. Since the main symptom of this disease is excruciating pain in the ear, it is important for parents to know how to alleviate the suffering of the child. All otitis media are divided into external, middle and internal (but internal otitis media is often called labyrinthitis). If a child has symptoms such as severe pain in the ear, discharge from the ear, and the like, you should immediately contact an otolaryngologist (ENT) for treatment, self-medication can be dangerous!

Otitis externa

Otitis externa develops when an infection enters the skin of the ear canal, for example, with constant contact with water while swimming. It can occur when performing a hygiene procedure (cleaning the ears). There is swelling and redness of the skin in the external auditory canal. In some cases, discharge from the ear canal may appear.

Damage to the outer ear can occur with erysipelas, when streptococcus penetrates through microcracks in the skin. The temperature suddenly rises to high numbers, this is accompanied by chills, the baby refuses to eat. In addition to redness and swelling, blisters may appear on the skin of the auricle and in the external auditory canal.

Otitis externa can also develop with a boil or inflammation of the hair follicle in case of reduced resistance of the child's body. On external examination, the furuncle is not visible. It causes pain in the ear, aggravated by chewing, by touching the tragus (protrusion above the earlobe). Parotid. After a few days, it matures, and the abscess opens, then the pain decreases. Timely initiation of treatment of otitis externa leads to a favorable outcome of the disease.

Otitis media

According to the nature of the course, otitis media can be acute and chronic. There are serous and purulent acute otitis media.

There are several causes of otitis media:

• inflammatory process in the nasopharynx: the infection enters the ear through a wide and horizontally located auditory tube (Eustachian tube) in children, connecting the nasopharynx with the ear; the outflow of fluid from the middle ear through the inflamed auditory tube is disturbed, the fluid accumulates in the middle ear and becomes infected;
• violation of the temperature regime (hypothermia or overheating of the child);
• improper feeding of the baby (in the supine position): breast milk or mixture can enter the middle ear from the nasopharynx;
• Availability ;
• weakness, especially with artificial feeding.

The onset of the disease is acute, sudden, often at night. A small child wakes up from severe pain in the ear and screams piercingly, cries without ceasing. The temperature can reach 40 ˚ C, sometimes vomiting appears and. The kid turns his head, can rub or cover the sore ear with his palm, preventing him from touching it.

When the baby is sleeping, you can try to lightly press on the tragus. If the child pushes back the head, frowns or cries, then this confirms the inflammation of the ear, and you should immediately consult a doctor.

Attempts by parents to self-treat a child can lead to complications: the spread of infection to the airway in the behind-the-ear region. The timing of the appearance of this complication (mastoiditis) is different, shortly after the onset of the disease or after some time.

With serous or catarrhal otitis, fluid accumulates in the middle ear, which leads to hearing loss. The main manifestation of catarrhal otitis is severe pain, due to which the child does not sleep, pulls his ear with his hand. If the process is one-sided, then the baby tries to take a forced position: lying on the side of the lesion.

The pain intensifies when swallowing, so the child refuses to eat. During the examination, the doctor sees redness and protrusion of the eardrum. With timely treatment, such inflammation disappears after a few days.

Acute suppurative otitis media

Acute catarrhal otitis can quickly (even during the first day) turn into purulent. Purulent discharge from the ear appears, indicating that the eardrum has burst, and pus flows into the ear canal. The pain in the ear is reduced.

The appearance of purulent discharge from the ear is an indication for urgent medical care. You should put a wick (turunda) rolled from a bandage into the child’s ear, put on a hat and go to the doctor.

In some cases, the doctor himself makes a puncture (paracentesis, or puncture) of the eardrum to ensure the outflow of pus through the puncture hole. Healing at the puncture site then occurs within 10 days. At this time, careful care is taken for the ear of a small patient.

Chronic otitis media

The transition of otitis into a chronic form is most often noted with a reduced body resistance as a result of the presence of concomitant pathology (, frequent, deviated nasal septum, adenoids, etc.).

The main symptoms of chronic otitis media:

• prolonged non-growth of the hole on the eardrum;
• discharge of pus from the ear, recurring periodically;
• hearing loss (the intensity of which increases with a long process);
• undulating course of the disease.

Complications of otitis media

With untimely treatment or a lightning-fast course of the process, serious complications can develop:

• paresis of the facial nerve;
• hearing loss;
• mastoiditis (inflammation of the mastoid process of the temporal bone);
• (inflammation of the meninges);
• damage to the vestibular apparatus (an organ that responds to changes in the position of the body and head in space).

Features of the course of otitis media in children under one year old

Acute respiratory diseases in children under one year old can often be complicated by otitis media. Since the baby cannot explain what hurts him, the mother should carefully monitor the sick child so as not to miss the onset of otitis media.

Most often, the main sign of ear inflammation in young children is a sharp anxiety, seemingly unreasonable outwardly. The baby becomes moody, often crying loudly. Crying is aggravated by an accidental touch to the ear. Sleep becomes restless: in the middle of the night, the baby may wake up screaming.

The appetite also worsens: during feeding, the child, having taken 2-3 sips, suddenly throws the mother’s breast or a bottle with the mixture and “rolls up” crying. And this is due to the fact that when sucking and swallowing, the pain in the ear increases.

Sometimes in children under one year old with otitis media, vomiting and diarrhea are noted; are possible .

Features of the treatment of otitis in children under one year old are that ear drops are not prescribed, and only 0.01% Nazivin is instilled into the nose.

Otherwise, treatment is carried out in the same way as in older children (see below).

Treatment of otitis media in children

An appeal to an otolaryngologist is mandatory in any case of a child with pain in the ear. If a discharge (especially purulent) appears from the ear, you should seek medical help immediately.

Otitis media is treated on an outpatient basis. Hospitalization is indicated only in case of a severe course of the disease.

What can be done at home?

In no case should you self-medicate. Before visiting a doctor, you can only give your child an antipyretic at an age dosage (Paracetamol, Nurofen; older children - Nimesulide, etc.). These drugs will also reduce ear pain.

The nasal passages should also be cleared for free breathing (let the child gently blow his nose, and in younger children, suck the mucus out of the nose with a douche).

It is dangerous to bury ear drops before a doctor's examination, since in the event of a rupture of the eardrum, the drops can enter the middle ear cavity and damage the auditory nerve or auditory ossicles, which will lead to hearing loss. It is better to use a turunda from a bandage instead of direct instillation of drops: insert it carefully into the external auditory canal, and drip 3-4 drops of warm (heated) 3% boric alcohol onto the bandage.

After examining the child by a doctor, you need to carry out all medical appointments at home:

• instill special drops in the ear;
• if necessary, give antibiotic tablets;
• make compresses on a sore ear;
• warm the ear with a blue lamp or a bag of heated salt;
• clean the nose of the child for free breathing;
• provide proper care for the child.

Instillation of drops in the ear

After the examination, the doctor will prescribe ear drops to the child, which have both analgesic and anti-inflammatory effects (for example, Otipax or Otinum). You need to bury these drops in a heated form, otherwise the cold liquid will increase the pain in the ear.

You can first heat the pipette in hot water, and then draw drops into it. If the bottle with drops has a dosing pipette, then you need to turn the bottle over, close the cap and heat in hot water only that part of the drug solution that entered the pipette. Then remove the cap and drip the medicine into the ear or onto the gauze turunda inserted into the ear.

If the doctor has allowed direct instillation of the medicine into the ears, then you first need to warm the vial in your hand, lay the child on his back and turn his head to one side. Slightly pulling the auricle up and back, drip 3-4 drops into the ear canal (ear canal). It is advisable that the child lie down for several minutes in this position. If this was not achieved, then a piece of cotton should be placed in the ear.

Ear compresses

In acute catarrhal otitis, the doctor may prescribe a vodka or semi-alcohol compress (if pus is discharged from the ear, any compresses are contraindicated!).

Compress rules:

• take a gauze napkin in 4 layers, the size of which extends 2 cm beyond the auricle, make an incision in the middle;
• moisten a napkin in a half-alcohol solution (alcohol, half diluted with water) or vodka, wring it out slightly, put it on the ear area (put the auricle through the cut on the napkin);
• put compress paper on top of the napkin (its size should be larger than the size of the napkin);
• put a layer of cotton wool on top, the size of which is larger than the size of the paper;
• fix the compress with a handkerchief;
• keep the compress for 3-4 hours.

Other ways to warm up the ear

You can warm up the diseased ear of a child with catarrhal otitis media using a reflector with a blue lamp. A session of such warming lasts 10-15 minutes and is carried out 2-3 times a day.

Effective heating is also provided by a bag of salt, preheated in a pan. The pouch should be pleasantly warm, but not burn, so its temperature must be assessed by hand before being applied to the child's ear. A bag of salt is also held near the ear for 10-15 minutes.

Depending on the stage of the disease, the otolaryngologist may prescribe additional physiotherapeutic methods of treatment: UVI (ultraviolet radiation), electrotherapy (UHF), laser radiation.

Ensuring free nasal breathing

An important point in the treatment of otitis media is to ensure that the child breathes freely through the nose. You can free the baby's nasal passages with cotton flagella, wetting them with baby oil. You can use a small syringe to suck out mucus from the nasal passages, but do it very carefully.

With a sharp suction, a negative pressure is created in the nasal cavity, and this can lead to hemorrhage in the middle ear cavity and detachment of the mucous membrane. Older children should be taught how to properly blow nose discharge: you can’t blow your nose in both nostrils at the same time, but only alternately. As prescribed by the doctor, vasoconstrictor nasal drops are used, which will ensure not only free breathing through the nose, but also the patency of the auditory tube.

ear toilet

With purulent otitis, it is important to regularly toilet the ear. This procedure is carried out by a doctor or an experienced nurse; It is strictly forbidden for parents to try to clean the child's ear on their own.

The doctor removes pus from the auricle and from the ear canal using a probe with cotton wrapped around it. At the same time, he pulls the child's ear down and back.

After removing the pus, the ear is treated with disinfectants (hydrogen peroxide 3% solution), and then an antibiotic solution, Dioxidin, Sofradex, etc. is instilled.

Otitis media in children is extremely common. Approximately eight out of ten children experience this disease at least once. All parents need to know the main symptoms of the disease, its causes, features, as well as treatment methods. It is not so difficult to determine in a child, but only a specialist can make an accurate diagnosis.

Warning! It is dangerous to do anything on your own until a verdict is issued. Any methods can aggravate the situation if used inadequately.

Characteristics of the disease and its classification

In medicine, otitis media is understood as inflammation of the ears, accompanied by severe pain and other unpleasant symptoms. The causes of the disease are often associated with a discrepancy between atmospheric pressure and - in the inner cavity of the ear, which, in turn, can be provoked by various factors.

There are several classifications of otitis media. They are built taking into account certain fundamentally important parameters. So, depending on the place of localization in medicine, it is customary to divide the disease into:

1. Otitis externa - is deployed in the auricle and ear canal to the membrane. It is most easily tolerated, but is relatively rare.
2. Otitis media. It affects the Eustachian tube, which connects the eardrum with the nasopharynx. It has five stages of development. Children's otitis media in the vast majority of cases is of this type.
3. Interior. It affects the so-called cochlea, the opening at the entrance to it, as well as the semicircular canals. Another name for this type of otitis media is labyrinthitis. It also doesn't happen often. Is fraught with serious consequences.

From the point of view of the duration of the disease, there are three types of inflammation of the middle ear:

1. Acute otitis media. It develops very quickly. Accompanied by severe symptoms. Lasts no longer than three weeks.
2. Subacute look. Accompanied by constant relapses. Lasts from one to three months.
3. Chronic otitis media. It may drag on for years. It often results from constant contact with water. It also overtakes the patient with inadequate treatment of the acute form. It happens that inflammation of the eardrum in the chronic course of the disease is caused by its mechanical damage.

Depending on the type of inflammation, the following types of disease are distinguished:

1. Catarrhal otitis in children. Usually becomes a consequence of SARS. Pathogenic microorganisms, along with catarrhal mucus, enter the ear canal from the nasopharynx during sneezing and coughing, causing inflammation in the ear. This variety is one of the most common complications of acute respiratory viral infections.
2. Exudative otitis. It is also called secretory, mucosal, or serous. It develops very slowly, has several stages. It is provoked by taking antibiotics, as well as poor ventilation in the ear canal.
3. Allergic otitis. Becomes a consequence of allergies occurring in a chronic form. Due to the swelling of the tissues inside the ear, hearing is impaired. Often, against the background of this form, an infectious species develops.
4. Purulent otitis media in a child. It is a complication of inflammation of the ear in any of its departments: external, middle or internal. It is very hard to bear. It is characterized by the release of pus from the auditory canal. Therapy should be carried out in a hospital setting, especially if a very small child is sick.

In addition to all of the above, there are also bilateral and unilateral otitis media. The first affects both ears. The second is just one of them.

Comment! If there is left-sided or right-sided otitis media, and drops are used during treatment, then not only the diseased, but also the healthy ear should be instilled.

Causes of the disease

Any disease has its provoking factors, and ear inflammation is no exception. The causes of otitis media are quite diverse. The main ones include:

1. Viral infections. The most common factor A huge number of children get ear problems due to SARS. In this case, we are talking about viral otitis media.
2. bacterial infections. In particular, Haemophilus influenzae, moraxella or pneumococcus. It's also a fairly common reason. If it is identified, then the disease is classified as bacterial otitis media.
3. Allergies. This has already been discussed above. Chronic allergic rhinitis leads to swelling of the mucosa and problems with the ears.
4. hereditary factor. Not considered very common. But still, sometimes frequent otitis media in a child is explained precisely by the fact that the father or mother also regularly manifested this disease in childhood.
5. Adenoids. If they are enlarged, then the walls of the nasopharynx are compressed, and the ear canal is narrowed. This leads to poor ventilation in the latter, and, as a result, to otitis media.

Comment! Otitis in infants and children of younger preschool age is often explained by the anatomical features of the auditory tube. It is wide and short, which makes it easier for infections from the nasopharynx to the ear.

Other diseases can contribute to the occurrence of otitis media in children. Such, for example, as:

• diabetes;
• anemia;
• rickets;
• pathology of ENT organs.

In general, almost any ailment can become a "background" for inflammation in the ear. This is explained very simply. Immunity during illness is reduced, and any wound in the ear and other sources of ear infection can turn into severe inflammation.

Attention! In newborns, otitis often becomes the result of diseases suffered by the mother during pregnancy, as well as inflammatory ailments that she currently suffers from.

Symptomatic picture

Anyone who knows what otitis is only by hearsay will never be able to imagine the pain that occurs with it. Exhausting, aching or throbbing, aggravated in a supine position, not allowing to eat or sleep ... It can be considered the main sign of otitis media in a child (as, indeed, in an adult). Most of the remaining symptoms largely depend on the specific type of disease.

So, usually with external otitis observed (look at the photo):

• hearing loss;
• itching in the ear canal;
• swelling inside the auricle;
• redness in the ear.

As a rule, such otitis occurs without temperature. And if it rises, it does not exceed the 38-degree mark.

Important! The external form may not manifest itself in any way or practically in any way, which allows the disease to progress, remaining unnoticed.

With otitis media, a child is observed (see photo):

• pulsating pain radiating to the jaw and head;
• "Pawned" ears, a sharp deterioration in hearing;
• sore throat;
• viscous discharge from the eyes;
• pus and blood from the ear;
• fever;
• stomach upset;
• very high temperature.

Signs of an internal type can be:

• hearing loss;
• impaired coordination of movements;
• "flies" in the eyes;
• nausea and vomiting.

Approximately half of all cases of otitis media occur in infancy. In addition to the anatomical features of the hearing aid, this is also due to the fact that the baby lies almost all the time, and mucus from the nasopharynx is very easy to get into the ear. But to recognize the disease is difficult, because the baby will not tell what hurts him. The main symptoms of otitis in infants:

• restless behavior;
• incessant crying;
• sleep in fits and starts;
• tilting the head;
• attempts to reach the ear (in children older than four months);
• swelling of the fontanel;
• a sharp cry when pressing on the tragus.

Comment! Otitis in a newborn can be suspected if, starting to suck on the breast, he suddenly throws it and screams for a long time after that.

And one more important general point to keep in mind. Ear pain is not always a symptom of otitis media in children. It may also indicate mechanical damage to the eardrum, caries, inflammation of the lymph nodes and other abnormalities. It is impossible to treat an ear based only on the presence of this symptom.

Diagnosis of the disease

In order to stop the symptoms and start treatment of otitis media in children on time, it is necessary to call a local pediatrician at home at the slightest suspicion. He will examine the baby, listen to complaints and, if in doubt, refer him to an otolaryngologist. The ENT will be able to accurately recognize otitis media, thanks to the use of a special mirror that will show the condition of the eardrum and the walls of the auditory canal. But this device alone is not enough. There are additional methods for diagnosing otitis media:

• bacteriological studies:
• audiometry;
• CT (if in doubt).

The tactics of the examination largely depends on the age of the patient. In a newborn, it will be one, and in a child of 3 years of life, it will be completely different. In some cases, a consultation with a neurologist is required, which will help to understand whether intracranial complications of otitis media have developed.

First aid

It is impossible to treat otitis media in a child on your own, without consulting a doctor. This is a serious disease, fraught with consequences - up to disability. Only a specialist can choose an adequate therapy. But if there is no way to get to him in the next hour, first aid for otitis media may well be provided by parents.

Non-steroidal drugs allowed for children will help to stop the pain syndrome. These are Panadol, Tailed, Efferalgan, Nurofen, Naproxen and others. They will not only relieve pain, but also slow down inflammation, and also remove fever if the temperature during otitis in a child goes off scale.

You can drip something vasoconstrictor into the nose. For example, Nazol, Afrin, Tizin. This will help relieve swelling of the mucous membrane of the nasal and auditory passages.

Attention! It is impossible to drip anything into the ear (Sulfacyl Sodium, etc.) before a medical examination, since many drugs have contraindications and can damage the eardrum.

Medical treatment

Features of drug therapy depend on the type and stage of the disease. So, with the external form, the treatment of otitis in children is limited to warming up, laying cotton swabs soaked in alcohol in the ears, and careful toileting of the auricles. If after a few days the boil has not disappeared, it will have to be opened.

A more serious approach requires the treatment of acute otitis in a child in case of damage to the middle ear. It must be comprehensive. If the cause of the disease is SARS, antiviral drugs will be required. If you have an allergy, then remedies for it.

In many cases, antibiotics are required for otitis media in children. Especially often they are prescribed to very tiny patients, as well as in cases of severe disease. If the child has not received antibacterial drugs during the previous month, Flemoxin Solutab is usually prescribed for otitis media. Regularly ill children, as well as with the ineffectiveness of the therapy, are prescribed other drugs from this group. A good medicine is considered, in particular, Amoxiclav.

As noted above, ear instillation should be approached with caution. Many remedies are contraindicated if the eardrum is even slightly affected. And some can damage it. Albucid for otitis is a completely safe antibacterial and analgesic. It is actively used in most cases.

Comment! Sulfacyl sodium can be dripped into the ears only with the permission of the doctor, since the drops are eye drops and there are no instructions for other situations!

The purulent appearance requires paracentesis of the membrane, which will ensure the outflow of fluid. Here already one children's ear drops will not manage. The exudative form often requires myringotomy and similar procedures. Without them, it will be difficult to remove mucus.

Especially carefully should be approached with otitis media of the inner ear. Labyrinthitis is fraught with serious complications and requires appropriate measures. Therapy must be carried out in a hospital. Treatment at home is unacceptable.

With the ineffectiveness of conservative methods and the progression of the disease, surgical intervention is indicated. In particular, it is carried out when the disease has already provoked hearing loss. The destroyed auditory ossicle is replaced with a prosthesis.

ethnoscience

Treatment of otitis media in children at home allows the use of traditional medicine methods. They cannot replace drug therapy, but can be used as a supplement.

Popular folk remedies for otitis are warming up. A hot egg, a bag of warm salt, or a heating pad are applied to the affected ear. A similar effect is provided by special compresses. For example, applying napkins soaked in camphor oil to the ear (a hole must be made in the center so that the liquid does not enter the ear canal).

Important! In case of otitis with temperature or with a purulent form, it is impossible to carry out warming measures in any case.

Complications of inflammation

Lack of treatment, as well as inadequate therapy, can lead to very serious consequences. And hearing loss is not the worst complication after otitis media. The disease is fraught with:

• meningitis;
• paralysis of the facial nerve;
• abscesses;
• acute mastoiditis;
• purulent streaks;
• sepsis;
• encephalitis;
• complete deafness.

Some of the above pathologies are deadly. Ear treatment should be started on time. In the later stages, the risk is too high.

Preventive measures

Any disease is easier to prevent than to fight it - this is a well-known truth. To prevent inflammation of the ear in a child, parents need to be on the alert. Namely:

1. Closely monitor the condition of the baby, paying attention to every feature in his behavior. A baby, as well as a one-year-old child, does not have the opportunity to tell his mother about his condition. Therefore, any deviations should be regarded as a signal. Poor sleep, refusal to eat, moodiness, prolonged crying ... All this may indicate that the baby is suffering from headaches, which often become harbingers of ear problems.
2. Carefully treat SARS. Many parents, trying to protect their child from chemistry, resort exclusively to folk methods of dealing with colds. But often antibiotics are needed. Without them, the disease can give complications. And otitis media is not the worst thing that a seemingly ordinary SARS threatens.
3. Boost immunity. If a child of 2 years of age still has the opportunity to eat mother's milk, this will have a very good effect on the defenses of his body. Babies who are weaned early are much more at risk of contracting otitis media. It is also necessary to harden the baby, walk a lot in the fresh air and feed well.
4. Clean ears only with special sticks (preferably with limiters).

And the most important measure for the prevention of otitis media is to prevent water from entering the ear by covering it with a cotton swab when bathing. By adhering to these rules, you can significantly reduce the risks and save your baby from suffering. Treating otitis in children (especially in very tiny ones) is a difficult, nervous and long business. We must try at all costs to prevent it.

So, in this article, such a disease as inflammation of the ear is considered in detail. Its causes, symptoms and features of the course are described. The most common medicines for otitis media are listed.

The information will be useful both for those whose child is already ill, and for parents who want to insure themselves. It is impossible to be guided exclusively by it during treatment. It will be a good help, but will not replace the advice of a competent doctor. Good health to you!

Watch the video of Dr. Komarovsky:

According to statistics, about 90% of children under the age of 5 have experienced otitis media at least once in their lives. Thus, it is safe to say that otitis media is the most common disease in children. Moreover, it is children who are most susceptible to this disease due to some features of the structure of the ears and physiologically reduced immunity.

The first place among the sick remains precisely for children under 5 years old. The second place is occupied by the elderly, and the third - by teenagers under 14 years old. Unfortunately, the prevalence of otitis in children, as well as the relative ease of treatment, misleads many parents about the seriousness of this disease.

In fact, the disease is quite serious, capable of causing very unpleasant, even terrible complications, including deafness or meningitis. Therefore, knowing the symptoms and treatment of otitis media in a child is an important part of every parent's education.

What is otitis

Otitis is called any inflammatory process in the ear. Since the human ear is anatomically divided into three sections, otitis is also divided into external, middle and internal. Most often, otitis media occurs in children, and the most severe, of course, is internal otitis media. Inflammation of the middle ear is divided into catarrhal and purulent.

As a rule, the causative agent of otitis is various pathogenic bacteria, such as staphylococci or streptococci. Unlike other inflammatory processes, otitis media is almost never caused by viruses, and even more so by fungi.

Causes of otitis

To understand what are the causes of otitis and why children get sick more often, you first need to turn to the structure of the ear. We usually call the auricle an ear, when its largest and most important part is located inside the skull. The auricle only picks up sounds and directs them through the auditory canal to the tympanic membrane, which separates the outer and middle ear. The function of the tympanic membrane is that it picks up sound from outside and resonates, passing it on, like skin stretched over a resonant drum.

The middle ear is a small cavity in the temporal bone. This cavity contains a complex and very small structure of bones that transmits sound to the inner ear. The inner ear is most like a cochlea, and in this cochlea are nerve endings that transmit signals to the brain.

In order for the eardrum to function properly, it is very important to balance atmospheric pressure in the middle ear. For this, the middle ear cavity is connected to the nasopharynx by a passage called the auditory or Eustachian tube.

This is where the cause of frequent otitis media in children lies. The fact is that, like many other systems, the ear after birth is not fully formed. In children under 5 years of age, the Eustachian tube is much shorter and wider than in adults, in addition, it is located in a horizontal plane. All this facilitates the penetration into the cavity of the middle ear of various fluids from the nasopharynx. Most often it is mucus accumulated in the nose during a common cold.

However, if the rules for feeding newborns are not observed, breast milk or formula can enter the middle ear cavity. During feeding, the baby often swallows a large amount of air, and after feeding this air must be released, holding the baby upright. Together with air, a small amount of milk or a mixture often comes out of the stomach. If spitting up occurs when the child is lying down, food can enter the nasopharynx, and then the middle ear cavity through the Eustachian tube. Immediately after birth, amniotic fluid may remain in the cavity.

Unlike nasal mucus, milk and amniotic fluid themselves do not contain pathogenic flora, but they are a breeding ground for the development and reproduction of bacteria. However, most often otitis media develops against the background of various colds, flu, scarlet fever, diphtheria or other childhood diseases. At this time, two risk factors are combined: the presence of pathogenic flora and a decrease in the immunity of the child.

Another cause of otitis allergic reaction. Allergies can also cause rhinitis, the rapid formation of nasal mucus and its flow into the auditory tube.

Otitis media rarely develops on its own. In the vast majority of cases, it only accompanies inflammation of the middle ear, if it was not recognized and treated in time.

The easiest way is with otitis externa. It is also called traumatic, as it develops as a result of infection in microcracks in the skin of the auricle and ear canal. It is possible to injure delicate skin due to careless cleaning of the ear canal or if foreign objects get into it.

Symptoms

It is easiest to recognize external or traumatic otitis media, since the focus of inflammation is located outside. Otitis externa usually begins with a sharp skin redness auricle or ear canal. Then begins tissue edema , and the opening of the ear canal sharply narrows. This condition usually goes away on its own. The eardrum blocks the entrance to the middle ear and prevents further infection.

Obviously, the confidence of some parents that otitis can be obtained from the outside is completely groundless. Inflammation of the middle and inner ear develops only as a result of infection from the inside. However, one of the factors leading to the development of otitis media can be hypothermia.

Every parent should know the symptoms of otitis media in children: sudden rise in temperature up to 38–40 degrees, weakness, and, most importantly, earache. It can be pulsating, shooting, pulling, aching. One thing in common: the pain is very strong, growing, sometimes even unbearable. Because of the pain, the child can become irritable, restless. Possible sleep disturbance.

It is good if the baby already knows how to speak and can complain of earache. And if not? How, then, to recognize the symptoms of otitis media in children under one year old? It is very important to closely monitor the behavior of the baby. The child will try to lie on a sore ear, rub it against your arm or pillow. In general, in the supine position, a child with otitis media, as a rule, feels worse, this is due to pressure on the focus of inflammation from the nasopharynx.

Most likely the baby will refuse food . The fact is that during sucking in the nasopharynx and, accordingly, in the middle ear, an area of ​​​​negative pressure is formed. Because of this, the pain in the ear also intensifies, so the child can, barely sucking on the breast or bottle, immediately spit it out with a cry. In order to make sure that the pain is associated with the ear, you can put pressure on the tragus - this is a small triangular cartilage that covers the entrance to the ear canal. If, when pressed, the child begins to worry, screams, then most likely we are talking about otitis media.

At the first signs of otitis media in children, it is necessary to appear to an ENT specialist or at least a pediatrician. No matter how obvious the diagnosis is for the baby's parents, it is impossible to be completely sure that the child is sick with otitis media. In addition, otitis media can be very diverse, and treatment directly depends on its type.

It is noteworthy that allergic otitis media does not cause fever. The more difficult it is to recognize. Without signs of intoxication, only symptoms associated with sensations in the child's ear remain. If the baby cannot voice them, it is possible to guess the existence of a problem only by behavior, and then, thanks to an exceptionally attentive attitude towards your baby.

The only case when there is no doubt about the diagnosis is with purulent otitis media. The tympanic membrane ruptures and pus begins to flow from the ear . By the way, during this period, the child usually experiences a sharp relief of the condition, since the pressure in the middle ear cavity decreases, the pain decreases, and the temperature often decreases. Please note that such relief of the condition is not a reason to refuse to see a doctor. The baby still needs treatment. Otherwise, acute otitis media can smoothly flow into chronic. Then you will face the same problems again and again. Treatment of chronic inflammation in children is a much more complex process than getting rid of acute otitis media.

First aid for otitis media

Unfortunately, in the realities of our country, it is sometimes simply impossible to get to the doctor at the first symptoms of otitis in a child: the appointment is booked weeks ahead. In this case, it is worth calling a doctor at home and taking all possible measures to alleviate the condition of the baby. But you should not start treatment on your own, you can damage the child with the wrong selection of drugs for the treatment of otitis media.

In general, self-treatment, and even more so the treatment of otitis media in children with folk remedies, can cause serious complications. Not all the methods that our grandmothers offer to use are truly effective and safe.

Therefore, the task of parents is only alleviate the condition child. If he has a high temperature, above 38-39 degrees, it must be brought down. For this, standard drugs are used: Paracetamol or Ibuprofen. They are also good because they have an analgesic effect. It is better for infants to choose drugs in the form of rectal suppositories, since intoxication can cause them to vomit.

It is widely known that dry heat helps with otitis media. However, it is important to remember that no warm compresses can be applied during periods of fever. This can only worsen the condition.

If the high temperature of the child does not bother, then the ears can be warmed up. For example, using an ultraviolet lamp, or semi-alcohol compresses.

Very important allow the child to breathe freely . To do this, it is necessary to clear the nose of excess mucus using a special pear or aspirator. However, this must be done correctly and very carefully, without causing pain. Do not force the child to blow his nose, pinching both nasal passages. You need to clean them one by one.

Boric alcohol has long been an integral part of the treatment of otitis in children. Until now, many grandmothers or acquaintances may advise to drip it into the child's ear. However, this should not be done. Alcohol irritates the delicate skin in the ear canal and can even cause a burn. Today, boric alcohol is not used in medical practice. In the case of purulent otitis and rupture of the eardrum, it is completely forbidden to drip alcohol solutions into the ear, since alcohol can damage the delicate apparatus inside the middle ear.

Treatment

So how and how to treat otitis media in a child? Much depends on the type and stage of development of the disease. So, catarrhal otitis media in a mild form does not always require therapy. antibiotics which surprises the parents. Treatment of otitis media in children with antibiotics seems mandatory to many. But if the baby’s immune system is normal, pus does not form, and the condition of the little patient is clearly not serious, then the body is able to cope on its own, provided adequate outside help is provided in the form of compresses, cleansing the nose and anesthesia.

Unfortunately, this situation is extremely rare. In most cases, even catarrhal otitis in a child requires antibiotic treatment. They can be given as tablets, suspension or topical drops. If drops were prescribed in your case, remember that direct instillation into the ears is contraindicated for small children. It is better to use cotton turundas. Turunda is inserted into the ear, and drops warmed in warm water or hands are already dripping onto it. Gradually, the cotton wool will be saturated with the medicine and it will reach its destination without damaging the skin in the ear canal.

Prescribed by a doctor, most likely, and vasoconstrictor drops for the nose to facilitate breathing and free the nasal passages from excess mucus.

Antibiotics are usually associated with taking antihistamines and drugs for dysbacteriosis . This is due to the fact that antibiotics kill not only the pathogenic flora, but also all other microorganism, including those that are vital to our body. The beneficial bacteria in the gastrointestinal tract are usually the most affected.

As a rule, the treatment of otitis media in children takes place at home. However, in severe cases, hospitalization may be required. The most difficult thing is to treat purulent otitis media in a child. The eardrum in children is thicker than in adults. As a result, with purulent otitis media, it may not rupture. As a result, pus accumulates in the cavity of the middle ear, presses on the membrane and on the walls of the cavity, causing severe pain. In addition, in this case, pus can penetrate into other cavities of the skull, causing various complications.

For this reason, doctors may insist on hospitalization and eardrum puncture. You should not be afraid of this, because, firstly, the procedure takes place under local anesthesia, and secondly, after recovery, the eardrum fuses without loss of hearing acuity.

Hospitalization may also be required if there are signs of any complications.

Possible Complications

Since almost all systems in the head are connected in one way or another, any inflammation, including otitis media, can spread to neighboring organs and tissues. The weed of the middle ear is directly adjacent to the inner ear, the sinuses in the bones of the skull, the eye sockets and, of course, the nasopharynx.

Incorrect or untimely treatment of otitis media can provoke transition of acute otitis media into a chronic form . This means that the child will encounter inflammation in the ear much more often, since the pathogenic flora will be constantly present in his body. Chronic otitis is much more sluggish than acute otitis, but it is more difficult to cure and often causes complications.

Otitis media can spread to the inner ear, eyes, or sinuses in the bones of the skull. This may result in complete or partial hearing loss, blurred vision, severe headaches . In addition, the bony sinuses are only separated by a thin membrane from the brain. If the sinuses are filled with pus, the membrane can burst, and then the infection spreads to the cerebral cortex, which leads to the development meningitis .

Fortunately, modern medicine has effective ways to treat otitis media, and if parents turn to doctors in a timely manner and strictly follow all their recommendations, complications of otitis media develop extremely rarely. That is why it is so important that parents are well aware of the symptoms of otitis media in children.

Prevention

Prevention of otitis is, first of all, in maintaining the immunity of the child, as well as timely treatment of respiratory diseases. Preferably as much as possible breastfeed your baby longer, since breast milk for newborns is a source of mother's antibodies. It is it that helps to form protection at a time when your own immune system is not yet working at full strength. Be sure to follow all the recommendations for feeding and give the child the right burp.

Promote the development of immunity and frequent outdoor walks. Ideally, you need to regularly get out of town with your child, but walking in the city will only benefit him. In addition, it is necessary to regularly ventilate the room in which the child is most often located, since stagnant air provokes the development of colds.

An important part of the developing immune system are vitamins. The lack of many of them makes the human body vulnerable to a variety of infections. Therefore, it is very important to ensure that the child's diet has a sufficient amount of vitamins. In the summer, you can buy him more fruits and vegetables, as natural vitamins are better absorbed by the body. In the off-season, it will be useful to drink vitamin complexes in courses, since it is at this time that children most often get colds.

If ORS has not been prevented, which happens to almost everyone from time to time, it is important to treat the disease as early as possible. Make sure that the mucus does not stagnate in the nose, so that it does not flow into the Eustachian tube. In addition, it is very important to carefully monitor the condition of the child and notice the symptoms of otitis media in a timely manner, if it was still not possible to prevent its development.

On the one hand, almost every child has had otitis at least once in his life, and most of those who have been ill hear perfectly well and have not acquired inflammation of the cerebral cortex, on the other hand, this is not a reason to relax and leave such a serious disease unattended. A sick child definitely needs medical care, adequate and timely.

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Answers

If we are talking about acute otitis media, then in most cases we mean inflammation of the middle ear or acute otitis media in children. The acute form of the disease is characterized by vivid clinical manifestations and complaints from the patient. With timely assistance, otitis media resolves without complications.

Chronic otitis media is usually the result of mistreated in the past or undertreated acute otitis media. The disease in the chronic form proceeds cyclically - the clinical picture worsens and subsides from time to time. The main symptom of chronic otitis media is hearing loss. If left untreated, hearing will continue to deteriorate.

What causes otitis media in children

Acute otitis in children occurs mainly at an early age. This is due to their high susceptibility to infections due to the imperfection of the immune system and the peculiarities of the anatomical structure of the auditory tube, which has a shorter length and a wider space without any bends. This greatly facilitates the task of penetration of the pathogenic flora to the area of ​​the eardrum.

The main causes of acute otitis media:

• Inflammatory process in the upper part of the nasopharynx of a bacterial or viral nature. Pathogenic flora spreads through the auditory canal into the Eustachian tube. Against the background of inflammation, the exudate from the eardrum cannot come out, which causes an acute form of otitis media.
• Incorrect position of the child during feeding. If the baby is on its back, milk or formula can flow into the middle ear during feeding and cause inflammation in it.
• Weak immune system.
• Hypothermia or overheating of the body.
• presence of adenoids.
• Fungal infections.
• Second hand smoke.

Pathogenesis

Acute otitis in children has several stages of development, each of which has its own clinical signs. But it is not at all necessary that the disease will pass according to a certain scenario. If treatment is started in a timely manner, the disease will be reversible.

Initial stage - preperforative

At the very beginning of the disease, symptoms of intoxication of the body and severe pain in the ear area appear. This stage can last from several hours to several days. The pain is due to irritation of the glossopharyngeal and trigeminal nerve. It can give to the temple or teeth. The child's hearing is reduced, as the auditory ossicles in the eardrum lose their normal mobility due to inflammation.

At the preperforative stage, pus begins to accumulate, but the tympanic membrane has not yet ruptured. It increases in size, becomes inflamed and reddens. Pain gradually increases, especially in the supine position or when the head is tilted to the side. At this point, if the doctor examines the child, he will see a thickening of the tympanic membrane and purulent contents, translucent under it.

perforative stage

The accumulated pus breaks through the eardrum and comes out. Initially, there are many mucopurulent discharges, especially in the first hours of the breakthrough, sometimes traces of blood are found in them. But at the same time, the pain begins to subside, the temperature decreases, signs of intoxication disappear.

After examining the child at the perforative stage, the doctor with the help of an otoscope will see the injured eardrum and the pulsating removal of pus from it. Gradually, the number of discharges is reduced. This stage lasts up to 7 days.

Usually, at this stage of acute otitis in children, the membrane is slightly damaged, only if the disease did not occur during tuberculosis, scarlet fever, or measles. In these cases, perforation may not occur outside, but into the skull, which is fraught with the development of sepsis and death.

Reparative stage

The last stage of otitis, during which the perforation site is scarred. From that moment on, there is no more discharge of pus, hearing abilities return to normal. Reduces swelling and inflammation of the eardrum. In the process of otoscopy, the doctor sees its brilliance and clear outlines.

If the perforation turned out to be minimal - no more than 1 mm, it is tightened without scarring of the tissues. If the breakthrough was of impressive size, fibrous tissue is formed, sometimes salt deposits.

Diagnostics

Older children can tell their parents about ear pain. If the child is not yet 2 years old, he will indicate pain by crying and expressed anxiety, a firm refusal to eat, less often - vomiting and diarrhea. To determine otitis, you need to press on the tragus of the ear. The increased crying of the child unmistakably confirms the alleged diagnosis.

Any suspicion of the development of the disease requires an urgent consultation with a pediatrician or otolaryngologist.

How does a specialist make a diagnosis? He has an ear mirror - a specific device, thanks to which the doctor sees all the changes that have arisen in the external auditory canal and eardrum.

Treatment

The sooner treatment of acute otitis in children is started, the better the result will be. Most often, the doctor follows a complex scheme.

Paracetamol-based drugs will help reduce the manifestations of pain. The dose of medication depends on the weight of the child. In addition, a doctor with otitis media can prescribe Dimexide, which has a pronounced local anti-inflammatory and analgesic effect. In a diluted form, Dimexide is injected into the ear cavity with the help of cotton turundas for 30 minutes.

Successfully eliminate pain in the ear with ear drops, for example, Otipax, which are also a local antibiotic. In the ear canal, you need to instill 3 drops per day.

The infection is treated with. The most commonly prescribed is Amoxicillin. The drug is taken orally for 5 days according to an individual scheme. The dosage of Amoxicillin depends on the weight and age of the child. If after 2-3 days the effect of treatment with Amoxicillin is absent, the doctor may replace the drug with Augmentin or Ceftriaxone.

Antibacterial therapy for acute otitis in children should be carried out for at least 7 days. If the child's condition improves, the course of treatment is by no means canceled, since premature discontinuation of drugs can cause a relapse of the disease after a short period of time.

Eliminate nasal congestion, normalize breathing and improve the outflow of purulent contents from the ear can: Sanorin, Tizin, etc. They are used for no more than 7 days at a dosage recommended by the doctor. Antiallergic drugs - Suprastin, Loratadin, etc. help to remove swelling of the auditory tube. They are prescribed in combination with general therapy.

If medical treatment does not help, and the disease continues to progress, the child needs the help of a surgeon. Most often, they resort to shunting or paracentesis (an incision in the eardrum).

An additional method of treating acute otitis is a physiotherapeutic effect: UHF, pneumomassage.

Prevention of acute otitis media

With the classic course of acute otitis media and the provision of timely medical care to the child, a period of recovery soon begins with complete normalization of hearing abilities. If the factors provoking the disease are not eliminated, otitis media can recur or become chronic.

Prevention of otitis requires strengthening the immune defense, eliminating injuries to the external auditory canal and eardrum with foreign objects (cotton buds, hairpins, etc.), teaching the child to blow his nose properly. It also requires mandatory treatment available, including surgical, if a small patient suffers, and other problems.

You can not treat the child yourself, because otitis media is a serious disease that is fraught with hearing loss. At the first sign of trouble, the child should be examined by a pediatrician or an otolaryngologist.

Otitis media

Inflammation of the middle ear is called otitis media. This form of the disease is most common in childhood - in the first year of life, it occurs in every second child. At the same time, it was noted that boys get sick more often than girls. There are serous and catarrhal acute otitis media in children.

Catarrhal otitis media is characterized by an acute course of the disease against the background of an inflammatory process in the auditory tube, tympanic membrane and mastoid process. With untimely treatment, catarrhal otitis media is dangerous with hearing loss in full. The symptoms of the disease are quite bright, so catarrhal otitis differs from other forms of otitis media. If you do not start treatment, the disease can turn into a purulent form.

Serous otitis is characterized by a weak symptomatic picture and accumulation of non-purulent exudate in the ear. Fluid accumulates in the tympanic cavity, this causes a feeling of pressure and stuffiness in the ear, a slight decrease in hearing capabilities. Acute serous otitis media in children is dangerous by the transition of the disease to purulent otitis media and irreversible complications in the form of hearing loss and discomfort in the ears.

Patients with otitis media often complain of shooting pain in the ear. During the examination, the doctor detects characteristic signs of inflammation in the middle ear, in advanced cases - accumulation and discharge of pus or acute purulent otitis media in children.

How to avoid complications?

Properly organized treatment and a good state of the immune system contribute to a complete recovery from acute otitis media, including the restoration of temporary hearing loss.

To avoid complications of otitis media, such as mastoiditis, purulent labyrinth and sepsis, it is recommended to comply with the following requirements:

• consult a doctor in time when the first symptoms of the disease appear;
• eliminate negative external factors at least for the duration of treatment, do not smoke near the child, avoid drafts, hypothermia;
• engage in strengthening the immune system and treating underlying diseases that are the root cause of acute otitis media.

The prognosis for uncomplicated acute otitis and its adequate treatment will be favorable. If the disease recurs, you need to show the child to an immunologist and an endocrinologist. It is also strongly recommended to consult a pediatrician about the features of child care, including bathing and feeding the baby.

Useful video about the causes and treatment of acute otitis media in children