Earache

From crying and discomfort at night to ear pain and impaired hearing, otitis media presents in various and diverse forms. How do we identify one of the common childhood diseases? How do we treat it?

Dr. Ephraim Rosenbaum

Screams of agony in the middle of the night. Crying, discomfort, pain. Every attempt to lie down exacerbates the pain, leaving the child in distress. Older children may report ear pain, while younger ones tug at their ears, and touch them. The child tosses, turns, appears irritable, may have a fever, suddenly struggles to hear and does not respond to faint sounds, is more lethargic than usual, unsteady, and appears unstable.
All these are signs of otitis media, one of the most common diseases in children.

What is Otitis Media?

Otitis media is usually caused by bacteria and often begins after a cold, sore throat, or another respiratory infection. The bacteria or viruses causing the disease spread towards the middle ear and settle there. The inflammation that develops leads to the accumulation of fluids behind the eardrum.

What Causes Otitis Media?

Middle ear inflammation is caused by one or more of the following:

The Eustachian tube connecting the middle ear to the nasal cavity is relatively straight in children and does not allow fluid drainage easily. Bacteria and viruses entering through the nose reach the middle ear, and the fluid accumulates, pressing against the eardrum.
Drinking, especially from bottles, in a lying position leads to fluid entry into the ear and inflammation.
Bacteria and viruses transmitted among children, their tendency to put hands and objects in their mouths while in poorly ventilated rooms.
Exposure to cigarette smoke increases the likelihood of middle ear disturbances and otitis media.

How to Treat Otitis Media?

About 30% of cases of otitis media are viral, and there is no need for antibiotic treatment. Alleviating the child's pain can be done by administering ear drops for relief, such as Otodyn or anesthetics, ear drops designed to alleviate ear pain and discomfort. The use of medication is to alleviate pain in acute inflammation of the middle ear and the onset of outer hearing. The use of general pain relievers such as acetaminophen or ibuprofen will help reduce fever and relieve pain. Recent medical research has shown that the effect of ibuprofen against ear pain in children was greater than the effect of acetaminophen.
In about 60% of cases, otitis media is caused by bacteria, and the body's immune system is capable of overcoming them, so there is no need to start antibiotic treatment. In contrast, in children under six months of age, the immune system is not as developed, and it is advisable to start antibiotic treatment due to the concern for significant complications following untreated otitis media.

How to Reduce the Frequency of Otitis Media?

Breastfeeding for as long as possible strengthens the baby's immune system.
Do not smoke indoors or near children.
Do not feed a baby lying down and do not let them fall asleep with a bottle.
For toddlers suffering from recurring and persistent otitis media, it is recommended to minimize contact with sick children as much as possible, maintain proper hygiene conditions, and limit exposure to a small number of children.
Pacifier use should only be during sleep.
It has been found that the pneumococcal vaccine, which acts against pneumococcal bacteria, reduces the incidence of otitis media.
Influenza vaccines reduce the frequency and severity of the disease and its complications, including otitis media.
Adhere to hygiene conditions - frequent handwashing of the child and caregivers.
When children suffer from recurrent and persistent otitis media, considering surgical treatment such as tube insertion or preventive antibiotic treatment is advisable.
Homeopathic treatment and dietary changes can slightly alleviate otitis media.

Dealing with recurrent and persistent otitis media

Despite preventive efforts, some children suffer from recurrent and persistent otitis media, sometimes more than 5 or 6 times a year. In such cases, many doctors will recommend a medical procedure called tube insertion surgery. During the procedure, a small ventilation tube is inserted, which helps airflow and prevents fluid accumulation in the middle ear. Sometimes, the recommendation also includes removing the adenoids during the surgery as part of the attempt to prevent the spread of inflammation.

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