Otitis media in children How to solve it?
In the pediatric age, there are several respiratory diseases that can be avoided if a successful resolution of flu symptoms is carried out.
On the contrary, if it is allowed to evolve and the correct measures are not taken, a simple viral flu can end in a bacterial infection.
A common case among young children is otitis media, but how can it be solved?
Now, is otitis media a worrisome clinical picture? Is the administration of antibiotics necessary?
What is otitis media?
As its name implies, it is a disease that affects the middle ear. Technically, it is described as inflammation of the mucous and periosteal lining inside the middle ear.
In turn, this inflammation affects the tympanic membrane. It is worth mentioning that it always has an infectious origin, in general, it begins as a viral condition, but evolves into a bacterial condition.
Why is otitis media common in children?
The answer is found in the anatomy of the ear in pediatric age, mostly in a structure called the Eustachian tube, auditory tube or pharyngotympanic tube.
In children, the tube is more horizontal and shorter. In this way, the secretions can easily pass from the nose to hatred.
Also, the tube can collapse more frequently. However, don't worry, it doesn't stay that way for life.
As the child develops and grows, the tube becomes more oblique and lengthens. In this sense, the symptoms of otitis media decrease.
What is the function of the Eustachian tube?
The function of the tube is essential. First, it is the gateway between the middle ear and the nose. It is an air inlet from the outside. The functions of the tube are.
Drainage: Thanks to the tube, secretions can be drained from the middle ear.
Isopressor: The tube helps mediate pressure changes that occur in the middle ear, as well as aerate the ear.
Anti-reflux: It prevents secretions from having a retrograde sense, that is, it prevents the passage of secretions from the nasopharynx to the middle ear.
What is the cause of otitis media?
Very simple, the microorganisms that trigger this infectious picture are bacteria, the following being the most frequent.
Streptococcus pneumoniae by 33%
Haemophilus influenzae by 21%
Moraxella catarrhalis by 6%
How does infection occur in otitis media?
First, it starts out as a viral picture. What's more, otitis media is a complication of the common cold.
Next, the virus is going to cause an inflammation of that area, specifically, of the nasopharynx.
Consequently, this will favor the bacteria to colonize in the nasopharynx. This results in a dysfunction of the Eustachian tube.
So, since the tube is not working as it should, microorganisms can migrate to the middle ear. Finally, the inflammatory response is established in the middle ear.
What are the stages of otitis media, and what are the symptoms?
Basically, there are 4 clinical phases in otitis media. In addition, each one has different characteristics in terms of the appearance of the tympanic membrane, when visualized with a pneumatic otoscopy.
Tubotympanitis phase: The symptoms of this phase are those of the common cold. However, the child may "pull" on his ear, which could mean that he has a "busy ear" feeling.
If otoscopy is performed, the most common thing to see is that the light reflex of the tympanic membrane is diminished.
Hyperemia phase: The predominant symptom is fever over 39 °C, there is general malaise and earache (otalgia).
In this phase, the membrane is already opaque, and its mobilization generates pain.
Exudation phase: The fever is high and persistent, there is nausea, vomiting, general malaise and earache.
The membrane is reddened, and the light triangle is no longer visible. Also, the tympanic membrane bulges out.
Suppuration phase: This is the last phase, which is characterized by the same symptoms as the previous one, but more severe.
During this phase, what occurs if a timely approach is not performed is the perforation of the tympanic membrane. At the same time, it drains the collection of discharge from the middle ear.
With pneumatic otoscopy, the membrane may appear bulging and taut.
What is the treatment for otitis media?
Of course, the mainstay of treatment should be antibiotic therapy. The choice of antibiotic depends on the age of the child. It is not the same for a 6-month-old infant as it is for a 3-year-old preschooler.
In the same vein, some of the most widely used antibiotics in otitis media are.
Amoxicillin
Amoxicillin plus clavulanic acid
Ceftriaxone
Azithromycin
Clarithromycin
Measures to prevent otitis media
Despite the fact that it is an infectious disease, it is true that there are measures you can take to reduce the incidence of otitis.
One of the preventive measures is to avoid prolonged exposure to cold, since low temperatures do not allow the cilia that cover the entire respiratory epithelium to mobilize secretions adequately.
If the child is going to be outside, what is recommended is that you can cover the throat and nose.
Another measure is to prevent children from inhaling cigarette smoke. Also, strong detergent odors.
Nasal washes are another way to prevent otitis, as you will be clearing the nasal passages of secretions.
On the other hand, if the episodes of otitis media are very recurrent, it is advisable that you take the child to a specialist in the area, that is, to an otolaryngologist.
Complications of otitis media
The middle ear is an anatomical area underlying nerve structures. For this reason, prompt treatment should be started in order to avoid the appearance of some following complications.
Bacterial meningitis
Mastoiditis
Labyrinthitis