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Otitis Media Interna (Ear Infections)
HOW COMMON ARE EAR INFECTIONS?Ear infection (Otitis Media Interna, OMI) is the third most common reason for pediatric visits in the United States. These infections account for a large amount of lost time from school and reduced productivity for both children and parents who are often compelled to leave work to care for the affected child.
HOW DO I KNOW IF MY CHILD HAS INFECTION?HOW SHOULD IT BE TREATED??
WHAT ARE COMPLICATIONS OF EAR INFECTIONS?If left untreated, complications can range from permanent hearing loss to poor school performance , and even includes a remote risk of brain or skull infection. Billions of dollars are spent in antibiotics and surgery for ear tube placements every year.
WHY DO SOME CHILDREN SEEM MORE PRONE TO RECURRENT EAR INFECTIONS?Many parents ask me this not -so -simple question of why their child seems to get recurrent infections. To answer this question, it is important to understand the common mechanism of Otitis Media Interna (OMI). Every child is born with a full adult length Eustachian Tube (ET) which drains fluid from behind the eardrum to the throat. This natural gutter bypasses the tonsils in order to fulfill its mission. Because a child’s head is relatively small , the ET tends to be rolled up, somewhat like a party favor, tapering at the very end as it enters the back of the throat. As a child's head grows, the tube slowly unfurls to its full adult length. The degree to which this occurs depends on the basic anatomy of the child's head and the shape and size of the ET. When a child has any type of upper respiratory infection , pressure in the middle ear increases, crimping the tube as it drains fluid. This is somewhat like crimping a straw as you attempt to suck water through it. The result is stasis of fluid in the middle ear chamber behind the ear drum. Over time, the stagnant fluid becomes infected, usually with the same bacteria one finds in the sinuses or in the mouth.
CAN A CHILD RECEIVE TOO MANY ANTIBIOTICS?Management remains one of the biggest challenges, as increasing resistance to antibiotics over the years has complicated treatment. The younger a child at the time of diagnosis, the more frequent he or she may develop recurrent OMIs. As these children take repeated courses of antibiotics, bacteria develop resistance. In some cases, the only option to reduce the frequency of episodes is to place small ventilating tubes in each eardrum to reduce the buildup of pressure during upper respiratory infections. As a child ages and the et unfurls, natural drainage is easier and the frequency of infections decreases. Some simple things parents can do : wash your hands during the winter months, when viral infections are more frequent. Make sure that your child is up to date on all vaccines. If eligible , consider the flu vaccine for your child and household. Reducing the chance of a major viral illness can only help reduce the risks for recurrent OMI. Finally , ask your baby's doctor about a specialist referral if your child has a history of more than one ear infection per month over 3-4 months. A hearing test can then be considered if appropriate. With a watchful eye and care, many children with an early history of frequent omi can escape the complications of this illness .
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