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Oct 1, Issue. Otitis Media: Diagnosis and Treatment. This is a corrected version of the article that appeared in print. Author disclosure: No relevant financial affiliations. C 8 Middle ear effusion can be detected with the combined use of otoscopy, pneumatic otoscopy, and tympanometry.
C 9 Adequate analgesia is recommended for all children with AOM. Sometimes, myringotomy is done. For this procedure, doctors make a tiny slit in the eardrum, remove the fluid, and insert a small ventilating tube called a tympanostomy tube in the slit to provide drainage from the middle ear to the outer ear. The adenoids may be removed at the same time called adenoidectomy. Sometimes a myringotomy is done only to remove fluid and not insert ventilating tubes.
If fluid is removed but no tubes are inserted, the procedure is called tympanic membrane perforation or tympanocentesis. Occasionally, the middle ear can be opened temporarily using a Valsalva maneuver or politzerization. Both techniques require that the child is capable of following instructions and does not have an infection causing a runny nose. To do the Valsalva maneuver, the child keeps the mouth closed and tries to forcibly blow air out through the pinched nostrils popping the ear.
Air travel and scuba diving should be avoided or delayed if possible because they can cause painful changes in pressure in the ear. If air travel cannot be avoided, young children may be helped by chewing food or drinking for example, from a bottle. A Valsalva maneuver or politzerization may help older children. During a myringotomy, doctors make a small opening in the eardrum to allow fluid to drain from the middle ear. Then they place a tiny, hollow plastic or metal tube tympanostomy tube, or ventilating tube in the eardrum through the opening.
These tubes balance the pressure in the environment with that in the middle ear. Doctors recommend ventilating tubes for some children who have had recurring ear infections acute otitis media or recurring or persistent collections of fluid in their middle ears chronic secretory otitis media.
General anesthesia or sedation is usually required. After the procedure, children usually go home within a few hours. Antibiotic ear drops are sometimes given after the procedure for about a week. The tubes usually come out on their own after about 6 to 12 months, but some types stay in longer.
Tubes that do not come out on their own are removed by the doctor, sometimes under general anesthesia or sedation. If the opening does not close on its own, it may need to be closed surgically.
Children with ventilating tubes may wash their hair and go swimming, but some doctors recommend children do not submerge their head in deep water without using earplugs. Merck and Co. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Manual was first published in as a service to the community.
Learn more about our commitment to Global Medical Knowledge. This site complies with the HONcode standard for trustworthy health information: verify here. Common Health Topics. Then, viruses or bacteria grow in the mucus and make pus, which builds up in the middle ear. When doctors refer to an ear infection, they usually mean otitis media rather than swimmer's ear or otitis externa. Otitis media with effusion is when noninfected fluid builds up in the ear.
It might not cause symptoms, but in some kids, the fluid creates a sensation of ear fullness or "popping. Kids especially in the first 2 to 4 years of life get ear infections more than adults do for several reasons:.
Other things that can put kids at risk include secondhand smoke , bottle-feeding, and being around other kids in childcare. Ear infections are more common in boys than girls. Ear infections are not contagious, but the colds that sometimes cause them can be. Infections are common during winter weather, when many people get upper respiratory tract infections or colds a child with an ear infection also might have cold symptoms, like a runny or stuffy nose or a cough.
Middle ear infections often go away on their own within 2 or 3 days, even without any specific treatment. In some cases, an infection can last longer with fluid in the middle ear for 6 weeks or longer , even after antibiotic treatment. Doctors will do a physical exam and examine the ear. They use an otoscope , a small instrument similar to a flashlight, to see the eardrum.
The type of otitis affects treatment options. Not all kinds need to be treated with antibiotics. Because most ear infections can clear on their own, many doctors take a "wait-and-see" approach. Kids will get medicine for pain relief without antibiotics for a few days to see if the infection gets better. Also, overuse of antibiotics can lead to antibiotic-resistant bacteria, which are much harder to treat. If a doctor does prescribe antibiotics, a day course is usually recommended.
Kids age 6 and older who don't have a severe infection might take a shortened course for 5 to 7 days. Some children, such as those with recurrent infections and those with lasting hearing loss or speech delay , may need ear tube surgery. An ear, nose, and throat doctor will surgically insert tubes called tympanostomy tubes that let fluid drain from the middle ear. This helps equalize the pressure in the ear. Antibiotics can be the right treatment for kids who get a lot of ear infections.
Their doctors might prescribe daily antibiotics to help prevent future infections.
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