Otite/Ear infection signs and treatment
What is otitis media?/Ear infection signs
The term otitis defines all inflammatory disorders of the ear, external, middle or internal, whether acute or chronic. These conditions, very frequent, must be recognized and correctly treated. Otitis is the second common infectious disease after rhinopharyngitis.
The different types of otitis
ACUTE MEDIUM OTITIS
Acute otitis media (AOM) an inflammation of the ear canal caused by infection. It is often in the course of a nasopharyngitis that the symptoms appear. A pain in one ear (unilateral earache) with a decrease in hearing (hearing loss) on the painful side often accompanied by fever. In infants there are other signs: bottle refusal, diarrhea, vomiting, fever, weight stagnation, greyish complexion, unexplained crying, sleep disturbances, etc. In babies, the signs of call are very diverse and it does not do not wait for him to bring his hand to his ear! Cries, restlessness and crying are only found in 7.5% of cases … That’s why the examination of the eardrums is part of the routine of the doctor consulted for a sick infant.
During the consultation, the doctor will look inside the ears using an otoscope. This examination makes it possible to differentiate several types of otitis media:
Congestive otitis: The membrane of the tympanum, still transparent, is pink or red. The reliefs are congestive but visible. The bright triangle has disappeared. The congestive eardrum is very painful. The pediatrician or ENT, a hearing care professional, will have to see your child again to compare his two exams to make sure it is not purulent otitis.
Exudative otitis: The eardrum is thick, opaque, congested or greyish. The reliefs are not very visible.
Suppurative otitis: The eardrum is bulging. The pain is permanent, insomnia, throbbing, intense and pulsating, radiating to the temple and occiput. The bulge of the tympanum begins in the postero-superior quadrant which will begin to overhang the handle of the hammer, removing the relief of it. On the other hand, the tympanic membrane, under the pressure effect of the purulent collection, becomes white. In the pre-perforation stage, the eardrum is bulging as a whole and yellowish in color.
Acute otitis with the flowing ear (othorea): This is the stage of spontaneously perforated otitis with loss of substance of the tympanic membrane allowing a flow of pus into the external auditory canal. Spontaneous otorrhea sometimes reveals otitis in an infant who was previously not too sick. The pressurized pus is evacuated through this “spontaneous paracentesis”. Often, the size of the orifice by bursting of the tympanum under pressure is insufficient to drain all the secretions. In addition, its seat on the eardrum does not always allow good drainage and good healing.
Otitis externa refers to inflammation of the external auditory canal caused by a bacterium or fungus. Two main causes are responsible for inflammation: the repeated contact of the duct with objects (for example by cleaning the ears) and the presence of water in the duct (for example after a bath). Otitis externa causes pain, itching and an outflow of the ear. In otitis externa, the pain when pulling on the ear is quite characteristic. Treatment is based on antibiotic, antifungal ear drops.
Frequent in children between 1 and 8 years, otitis serosa is not painful. It is the accumulation of more or less abundant and more or less thick liquid behind the tympanum which drowns the ossicles and mouths the Eustachian tube. This duct makes it possible to send air into the ear during swallowing or at altitude. To treat serous otitis, it is better to consult an ENT doctor who will restore optimal aeration of the Eustachian tube. In fact, untreated, this type of otitis creates a hearing loss because the eardrum will not vibrate properly.
THE VIRAL OTITE
Viral otitis is an inflammation of the ear caused by a virus. It often triggers after a flu. Be aware that most viral otitis is in fact acute otitis media. “Bubbles” liquid come to rest on the tympanic membrane which causes a sharp pain of ear. The treatment involves piercing the bubbles, taking anti-inflammatories and painkillers. The most common complication of viral otitis is a partial loss of hearing.
otitis media?/Ear infection signs treatment
The treatment of acute otitis media is aimed at relieving pain, lowering fever and treating infection. Taking analgesics is recommended: it can act on both fever and pain. The treatment can be supplemented with antibiotics in case of suspicion of bacterial origin. To relieve the ear canal, the doctor will also prescribe saline or decongestants to children. Nasal washes with physiological saline (Prorhinel®, Gifrer® nasal solution etc …) are essential. Antiseptic or antibiotic nasal drops are useful as long as nasopharyngeal aspiration is associated with them.
In case of very painful otitis or complications, or if these are repeated too often, a paracentesis with installation of trans-tympanic aerators, or diabolos, through the tympanum limits the recurrences. Paracentesis consists of the incision of the eardrum using a lanceolate needle, at the level of the posterior bulge, followed, if possible, by the aspiration of the purulent secretions, then a wetting of the auditory canal. The duration of the flow thus caused is 2 to 3 days. Paracentesis is performed without anesthesia in infants and under general anesthesia in children. General antibiotic therapy may be prescribed as a supplement to paracentesis for 8 or 10 days, adjusted according to the bacteriological findings of pus removal. Monitoring the eardrum in the days following the paracentesis is essential to control drainage efficiency and normalization of the tympanic reliefs. An examination is necessary one week after stopping the antibiotics to affirm the cure.
Otitis: the possible complications
Complications of acute otitis are rare with proper treatment. The favorable evolution under a correct treatment results in a very fast disappearance of the fever and the possible digestive signs. The auditory inflammation disappears very quickly and the eardrum regains an almost normal appearance in 3 to 4 days and normal in 7 to 10 days.
Facial paralysis: One must think of it in front of an asymmetry of facial features, especially when the child is crying, smiles or pouting. On the paralyzed side, the cleft of the eyelids is enlarged, the nasolabial fold is erased, the labial commissure is lowered while on the non-paralyzed side, the mouth is drawn upwards and outwards. This paralysis disappears with the healing of otitis.
Purulent meningitis: it is a complication always feared by the pediatrician during the purulent otitis of the child.
Labyrinthitis: It is manifested by vertigo, vomiting, nystagmus, deafness.
Acute mastoiditis: The cavities of the middle ear all communicate with each other, from the orifice of the Eustachian tube to the mastoid. In the absence of adequate treatment, externalized mastoiditis may occur: bulging under the skin behind and above the auricle of the ear, resulting in breakage of the mastoid cortical pus. The treatment is surgical: the specialist must open the bone and scrape it to remove pus and foci of necrosis. It is an “antrectomy” or “mastoidectomy”