Acute Otitis Media and ear infections are Becoming More Common

Otitis media is an inflammation of the middle ear (the cavity between the eardrum and the inner ear). The eustachian tubes equalise the pressure between the middle ear cavity and the outside atmosphere and allow fluid and mucus to drain out of the middle ear cavity. Inflammation of the middle ear causes the tubes to close causing the fluid to become trapped.

the University of Michigan in Ann Arbor, and colleagues conducted a study of 87 children with acute mastoiditis, defined as inflammation of the middle ear space and signs of mastoid inflammation or evidence of sigmoid sinus thrombosis, abscess formation, or destruction of mastoid air cells.

The study spanned an eight-year period, from January 2000 to December 2007, and during that time cases of acute mastoiditis and mastoid subperiosteal abscess became more frequent, the researchers found. The increase remained even after adjusting for case volume.

"This increase in cases of acute mastoiditis with subperiosteal abscess does not appear to be fully explained by changes in practice volume, referral patterns, antibiotic therapy, and antibiotic resistance, suggesting a possible increase in incidence," the authors write. "However, population-based studies that include appropriate data for calculation of person-time at risk will be necessary to definitively determine if the incidence of suppurative complications of acute otitis media is on the rise."

Known causes

The inflammation can occur as a result of an infection extending up the eustachian tube. This tube may become blocked by a bacterial or viral infection or by enlarged adenoids.Children are more commonly affected than adults because of the small size and horizontal position of their eustachian tube (the passage that connects the back of the nose to the middle ear. The four main causes of otitis media are allergy, infection, blockage of the eustachian tube and nutritional deficiency. Additionally, in infants, otitis media has been associated with bottle feeding.

Identify it

Serous otitis media may not cause any symptoms, however, fluid remaining in the middle ear for a long period of time may result in hearing loss. Although this condition can develop on its own, it most commonly occurs after being treated for acute otitis media.Acute otitis media causes sudden, severe earache, deafness, and tinnitus (ringing or buzzing in the ear), sense of fullness in the ear, irritability, tugging or rubbing the ear, an unwillingness to lie down, fever, headache, a change in appetite or sleeping patterns, fluid leaking from the ear, nausea and difficulty in speaking. Occasionally, the eardrum can burst, which causes a discharge of pus and relief of pain.Complications of a single episode of otitis media are rare and include otitis externa (inflammation of the outer ear), and spread inward from the ear to the skull, causing, mastoiditis, or into the brain, causing meningitis.

Treatment

After the diagnosis is made, a treatment plan is considered, taking into account the patient’s age, risk factors for having resistant bacteria, immunisation status, and hearing status. For low-risk children, the preferred treatment is to hold antibiotics for 24 hours and recheck the following day. Many children improve with only treatment for pain with analgesic eardrops, and then do not need any antibiotics. High-risk children are treated with antibiotics. The doctor may also recommend surgery.