Ear Infection With Ear Tubes

Otitis media is inflammation of some or all of the middle ear mucosa, eustachian tube, mastoid antrum and mastoid cells.

About 50 percent of babies have had this middle ear infection before their first birthday. This ear infection often develops after a viral infection, such as a cold or flu. The part behind the eardrum will swell and collect fluid (effusion).

Symptoms

Symptoms of otitis media in young babies consist of fever, fuss, decreased appetite, insomnia, fluid leaking from the ear and often tugging or rubbing the ear. Vomiting, nausea and diarrhea can also occur. Older children and adults may complain of ear pain and temporary hearing loss. These symptoms usually come suddenly.

Diagnosis

Contact your doctor if your child has the above symptoms. The doctor will do a physical examination and see your child's eardrum. He usually uses a device called an otoscope to look into the child's ear. Although this examination is not painful, most babies and children do not like or fear when their ears are examined. You may need to lap and hug your child if he is fussy when examined. The presence of thick fluid behind the eardrum marks bacterial infection.

In certain cases, the doctor will insert a needle through the eardrum to take pus samples from the middle ear to be examined in the laboratory. This procedure called timpanocentesis can help the doctor know the cause of the infection. The hole in the eardrum will usually close on its own within 24-48 hours.

Treatment

In infants over 24 months, the doctor may choose to wait and let the child's immune system work against infection. He may only give medicines to reduce fever and pain in the ear.

If after more than 48 hours your child's pain symptoms continue or even worsen, antibiotics may be prescribed. Antibiotics are usually given to babies younger than 24 months. Children older than 24 months can be treated with antibiotics or delay treatment. Antibiotics are not given to every child with ear infections because studies show that many older children can overcome ear infections without antibiotics. Giving antibiotics must be done wisely because unnecessary use can result in resistant bacteria. That is, certain antibiotics are no longer effective or higher doses are needed in subsequent treatments. In addition, ear infections can also be caused by viruses so they cannot be treated with antibiotics. This infection must be cured by the body's own immune system.

If your child has a recurrent ear infection (called serous or chronic otitis media) that does not heal and makes fluid build up that interferes with hearing and speech, doctors may recommend an operation called myringotomy to drain fluid from the middle ear and insert a ventilation tube. Because most children have infections in both ears, this operation is often done on both. In surgery that is usually done under general anesthesia by this ENT doctor, a small tube called a tympanostomy tube (T tube) is inserted into the eardrum for drainage and equalizes the pressure in the middle ear. This helps to prevent future infections and fluid accumulation, and helps normalize hearing. The tube will usually come out on its own in about 6 months. In the laser tiltotomy method, the opening of the eardrum is done by a laser, not a tube.

Complications

The tympanic membrane broke

One possible complication of ear infection is the rupture of the eardrum or tympanic membrane. The tympanic membrane can rupture when the fluid presses on it which reduces blood flow and causes the tissue to weaken. The rupture of the membrane does not hurt and many people even feel better because the pressure is released. Fortunately, the tympanic membrane usually recovers quickly after rupture within a few hours or days.

Fluid buildup

The fluid that collects behind the eardrum (effusion) can last for weeks to months after pain and infection disappear. Effusion causes temporary hearing loss, but usually goes away without treatment. This effusion needs to be monitored from time to time, which includes ear and hearing testing by doctors every three to six months until it disappears. If the effusion lasts for a long time, your child may need treatment. Decision treatment is based on how much effusion affects hearing and causes speech problems.

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