What is otitis media?
Infection of the middle ear
What are the symptoms of otitis media?
Earache
A high temperature (fever)
Being sick
A lack of energy
Slight hearing loss – if the middle ear becomes filled with fluid, hearing loss may be a sign of glue ear, also known as otitis media with effusion
What causes otitis media?
Bacterium or virus in the middle ear
This infection often results from another illness
How is otitis media diagnosed?
- Otoscope inside the ears
- Bulging tympanic membrane → loss of light reflex
- Opacification or erythema of the tympanic membrane
- Perforation with purulent otorrhoea
- Decreased mobility if using a pneumatic otoscope
- Stethoscope for breath sounds
How is otitis media treated?
5-day course of amoxicillin is first-line
Amoxicllin if persistent, if alergic erythromycin
What are grommets?
Grommets are very small plastic tubes, which sit in a hole in the eardrum.
They let air get in and out of the ear.
This keeps the ear healthy
What are grommets used for?
Some people get fluid behind the eardrum. This is sometimes called ‘glue ear’.
It is very common in young children, but it can happen in adults too.
We don’t know exactly what causes glue ear.
What are the alternatives to grommets?
Steroid nasal sprays may help some children if they have nasal allergy;
Congestion in the nose caused by allergy may affect the normal function of the nose and ears.
How are grommets put in?
- The operation is carried out down the ear canal so there are no cuts to see on the outside of the ear.
- A small opening is made in the eardrum using a microscope to magnify the area and the fluid is sucked out of the ear with a fine sucker.
- The grommet is then placed in the opening in the eardrum.
How long do grommets stay in for?
Grommets fall out by themselves as the eardrum is constantly growing.
They may stay in for six months, or a year, or sometimes even longer in older children.
You may not notice when they drop out.
What is glue ear?
- Glue ear is where the empty middle part of the ear canal fills up with fluid.
- This can cause temporary hearing loss.
- It usually clears up within 3 months, but see a GP about any hearing problems.
How does glue ear occur?
The cause is probably due to the Eustachian tube not working properly.
The balance of fluid and air in the middle ear may become altered if the Eustachian tube is narrow, blocked, or does not open properly.
What are the symptoms of glue ear?
- Dulled hearing
- Pain
- Development and behaviour change due to dulled hearing
How does glue ear progress?
Hearing is back to normal within three months in about 5 in 10 cases.
Hearing is back to normal within a year in more than 9 in 10 cases.
Glue ear persists for a year or more in a small number of cases.
What is the treatment for glue ear?
Wait and see
Balloon treatment
Grommets
What is otitis externa?
Inflammation of the outer ear
What are the causes of otitis externa?
- Infection
- Bacterial (Staphylococcus aureus, Pseudomonas aeruginosa) or fungal
- Seborrhoeic dermatitis
- Contact dermatitis (allergic and irritant)
- Recent Swimming
What are the features of otitis externa?
- Ear pain
- Itch
- Discharge
How do you diagnose otitis externa?
Otoscopy
- Red
- Swollen
- Eczematous canal
What is the treatment of otitis externa?
Topical antibiotic or a combined topical antibiotic with a steroid
Acetic acid or ciprofloxacin
If the tympanic membrane is perforated aminoglycosides are traditionally not used*
If there is canal debris then consider removal
If the canal is extensively swollen then an ear wick is sometimes inserted
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