Your child has had another episode of cold, and has been crying and rubbing the ear. You learnt that the ear and throat are connected, but are not really sure how the infection of the throat may pass up the ears. You are worried if your child may lose the sense of hearing. You are anxious and confused. Awareness about ear infections can help you offer good care to your child.
Basics of Ear
Ear is an organ for hearing and balance. It helps us to perceive sounds and maintain a sense of position and balance of the body. The ear has three parts: the outer, middle, and inner ear. The outer ear is the flap and the canal that leads towards inside. This part gathers and transmits sound to the middle part of the ear. The outer and the middle ear are separated by the ear drum. In the middle ear, are three tiny bones that set into motion due to sound waves hitting the ear drum and setting it into vibration. The movement of the bones amplifies sound. The sound waves are then transmitted to the inner ear that consists of fluid filled coiled channel. This inner ear structure called the cochlea is lined by hair cells. Due to the oncoming sound waves, the fluid in the cochlea is set into motion which in turn moves the hair like processes. The sound is hence converted into an electrical signal by these hair cells are connected to the nerve that carries sensation of hearing to the brain.
About Earaches
The commonest cause of an earache is an infection in the middle ear that causes fluid to accumulate in this part of the ear. The fluid can cause the ear drum to bulge and it may rupture to release the fluid into the ear canal. Earache can be caused by pain and swelling in the jaw, problem in the sinuses, a sore throat, enlarged tonsils, or an infection in the teeth. Any injury or foreign body in the ear or an impacted wax can lead to pain in the ear. Besides these, water, soap, shampoo left in the ear and irritation due to swabs used for cleaning the ear can cause earache.
Earaches are common in children as they are at high risk of ear infections. This is because they have smaller and less inclined eustachian tubes that can be easily blocked by an infection in the throat. The eustachian tubes connect the middle ear to the throat and help to maintain pressure in the middle ear. Children in addition are less capable of fighting infections as compared to adults. The defense mechanisms in then are less developed. Bottle-feeding, exposure to smoke and pollutants, and exposure to infections in the day-care put children at higher risks of ear infections.
Symptoms of ear infection
Ear infections cause pain or compromised hearing. The child may cry, pull the ears, get irritable, and may have disturbed sleep. Fluid may drain from the ear, if the ear drum has ruptured. Chewing and sucking may get painful and difficult. Some may develop problems with balance of the body.
Earaches caused by fluid accumulation in the middle ear can cause a transient loss of hearing. The child may show a delayed or no response to sounds, may talk loud, and appear inattentive at school. Such children prefer music on high volumes. This happens because the fluid impairs conduction of sound in the middle ear. The loss can be up to 30% of the hearing capacity.
Diagnosis
An ear infection can be suspected, if the earache follows a sore throat. The ear may discharge fluid, if the drum has perforated. The doctor may examine the ear by using an otoscope, an instrument with a light that is inserted into the ear canal to examine the ear drum. In infections, the drum may be red and inflamed. Tympanometry is another test done to check the flexibility and mobility of the drum in response to change in sound intensity or pressure.
Treatment
Some infections may settle spontaneously. So, the doctor may like to wait and watch. Medicines to fight infections, called antibiotics, may be used for 10 days in severe infections and 5 to 7 days in moderate infections. Pain or fever can be reduced by medicines like acetaminophen and ibuprofen. These are available over-the-counter. An infection that persists for longer than 3 months may need an examination every 3 to 6 months.
After an infection, the fluid may remain in the middle ear even after a complete course of treatment with antibiotics. This fluid clears by 3 to 6 weeks. Persistent fluid beyond 12 weeks needs to be drained surgically by making an incision in e ear drum. This may be influenced by the state of the ear drum and condition of the patient.
Ear tubes are inserted after surgical drainage of the middle ear to clear the fluid. Used in repeated fluid accumulations in the middle ear, these help to keep the ear drum open and permit the fluid to drain. They aerate the middle ear. Ear tubes stay for around 4 to 6 months.
Preventing ear infections
It is a myth that cold and allergy medicines like antihistamines and decongestants can help to prevent ear infections. Simple measures, instead can help to keep them away. All infants should be breast fed for at least 6 months. Breast milk builds the body’s defenses for infections. When given a bottle feed, the child should be held at an angle and the child should not be allowed to lie with it. All children should be well immunized. Both parents and children should keep clean, and practice hand washing to get rid of germs. Exposure to smoke should be avoided and a child with a respiratory infection should not be sent to the day care as the infection may affect other kids.
Prevention of ear infections and their timely management can help to keep ears healthy and safeguard hearing.
