Otitis is the inflammation of the ear or its tissues. It is a very frequent pathology in children: it is estimated that 19% of children between 4 and 24 months have suffered from it at some time.
Causes
Otitis is due to inflammation of the Eustachian tube, which will not allow the middle ear to ventilate and to have the same atmospheric pressure that exists on the outside.
Then, the middle ear mucosa produces a secretion that occupies this area and can become infected, causing pain, fever and, in the end, the rupture of the tympanic membrane towards the outside and the liquid comes out and oozes.
The Eustachian tube becomes inflamed when the neighboring structures adenoids and tonsils are in turn infected or inflamed, although it can also occur due to allergy or even malfunction due to its more horizontal situation in infants or due to malformations.
Otitis in children
Otitis is the most common infectious disease of childhood. For many pediatricians, it is the most frequent cause of visit and diagnosis of illness. It has also been considered the most frequent cause of illness after the common cold.
Nineteen percent of children between 4 and 24 months have had otitis. Children can be divided into three groups of approximately equal size in relation to otitis: a group with no disease, another group with occasional otitis, and a third with a susceptibility to otitis.
There are relationships of otitis with some personal traits: some races are more predisposed, such as North American Indians, Australian Aborigines or gypsy children. There is also a relationship with poor social and economic status or living in overcrowded conditions, although the causes are unknown.
On the other hand, it has been established that children who are breastfed for 12 months have less otitis than those who are fed artificially or breastfed for only one month.
Treatments
To treat otitis, broad-spectrum antibiotics or cephalosporin are administered in resistant cases, in addition to anti-inflammatory drugs and, exceptionally, oral corticosteroids.
To keep the nasal passages permeable, we will use serums or sterile seawater solutions, which will help to clear the secretions from the nose. In more persistent cases, locally acting topical nasal corticosteroids may be used.
Surgery
Surgery is considered when repeated otitis causes hearing loss lasting more than 3 months or tympanic membrane deformities occur.
In these cases, it is usual to place drainage tubes in the tympanic membrane, called ventilation tubes. They allow ventilation of the middle ear and make mucus and infection more difficult. In short, they substitute the function of the Eustachian tube until it recovers from its pathology.
When there are hypertrophic adenoids (vegetations) that obstruct the Eustachian tube or facilitate its inflammation, they are removed, a process called adenoidectomy.
The same occurs with the palatine tonsils (angina), which will also be removed in the event that repeated inflammatory processes damage the Eustachian tube (tonsillectomy).
Possible complications of otitis
Complications are exceptional in this disease. As otitis develops in the middle ear, complications reach nearby areas, such as the inner ear.
For example, labyrinthitis (swelling of the inner ear) causing dizziness and hearing loss or facial nerve involvement with paralysis may occur.
However, the most common complication is mastoiditis, which is inflammation of the area behind the pinna with pain and redness.
Prevention
The best way to prevent otitis is to be vaccinated against the germs (mainly pneumococcus) that cause middle ear infection.
Another method of prevention is chemoprophylaxis, that is, administering antibiotics to patients for long periods of time even if they do not have the disease.