Otitis Media: Symptoms, Treatment and Prevention

Otitis media is a common cause of ear pain, mostly in children, which is usually a painful complication of an upper respiratory infection such as the common cold or throat infection.

Causes of otitis media

1. The most common cause is due to viral infections of the upper respiratory tract, such as nasal congestion caused by a cold or flu, which can easily cause otitis media.

2. Blowing the nose too hard may also cause otitis media.

3. Inappropriate dilatation of the eustachian tube during swimming may cause bacteria to enter the middle ear and trauma to the eardrum, causing germs to enter the middle ear from the external ear canal and cause otitis media.

4. Due to certain physiological characteristics of infants, when breastfeeding in an incorrect position, such as nursing horizontally or lying down to suck on a bottle, milk can easily enter the middle ear via the eustachian tube and cause infection.

Symptoms of otitis media

The most common symptoms of otitis media are a feeling of stuffiness or blockage in the ear, hearing loss or tinnitus, etc. It often occurs after a cold.

1. Hearing loss: Hearing loss and sometimes blockage. If only one ear is affected, it may go unnoticed for a long time.

2. Ear pain: In acute cases of otitis media, there will be persistent mild ear pain or occasional throbbing pain, while in chronic cases of otitis media, the ear pain is not obvious.

3. Tinnitus: You may feel a slight ringing in your ears. When you yawn, blow your nose or perform head movements, a sound similar to water flowing in your ears may occur.

Hazards of otitis media

1. Repeated otitis media can cause the eardrum perforation to increase and the middle ear adhesions to harden, causing further hearing loss. If medication is not used properly, it may cause a decrease in the function of the nerves in the inner ear, making it more difficult to heal.

2. Repeated inflammation of the middle ear can lead to bone erosion, which may lead to intracranial and extracranial complications such as facial nerve palsy, meningitis, brain abscess, and even life-threatening conditions.

Some misconceptions about otitis media

Otitis media is one of the common ear diseases, but there are many misconceptions about the prevention and treatment of otitis media, which often lead to recurrence or aggravation of the disease.

（1） If you don’t have ear pain or pus, you don’t have otitis media

Not all otitis media have symptoms of ear pain and pus flowing from the ear canal. For example, in otitis media, there is usually no pus in the ear canal and less ear pain. Often, there are only manifestations such as ear congestion and hearing loss, so it is often missed and misdiagnosed. It is worth noting that childhood is a period of high incidence of secretory otitis media. Moreover, children are often unable to describe the symptoms accurately, which makes it easier to delay treatment. Parents must be vigilant if they find their children turning the sound on too loudly while watching TV or asking others to speak louder when talking to them.

（2） Watery or runny ear canal is definitely otitis media

In fact, there are many reasons for water and pus coming out of the ear canal. In addition to otitis media, many ear diseases also have watery symptoms. For example, otitis externa can sometimes manifest as water coming out of the ear canal and pus flowing if accompanied by bacterial infection. There are differences in the medications used to treat these diseases, and sometimes they have opposite effects. Therefore, it is important to go to the hospital for examination of watery ears and pus, and not to just buy ear drops on your own to avoid aggravating the condition with the wrong medicine.

（3)Taking antibiotics can cure otitis media

There are many ways to treat otitis media, and it is not as simple as taking antibiotics. For example, patients with secretory otitis media are treated mainly for different causes, such as rhinitis, sinusitis, upper respiratory tract infection, etc. Nasal drops and antibiotics can be used. In addition to antibiotics for those with acute otitis media, patients with ear pain also need to use specialized ear drops. Patients with chronic middle ear mastoiditis with recurrent attacks. Those with cholesteatoma-type otitis media should have surgery as soon as possible.

(4) Otitis media cannot be cured

Some otitis media can be cured. The main reason for recurrent otitis media is that medication does not cut the bottom of the inflammatory lesion and the tympanic membrane is not repaired, resulting in water in the middle ear and continued inflammation. With the development of microscopic otology technology, some otitis media can be completely cured through surgery, such as chronic middle ear mastoiditis and cholesteatoma-type otitis media.

Prevention and care of chronic suppurative otitis media

• (1) If you have upper respiratory tract diseases such as cold, wind, cough, rhinitis, etc., you should actively treat them.
• (2) Do not blow too hard when blowing snot in general.
• (3) Pay attention to prevent water from invading the ear, prohibit swimming and diving when you are ill, and pay attention to protecting the external ear canal when bathing, getting a haircut, or walking in the rain.
• (4) Adopt the correct breastfeeding posture for the baby, i.e., lactate the baby with the head in a high position.
• (5) Do not pinch the ears indiscriminately.
• (6) Pay attention to strengthening nutrition.
• (7) Exercise to enhance physical fitness.
• (8) Do not use topical drugs indiscriminately.
• (9) The working, living and studying environment should not be too hot.

Complications of otitis media

1. Facial palsy: The facial nerve is very close to the middle ear cavity, and if it is damaged, it can cause distortion of the mouth and eyes.

2. Labyrinthitis: If the inflammation invades inward and enters the inner ear, it can cause labyrinthitis, leading to vertigo and nausea and vomiting.

3. Intracranial complications: These include meningitis, extraneural abscesses and brain abscesses, which can be life-threatening.

4. Abscess: such as subperiosteal abscess behind the ear, sub-temporal muscle abscess, and abscess on the posterior wall of the external ear canal, etc. When an abscess appears, a very soft mass can be felt locally, with redness, swelling, severe pain, and high fever. If not treated in time, the abscess spreads to the neck, causing pain when the neck is turned, and in severe cases there is destruction of large blood vessels in the neck, leading to death.