Otitis media is a prevalent ear infection treated by ENT specialists worldwide. In Singapore, almost 60% of children have experienced an episode of otitis media by the age of six.
While many cases resolve with minimal intervention, otitis media can cause temporary hearing loss due to fluid buildup or limited eardrum movement. Should these issues persist, or recur, the potential for permanent hearing damage increases, particularly affecting the conductive pathway. Therefore, early recognition of symptoms is essential, enabling prompt treatment and preventing long-term hearing complications.
What Is Otitis Media?
Otitis media refers to the inflammation or infection of the middle ear. This condition often arises from colds, throat infections, or respiratory illnesses, which can cause fluid buildup behind the eardrum.
When this trapped fluid becomes infected by bacteria or viruses, it can lead to ear pain, pressure, and hearing difficulties. Although more prevalent in children, adults can also experience this condition.
Mild cases of otitis media may resolve on their own. However, persistent or severe infections may require medical intervention.
There are several types of otitis media:
- Acute Otitis Media (AOM): A middle ear infection that causes redness, swelling, and fluid buildup behind the eardrum. It often causes ear pain, fever, and temporary hearing loss.
- Otitis Media with Effusion (OME): Occurs after the infection clears, as fluid may linger in the middle ear without causing active inflammation. This can lead to a sensation of ear fullness and mild hearing issues, though symptoms may be subtle or absent.
- Chronic Otitis Media with Effusion (COME): Persistent or recurring fluid in the middle ear, even without an active infection. This condition can make it harder to fight new infections and may contribute to long-term hearing difficulties.
Symptoms of Otitis Media and Its Impact on Hearing
Otitis media commonly presents with a variety of symptoms:
- Ear Pain and Pressure: A persistent, aching sensation in the ear, often exacerbated by lying down.
- Fluid Drainage: Yellow, white, or brown discharge from the ear, which may indicate a ruptured eardrum.
- Fever and Irritability: Frequently observed in children, and is often accompanied by restlessness and fussiness.
- Balance Issues: Dizziness or unsteadiness, particularly in young children.
These symptoms can significantly impact hearing and cause:
- Temporary Hearing Loss: Fluid trapped within the middle ear space muffles sound transmission, resulting in temporary hearing loss.
- Long-Term Hearing Damage: Untreated or recurrent otitis media can lead to chronic inflammation and potential damage to the middle ear structures, resulting in conductive hearing loss.
- Speech Delays in Children: Prolonged hearing difficulties can hinder language development and speech acquisition in young children.
What Are the Causes and Risk Factors?
Otitis media can arise due to several factors, including:
- Bacterial and Viral Infections: Upper respiratory infections, such as the cold or flu, can lead to inflammation and fluid buildup in the middle ear, increasing the risk of infection.
- Eustachian Tube Dysfunction: When the eustachian tube fails to regulate pressure or drain properly, fluid stagnates, increasing the risk of infection.
- Air Quality and Allergies: Exposure to haze, dust, and allergens can trigger nasal inflammation, leading to eustachian tube blockage.
- Tropical Climate: High humidity encourages bacterial growth, making infections more common in tropical countries like Singapore.
- Enlarged Adenoids: Enlarged adenoids, located in the back of the nasal cavity, can obstruct the Eustachian tube opening, increasing the risk of otitis media.
How Is Otitis Media Diagnosed?
An ENT specialist plays a key role in diagnosing otitis media through various tools and methods. Common diagnostic tests include:
- Otoscopy: The primary method involves using an otoscope to inspect the eardrum for signs of infection, such as redness, swelling, or fluid behind the eardrum.
- Hearing Tests (Audiometry): To assess the impact on hearing, an audiologist may perform hearing tests to evaluate for any temporary or permanent hearing loss resulting from fluid accumulation or recurrent infections.
- Tympanometry: This test measures the pressure in the middle ear by adjusting air pressure in the ear canal. It helps detect fluid accumulation and assesses how well the eardrum moves, which is crucial for confirming an infection.
Additional diagnostic tests, such as blood tests and tympanocentesis (middle ear fluid sampling), may be necessary in cases of persistent or severe infection. These tests help ensure accurate diagnosis and guide appropriate treatment.
Treatment Options for Otitis Media
Treatment plans for otitis media are individualised based on the severity of the infection and the child’s specific needs. The following are the common treatment options for otitis media:
Medications
- Antibiotics: The doctor may prescribe antibiotics treatments to eliminate the persistent infection. However, mild cases are often observed for 2–3 days, as a child’s immune system can sometimes clear the infection without medication.
- Pain Relievers & Decongestants: Over-the-counter medications can ease pain and reduce fever. However, the dosage should be determined by an ENT specialist, as individual needs may vary.
Surgical Interventions
- Myringotomy: In cases of recurrent infections, severe pain, or complications, a small incision in the eardrum may be made in the eardrum to drain fluid. A ventilation tube (grommet) may be inserted to prevent future buildup.
- Mastoidectomy: In severe or chronic cases (such as mastoid bone infection that does not respond to antibiotics), a mastoidectomy may be necessary. This surgery removes infected tissue and ensures better drainage behind the ear.
Hearing Rehabilitation
- Hearing Aids: For long-term conductive hearing loss due to repeated ear infections or fluid buildup, hearing aids may be used. This is often recommended for patients with otitis media with effusion (OME). Hearing aids can be considered as early as three months old.
- Cochlear Implants: For profound hearing loss that does not improve with hearing aids, cochlear implants may be an option, particularly in cases of chronic otitis media with effusion (COME).
How to Prevent Otitis Media
While otitis media cannot be completely prevented, taking proactive measures can help reduce risk factors associated with it. These measures include:
- Ear Hygiene: Regularly clean the outer ear gently and avoid inserting objects into the ear canal, as this can introduce foreign bacteria and viruses that can cause otitis media.
- Vaccinations: It is best practice to ensure children are up-to-date with key vaccinations, such as the pneumococcal and influenza vaccines, to reduce the risk of ear infections significantly.
- Managing Allergies and Sinus Issues: Singapore’s tropical climate, with its humidity and air quality concerns, can aggravate sinus and allergy issues. Using antihistamines or nasal sprays can help prevent fluid buildup and reduce the risk of otitis media. Consult your ENT specialist before giving children any allergy medications.
- Avoiding Exposure to Cigarette Smoke and Pollutants: Cigarette smoke is a major irritant and can significantly increase the likelihood of ear infections, especially in children. It is important to avoid smoking and limit exposure to environmental pollutants, which can exacerbate respiratory and ear conditions.
- Regular ENT Check-ups: Regular check-ups with an ENT specialist are important, especially for those with a history of ear infections. These visits help detect early signs of ear problems and allow for prompt treatment to prevent complications.
Remember, early detection and treatment can protect your hearing and prevent future complications. If you or your loved ones are experiencing symptoms related to otitis media, schedule an ENT consultation. You may give us a call at 6738 1616 to book an appointment with our ENT specialist in Singapore.
