Otitis media means inflammation of the middle ear cavity with or without mastoid cavity inflammation. Otitis media can be bacterial or viral.
The middle ear is a cavity connected to the oropharynx by the eustachian tube and connected with the mastoid cavity by the mastoid antrum.
Otitis media is more common in children than in adults because the eustachian tube is shorter and more horizontal than in adults. These anatomical features cause the infection to be delivered more easily from the oropharynx to the middle ear cavity.
In children over 3 years, the diagnosis is easy as the child can talk and describe the illness and also detect the diseased ear. Also, endoscopic ear examination is possible which reveals middle ear inflammation. But, in children below 3 years, the diagnosis is difficult as the child cannot describe the illness. The child just cries loudly and sometimes hits his diseased ear with his palm.
In children below 3 years, otitis media can be missed by the physician and the sickness may be misdiagnosed as gastroenteritis because otitis media in this age presents with fever, vomiting, and diarrhea. Here, the endoscopic ear examination is helpful to confirm middle ear infection.
The treatment of acute otitis media in children is classified according to the stage of the disease whether it is before suppuration or after suppuration. Suppuration is the collection of pus behind the eardrum.
Before suppuration, the treatment is antibiotics, mucolytics, vasoconstrictor nasal drops, and analgesics. After suppuration, the treatment is mainly surgical. Myringotomy is mandatory to drain the collected pus from behind the eardrum and a prophylactic treatment is prescribed.
In the case of recurrent acute otitis media, surgical causes should be excluded such as enlarged adenoid tissue. Ventilation tubes can be introduced through the eardrum for adequate middle ear ventilation.
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