What is Otitis Media?
Otitis Media (OM) refers to the inflammation and infection of the middle ear space. It can vary in its presentation and severity.
When OM occurs, fluid is trapped behind the eardrum in the middle ear space - which is usually an air filled area. Fluid arises from the Eustachian tube, which runs from the middle ear space to the nose. The Eustachian tube function is to equalise pressure and clear any secretions that arise. When this isn’t working effectively, fluid can build up.
Sometimes, the fluid can cause temporary blockage and will clear on its own. However, when this fluid does not clear spontaneously, it can cause ongoing hearing loss and a blocked sensation in the ears. If this persists, the fluid can become infected. When this happens, there is often ear pain accompanied by swelling and redness of the eardrum. At this stage, the pressure gradient can become so great that the eardrum ruptures and the fluid is released into the ear canal.
If pain and discharge recurs time and time again, this is referred to as Chronic Suppurative Otitis Media (CSOM) otherwise known as Glue Ear.
Common Risk Factors
- Poor sanitation/overcrowding
- Underdeveloped or narrow Eustachian tube
- Climate – more likely in winter or spring months
- Respiratory infections
- Pre-existing or familial history of OM
- Age (common in young children whose features are still developing)
- Craniofacial abnormalities
Signs and symptoms of OM
Adults
- Ear pain
- Fever accompanied by ear pain
- Discharge from the ear
- Hearing loss
- Blocked sensation in the ears
- Fullness or pressure build up in the ears
- Tinnitus (ringing/buzzing/humming in the ears)
Children
- Speech delay
- Pulling at ears
- Fever
- Discharge from the ear/s
- Poor sleep
- Poor appetite
- Poor mood
When to see a Doctor
If you have these symptoms or are experiencing OM, it is best to consult with an Ear Nose and Throat specialist who can determine where the problem is arising in your personal situation and devise a management plan. If you are concerned about hearing loss, you can contact our team or perform a free hearing text online.
Treatment
The main goal in managing OM is to remove fluid from the middle ear space, aid in drainage and ventilation long term, and eliminate any infection.
Treatment can involve:
Antibiotics
- Often used to heal acute infections that do not recur
Improving nasal congestion and Eustachian tube function
- Balloon blowing or nose blowing
- Valsalva manoeuvre (moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth, pinching one's nose shut while expelling air out as if blowing up a balloon)
Surgery
- Small tubes inserted in the eardrum to aid in drainage and pressure flow that last between 12-36 months before falling out - often a management option for CSOM or Glue Ear for long term relief
