Ear Infections (Otitis Media)

One of most common conditions in children is middle ear infections (otitis media). US consensus estimates nearly 10 million children are treated each year for ear infections. This condition also occurs in adults, but usually much less frequently.

Otitis media is also the most common cause of conductive hearing loss in children. The ear is a very complex organ that can be divided into three parts. - the outer, the middle ear and the inner ear.

The middle ear is the location most common for ear infections in children. One of the reasons is that the middle ear is dependent on the Eustachian tube for part of its function. The eustachian tube is not completely mature during childhood, therefore making kids more prone to ear infections. The Eustachian tube connects the middle ear to the back of the nasal passage/throat, allowing for appropriate ventilation, and mucociliary clearance and pressure equalization.

Ear infections are most common among the youngest children, especially those between the ages of six months and three-years old. Ear infections usually follow an upper respiratory tract infection such as the common cold. Often otitis media clears spontaneously and/or when treated properly with antibiotic therapy. However, if the fluid or effusion does not clear, it may become chronic and last for weeks or months. Typically persistent middle ear effusion (fluid) lasting three months or greater requires further evaluation and treatment, possibly myringotomy tube placement. When otitis media does not respond well to antibiotics, you or your primary physician may refer your child to Dr. Parhizkar for an evaluation.

It is important to get a professional evaluation if your little one has frequent episodes of ear infections as it may affect speech, hearing, balance, sleep and behavior.

Depending on the presentation and circumstances, myringotomy and tube placement may be recommended. This procedure is intended to improve the ventilation and pressure equalization of the middle ear, which therefore :

1. Reduces Conductive Hearing loss and possible speech and language development
2. Significantly reduces the frequency and duration of ear infections
3. Provides a direct route to treat ear infection when they do occur via antibiotic ear drops vs. need for repeat oral antibiotics
4. Takes the guessing out for parents with toddlers! If your child has a high number of "colds" and fever, it is often hard to know if the ears are the problem. When your child has a tube placement, the parents will know if there is an infection because there will be ear drainage. Also kids are less likely to get temperature spikes with their ear infections if they have tubes inserted.

Duration of myringotomy tubes: Typically 6 months to 1.5 years. They usually excrude with normal growth of the eardrum, leaving little, if any, scarring.

Children at a Higher Risk of Ear Infections:

1. Have frequent exposure to cigarette smoke
2. Use a pacifier or sleep suckling on their bottle
3. Have allergies or asthma
4. Attend day care

Children with craniofacial anomalies, downs syndrome and or cleft palate are also more susceptible to Eustachian tube dysfunction and may be more likely to need myringotomy and tube placement.

If your child suffers from any problems caused by chronic middle ear infections and/or persistent fluid in his or her middle ear despite treatment, it is recommended that you meet with our pediatric ear, nose and throat specialist, Dr. Parhizkar, to discuss options. Dr. P wants each parent to be well informed about the pros and cons of each treatment option to determine if ear tubes are best option for your little one.

We believe our job is to inform you about your options just as much as to give you the best care possible. — Dr. P