6.5 Otitis Media

Question 1

Otitis Media Facts

Answer 1

• Infection/inflammation of middle ear.
• 75% of kids have one episode, 33% have more than 3 by age 3
• MOST COMMON BETWEEN AGE 6 months to 2 years due to angle of their ear canal.
• Mote common in boys than girls

Question 2

Otitis Media

Answer 2

• Purpose of Eustachian Tube is to drain the middle ear secretions into the pharynx, ventilate the middle ear and equalize pressure.
• Child eustachian tube is angled different than adults causing increased risk for ear infections.

RISK FACTORS
- Smoking in house (teach parents to not smoke in house)
- Bottle fed babies (because when a bottle is propped and the child is upright, there is more constant pressure while sucking on the bottle which causes secretions to get more easily trapped) - Breastfed pressure is less.

Question 3

Pediatric Differences

Answer 3

• Eustachian tube is shorter, wider and more horizontal (horizontal component makes children more at risk for otitis media)
• Adults have more of an angle

Question 4

Otitis Media

Answer 4

• Caused by bacteria or virus but most commonly H-Flu and Strep

Question 5

Ear Exam

Answer 5

• Cone of light on tympanic membrane

Question 6

Otitis Media Symptoms

Answer 6

• Biggest symptom is ear pain
• Fussy kids and irritable
• May have a fever or GI symptoms (vomiting diarrhea)

SEVERE
- Ruptured tympanic membrane (there will be initial pain relief then accompanied by severe pain. You will also see drainage )

Question 7

Treatment Otitis Media

Answer 7

Bacterial - Antibiotic eardrops for 10 days or systemic

• Most commonly “watch and wait” for 2-3 days to see if it resolves on its own to avoid antibiotic resistance.

Viral - Support Care
- Analgesics for pain
- Decongestion meds

Chronic Ear Infections
- PE Tubes (Pressure equalizer tubes)
- Also called tympanostomy tubes
- Help drain fluids and allow better ventilation of middle ear.
- Tubes remain in ears for about 6 months then spontaneously eject themselves
- Because these tubes are open, it is important to make sure these tubes to not become clogged or filled with water

EDUCATION
- Ear plugs when bathing/swimming

Question 8

Otitis Media Risk Factors

Answer 8

• Daycare attendance
• Smoking
• Crowded living