Ear infections (otitis media)
Otitis media is inflammation of the middle ear.
It often occurs at the same time as a viral upper respiratory tract illness
(cold, viral sore throat). Facts about otitis media:
- More than 80 percent of children have at least one episode of otitis media by
the time they are 3 years of age.
- Nearly half of these children have three or more episodes by the time they
are 3 years of age.
- Otitis media can also affect adults, although it is primarily a condition
that occurs in children.
- Otitis media is the most common diagnosis for children in the US.
- About 30 million visits to the pediatrician each year are due to otitis
media.
- Otitis media occurs most often in children younger than 7 years of age and
even more frequently in children between the ages of six months and three years.
- Otitis media occurs more frequently in the winter and early spring (the
seasons during which viral illnesses are more common).
Who is at risk for getting ear infections?
While any child may develop an ear
infection, the following are some of the factors that may increase your child's
likelihood of developing ear infections:
- Exposure to cigarette smoke on a regular basis
- Family history of ear infections
- A poor immune system
- Daycare (if child is two-years-old and younger)
- Absence of breastfeeding
- Having a cold
- Bottlefed while laying on his/her back
What causes otitis media?
Young children do not ventilate their ears as well as older
children and adults because of the anatomy of the eustachian tube, the structure responsible
for ventilating the middle ear space.
The eustachian tube opens when we swallow. We are not usually aware of
this unless there is a significant difference between the middle ear
pressure and the outside air pressure, which occurs when we are descending to
land in an airplane. The sensation of our ears popping occurs when the
eustachian tube opens, and the pressure within the ear suddenly changes.
As children grow, the anatomy of the eustachian tube changes and function
improves. This is one reason children usually outgrow ear infections.
When a child develops an upper respiratory viral illness, the mucous
membranes of the nose and throat become swollen including the tissue lining the
eustachian tube. This swelling decreases the ventilation of the middle ear and
increases the likelihood of an ear infection starting.
Allergies that cause congestion of the nose and throat can also reduce
ventilation of the middle ear through the same mechanism. If your child has
symptoms of allergies which cause chronic congestion of the upper respiratory
passages, allergy management may be helpful in managing his or her middle ear
problems. However, most children who have ear infections do not have allergies
as the main underlying cause.
Factors other than eustachian tube dysfunction, such as a less mature immune
system, probably contributes to the more frequent occurrence of ear infections
in younger children.