Treatment of otitis media in a 2-year-old child. Causes, symptoms and treatment of otitis in a child at home

Ear inflammation is a very common pathology among children, especially under the age of 3 years. This is due to the structural features of the organ of hearing and other predisposing factors in the development of this disease. At the same time, the signs of otitis in a child of 3 years are the same as in children of any other age. Differences may be due not to the age of the patient, but to the localization of the process. In this regard, otitis is divided into external, middle and internal. Most often, speaking about the signs, symptoms, prognosis of otitis media, it is precisely the defeat of its middle section that is meant.

The mechanism of the development of the disease

The development of the pathological process in otitis media is due to a violation of the patency of the Eustachian tube, leading to a decrease in pressure and stagnation in the tympanic cavity. The process of transmitting a sound wave to the auditory nerve can only be carried out at normal pressure in the tympanic cavity. Under such conditions, the tympanic membrane is able to transmit signals to the anvil, malleus and stirrup, and then further, to the auditory nerve located in the cochlea.

The disturbed pressure in the tympanic cavity prevents the normal functioning of this process. Audio transmission is difficult.

Reduced pressure in the tympanic cavity causes retraction of the tympanic membrane during otoscopy, which is an important diagnostic sign characteristic of catarrhal otitis.

Even greater changes occur in the ear, when, while maintaining the swelling of the auditory tube, mucus and pathogenic microbes from the nasal cavity continue to be thrown into the middle ear cavity. The stagnation existing there leads to the fact that the mucous membrane of the middle ear begins to produce exudate, and otitis from catarrhal becomes exudative.

The otoscopic picture is characterized by such signs of exudative otitis, characteristic of children and adults:

the tympanic membrane is still retracted into the cavity of the middle ear;
it is possible to determine the level of exudate, which varies depending on the position of the body.

Ear pain and hearing loss are common symptoms of otitis media in children 2 years of age and older. For younger children, these symptoms are also typical, but due to their age it is difficult for them to express complaints. The task of parents is to pay attention to the indirect and objective signs of otitis in a child 2 years old and younger.

Symptoms of otitis media in a 1-year-old child are as follows:

irritability;
bad sleep;
screaming, crying, especially at night;
constant head movements
poor appetite or refusal to eat;
increase in body temperature up to 39 degrees.

Given that otitis media is a complication of respiratory diseases, influenza, ENT pathology, the appearance of a runny nose, malaise, headache a few hours before the development of ear inflammation is very characteristic.

Careful observation of the patient allows you to determine other signs of otitis media in a 1-year-old child. These include attempts to take a forced position in bed, constant nervousness, a desire to touch the affected ear with your hand or scratch your earlobe. An important objective symptom of otitis in 3-year-old children, which makes it possible to determine the disease even in a newborn, is increased pain when pressing on the tragus of the affected ear. The child reacts to such an action by screaming or crying.

Features of purulent inflammation

With a severe course of the process, an increased amount of pus puts pressure not only on the tympanic septum, but also on the inner ear. In this case, there are symptoms that are more characteristic of labyrinthitis. Its presence is due to the fact that not only the organ of hearing is involved in the process, but also the organ of balance.

Dizziness, incoordination, vomiting are symptoms that are also characteristic of acute purulent otitis media.

A common but optional symptom of this disease for patients of all age groups is suppuration. The exudate is a viscous cloudy liquid of a yellowish or greenish color,
freely flowing from the external auditory canal. The presence of this symptom is characteristic only for purulent otitis media, and develops when the exudate thickens and the bacterial pathogen joins.

Despite the frightening appearance, otorrhea is a natural outcome of purulent inflammation. The patient's condition improves, the pain syndrome decreases, the temperature normalizes.

Hearing recovery occurs within the next 2-3 months.

With a small hole in the eardrum, scarring occurs on its own, without requiring medical or surgical intervention.

The ability of parents to suspect otitis in a child is an important part of timely treatment. In most cases, the disease is characterized by a benign and mild course. However, with the development of a purulent process, serious complications are possible. Timely diagnosis and correct treatment prevent the transition of the disease into a chronic form.

With such an ailment as otitis media, children and their parents encounter quite often. Medical statistics says that every child has had ear inflammation at least once in his life, and up to three years more than 80% of children have already suffered from this disease. In every eighth baby, otitis media is chronic. About why the ears become inflamed in children, and how to treat such a condition, tells the well-known pediatrician Evgeny Komarovsky.

About the disease

Otitis in children can be of three types. Depending on the localization of the inflammatory process, the disease can be external, medium or internal. The inflammatory process can be concentrated or diffuse, affecting the eardrum and other structures of the ear. According to the duration of the disease, otitis media are divided into acute and chronic. And the presence or absence of pus divides otitis media into two types - catarrhal (without pus) and exudative (with pus).

Bacteria, viruses and allergens can cause inflammation. They enter the auditory tube with improper blowing, sneezing, sniffing, which accompany any respiratory infection.

Therefore, it is obvious that otitis media itself is rare, much more often it is a complication of a viral infection. External most often manifested by boils in the auricle, this is a completely independent disease that is caused by microbes. Allergic otitis media is a type of reaction of the child's body to an antigen protein, it is extremely rarely purulent, but is accompanied by severe swelling. If the inflammation is localized only in the auditory tube, it is called tubo-otitis.

Some children get otitis rarely, others often. This, according to Yevgeny Komarovsky, depends not only on the immunity of this particular child, but also on the anatomical features of the structure of this particular ear.

In children with a short auditory tube, otitis occurs more often. With age, the pipe “catches up” in length and diameter of the norm, takes a more horizontal position, and frequent otitis media become rare or disappear altogether.

Symptoms

It is difficult not to notice external otitis - the auricle turns red, sometimes visually without special medical instruments (otoscope and mirror) you can see a boil or abscess, the child has a throbbing pain, characteristic of all abscesses. Hearing may deteriorate somewhat only at the moment when the abscess breaks and pus enters the auditory tube.

Otitis media manifests itself as "shots" in the ear, the pain intensifies, and then subsides for a while. There may be a slight decrease in hearing, headache, lack of appetite, dizziness, disorders of the vestibular apparatus, fever. A child who, due to age, already knows how to speak, is quite able to tell what worries him. A kid who has not yet learned to speak will often touch his ear, rub it, cry.

The most difficult thing to diagnose at home is otitis media in infants. But there are signs that will help parents figure out what exactly worries the baby:

During sucking, the baby's anxiety increases.
If you press on the tragus (the protruding cartilage at the ear canal), then the pain will increase, the baby will cry more.
If you attach the crumbs to yourself during feeding with a sore ear, it will become a little easier for him.

For any suspicion of otitis in an infant, even if the disease is not accompanied by fever or fluid from the ears, you should definitely show the baby to the doctor.

In the vast majority of cases, internal otitis is also not an independent disease, but occurs in case of improper treatment of otitis media, an advanced form of this disease, and also as a complication of meningitis. It can manifest itself a couple of weeks after suffering a viral illness with severe sudden dizziness. Often there is noise in the diseased ear, hearing is reduced. For diagnosis, you definitely need a doctor who will prescribe an MRI of the brain, tone audiometry.

Treatment according to Komarovsky

Yevgeny Komarovsky warns mothers and fathers that otitis should not be treated for a child using folk remedies and a prescription for alternative medicine, because the complications of the disease can be very serious - from the transition of an acute form to a chronic one, and then the child will be plagued by frequent otitis media, until deafness, facial paresis nerve, meningitis, etc. Therefore, burying heated oil with aloe or walnut juice is a real parental crime.

With purulent otitis media, it is absolutely impossible to warm anything up, make warming and alcohol compresses, instill warm oil, as caring grandmothers and traditional healers can advise. From such heat, the inflammatory exudative purulent process will only worsen.

Treatment of acute (suddenly occurring) otitis in a child Yevgeny Komarovsky recommends starting treatment with instillation of vasoconstrictor drops into the nose. They not only reduce the lumen of the vessels in the nasal mucosa, but also relieve swelling in the area of the auditory tube. For this, "Nazivin", "Nazivin Sensitive" (if the child is breastfed), "Nazol baby" are suitable.

The main thing to remember is that these drops do not drip for more than five days, since they cause persistent drug addiction, and it is necessary to choose children's drops in the pharmacy, the dosage of the active substance in which is lower than in similar adult preparations.

Vasoconstrictor drops are relevant only at the very initial stage of acute otitis media, when there is a chance to prevent its further development. If the chance remained unfulfilled or the attempt was unsuccessful, you should immediately contact an otolaryngologist, who will establish the type of disease, and upon examination, find out if the eardrum is damaged. If it is intact, you can use ear drops, if it is damaged, which happens quite often, then nothing can be dripped into the ear.

If pus flows from the ear, then Komarovsky urges to refuse self-treatment, not to drip anything anywhere before going to the doctor.

Suppuration with a high degree of probability indicates a perforation (breakthrough) of the eardrum, through this hole the pus enters the outer ear. With perforation, it is impossible to drip at the ear so that the medicine does not get on the auditory nerve, auditory ossicles and does not cause deafness.

If otitis media is accompanied by fever, it is reasonable to use antipyretic drugs and painkillers. To reduce high fever, it is advisable for children to give Paracetamol or Ibuprofen. Both of these medicines give a moderate analgesic effect. Often doctors prescribe a drug such as Erespal. It can be taken by children over two years of age in the form of a syrup. In tablets, this medicine is not given to children.

Are antibiotics needed?

Although most parents believe that antibiotics are necessary in the treatment of otitis media, this is far from always the case, says Yevgeny Komarovsky. With exudative otitis media, which occurs without symptoms, caused by the accumulation of fluid in the middle ear cavity, antibiotics will not affect the healing process in any way. Usually, such otitis media goes away on its own as the child recovers from the main viral disease - SARS or influenza.

Otitis media, accompanied by pain, "shooting" in the ear, can be caused by both bacteria (against which antibiotics are effective) and viruses (against which antibacterial drugs are completely ineffective).

Evgeny Komarovsky advises to wait about 2 days before starting active treatment. If there is no improvement on day 2-3, this is a signal to prescribe antibiotics to the child.

It is not allowed to wait two days if the baby's otitis media is severe, with high fever, very severe pain, and if the child is not yet 2 years old, the doctor will most likely prescribe antibiotics right away. For babies under the age of two, it is very important what kind of otitis media they have - unilateral or bilateral.

In the treatment of otitis externa, antibiotics are rarely required, usually antiseptic treatment is sufficient. Internal otitis requires symptomatic treatment, antibiotics for labyrinthitis are also rarely prescribed.

In any case, the doctor should decide on the appointment of antibiotics for inflammation of the hearing organs after conducting appropriate studies, including bacterial culture from the ear to determine the type of pathogen. If such a culture shows the presence of certain bacteria, the doctor will prescribe the antibiotic that is most effective against specific microbes.

The method of using antibiotics for ear inflammation, according to Yevgeny Komarovsky, is prescribed individually. If the eardrum is intact, the doctor may recommend drops with antibiotics, but most often antimicrobials are prescribed in tablets, and this is quite enough. There is no need to inject medicines to the child.

For the effectiveness of treatment, it is important that the drug accumulates in a problematic sore spot, and therefore, with otitis media, antibiotics are drunk for a long time and in increased doses. The minimum course is 10 days. If the child is under two years old and if he attends a kindergarten, the course is not reduced. If the baby is older than 2 years and does not go to kindergarten, then the doctor may prescribe antibiotics for him for only 5-7 days. It is very important to observe the timing and dosage in order to reduce the risk of recurrent otitis media.

Otitis media and deafness

In almost all types of otitis media, hearing is reduced to some extent. Yevgeny Komarovsky advises treating this as an inevitable situation. Otitis can lead to deafness or persistent hearing loss only if the inflammation was treated incorrectly, the auditory ossicles or the auditory nerve are affected.

Children who have been successfully treated for otitis media still have hearing loss for some time. It recovers on its own within 1-3 months from the end of treatment.

Surgery

Usually, surgery is not required for otitis media. The exception is cases when a child with severe and prolonged pain and suppuration in the ear cavity does not rupture the eardrum. Its strength in each child is individual, in some, otitis media flows from the ear already in the initial stage, in others, perforation does not occur. Then there is a risk of a breakthrough of purulent masses anywhere, including the brain. If there is such a threat, doctors make a small incision in the eardrum to ensure the outflow of pus.

Evgeny Komarovsky reassures - the rupture of the eardrum and its incision are not dangerous for the child. Usually it is quickly restored, only a small scar remains, which in no way subsequently affects a person’s hearing.

Compress for otitis media

The compress should be dry, it is not required to moisten it with anything. To prepare it, cotton wool and a small piece of polyethylene are enough. Cotton wool is applied to a sick child's ear, covered with polyethylene on top and tied with a scarf or put on a hat. The ear is thus somewhat "isolated" from the environment, less injured, including by loud sounds. In addition, a cotton compress is very useful for the mother of the sick person, she is so calmer. Traditional medicine no longer sees any benefits from the compress, since it does not affect either the risk of complications or the duration of the inflammatory process.

When a child's ears begin to hurt, even experienced parents can lose their temper from whims and tears. In order to effectively fight the disease, it is necessary to know the enemy, what is called "in person", forewarned means armed.

What is otitis?

Otitis media refers to any inflammation of the ear. Distinguish:

The outer ear (pinna and external auditory canal to the tympanic membrane) inflammation of which will be otitis externa. Here, boils caused by staphylococci and fungal infections of the ear canal come first.
The middle ear begins behind the tympanic membrane and includes the tympanic cavity, Eustachian tube, mastoid cells, and antrum. Inflammation in this area is called otitis media. This is the most common ear pathology in children.
Otitis media is also called labyrinthitis. In this case, inflammation affects the cochlea, its vestibule or semicircular canals.

Who is guilty?

Otitis media develops against the background of a bacterial (rarely viral) infection. The most common cause of its development is an aggressive streptococcal or staphylococcal flora. Most often, the infection enters the ear cavity through the Eustachian tube, which balances the pressure between the ear and the nasal cavity. Therefore, very often otitis media is the outcome of a runny nose.

A prerequisite for the development of otitis media is a significant decrease in local immunity in the child's body, children are more susceptible to ear inflammation:

suffering from rickets (see)
anemia
underweight
chronic pathologies of ENT organs
exudative diathesis
extreme forms of immunodeficiency takes diabetes, AIDS and leukemia.

But even a child without severe somatic diseases can become a victim of otitis media with banal hypothermia. The fact is that the external auditory meatus of a child, unlike an adult, does not have an S-shaped curvature. Therefore, any flow of cold air can provoke otitis in a child, the symptoms of otitis media will directly depend on the location of the inflammation.

Otitis media

With otitis externa, symptoms in children may vary depending on the severity of the process.

Also, the child will be disturbed by temperature rises and intoxication (muscle, joint and headaches, fatigue and weakness).

In addition to acute otitis media, a chronic inflammatory process can develop, which is divided into exudative otitis media, purulent or adhesive. Exudative and adhesive variants of otitis have mild manifestations in the form and hearing loss. Adhesive (adhesive) otitis media is the result of proliferation of connective tissue and fibrosis of the tympanic cavity and tympanic membrane.
In a chronic purulent process, there is periodic leakage from the ear and persistent hearing loss due to the constantly existing perforation of the eardrum.
Labyrinthitis is manifested by pain, hearing loss and, since the balance organ associated with the inner ear is involved in the process.

How to suspect otitis at home?

Older kids may well complain about earache and even talk about what kind of pain it is and where it gives. It is much more difficult with babies under two years old, who still cannot really talk and simply cry in response to pain (including otitis media). Symptoms in infants with this pathology are nonspecific:

the thought of inflammation of the middle ear can cause anxiety in the child
his unmotivated crying
rejection of the breast or bottle
also children can grab handles for a sore ear
turn head from side to side
if you press the tragus of the affected ear, the child's restlessness or crying increases due to increased pain

With any suspicion of otitis, the child should be immediately shown to a pediatrician or ENT doctor.

How does a doctor define otitis media?

The otolaryngologist has such a simple and convenient device as an ear mirror. With it, you can see changes in the external auditory canal, eardrum. So, otitis media correspond to changes in the light cone on the eardrum. For the same purpose, the doctor can use an otoscope.

First aid for otitis media

If a visit to the doctor is postponed for objective reasons (although you can’t delay it), and the child is worried and crying, the first thing you need to do if you suspect otitis media is to anesthetize the ear.

For this purpose, you can use non-steroidal anti-inflammatory drugs that have the ability to suppress inflammation, temperature and pain. Derivatives (Thyled, Calpol, Efferalgan, Panadol, Tylenol), (Nurofen, Ibuklin) and Naproxen (Cefecon) are allowed for children - see review, with dosages and prices. You can use syrup, tablets or rectal suppositories.

The second remedy for otitis media will be ear drops Otipax (170-250 rubles), Otirelax (140 rubles). This is a combination drug, which includes anti-inflammatory phenazone and local anesthetic lidocaine hydrochloride. It must be remembered that otipax can only be used if the eardrum has not been damaged (the ear has not flowed). In infants, 2 drops are instilled, and in children over two years old, 3-4 drops in each ear.

How to correctly drip drops?

Before instilling drops, the bottle with them must be warmed to room temperature. In infants, the temperature can be up to 36 degrees. Alternatively, drops are poured from a vial into a warm spoon, and then pipetted.
The child should be laid with the ear up and the auricle pulled back and down to straighten the ear canal.
After the drops are instilled, the child is held up with the ear up for at least ten minutes so that the medicine does not leak out.
In children, drops are instilled into both ears, since the process is usually bilateral.
In a baby suckling a pacifier, it must be removed before instillation of drops. In combination with a stuffy nose, a pacifier can cause barotrauma of the eardrum.

Treatment of otitis externa

Furuncle of the outer ear (purulent otitis media) is treated according to the classical scheme. At the stage of infiltration (before the formation of the rod), anti-inflammatory drugs and alcohol compresses for the purpose of resorption. After the rod is formed, surgical opening of the abscess with drainage of the cavity, washing with hydrogen peroxide or Chlorhexidine, and subsequent ointment dressings with levomecol until the wound is completely healed. With intoxication, high temperature, lymphadenitis, antibiotics are connected.

Fungal lesions of the ear canal are treated with antifungal ointments (clotrimazole, candide, flucanazole), if necessary, systemic (amphotericin, griseofulvin, mycosyst) are prescribed. As a rule, systemic antifungal agents are not used in children under two years of age.

Treatment of otitis media

In the smallest, preference is given to local treatment. For them, systemic antibiotics are too heavy a burden on the immune system and intestines (see). Therefore, very strict indications are set for antibiotics:

hyperthermia within three days from the start of local therapy
severe intoxication
poorly controlled pain that prevents the child from sleeping and eating normally

Drops in the ears are used in a course for seven to ten days. During this period, the child must be examined by an otolaryngologist to ensure the positive dynamics of inflammation or to adjust the treatment if the result is unsatisfactory.

In older (from two years old) children, therapy also begins with ear drops, supplemented with anti-inflammatory drugs (see First Aid for Otitis).

A prerequisite for the treatment of otitis media is getting rid of the common cold. With untreated rhinitis, there is a risk of re-development of inflammation of the middle ear. For this purpose, antiviral (interferon), antibacterial (drops - isofra, polydex, protorgol) and combined (vibrocil) drops are used.

Drops in the ears

— Otipax combines anti-inflammatory and analgesic effects.
—Sulfacyl sodium (albucid) is a universal antimicrobial and antiviral agent.
— Otofa- an antibacterial drug based on the antibiotic rifamycin.
Albucid and otofa are not contraindicated in case of perforation of the tympanic membrane.
— Polydex- children over two and a half years old have the opportunity to use polydex (a combination of antibiotics neomycin and polymyxin with the addition of the hormonal anti-inflammatory dexamethasone).

Course treatment is carried out from seven to ten days. During this time, it is quite possible to cure uncomplicated catarrhal otitis in a child. Treatment should be prescribed and monitored by an ENT doctor.

Antibiotics in tablets, suspensions or injections

Requirements for these drugs: safety, non-toxicity, reaching sufficient concentrations at the site of inflammation, maintaining therapeutic doses for a long time (at least eight hours for a comfortable frequency of doses per day). The duration of antibiotic therapy is seven days, except for drugs that can accumulate and maintain therapeutic concentrations in the blood for a week or ten days (for example, azithromycin, which is prescribed for three to five days).

Penicillins. Preferably semi-synthetic (oxacillin, amoxicillin, flemoxin, ampicillin, carbenicillin) and inhibitor-protected, allowing to resist resistant strains of microbes (amoxiclav, flemoklav, augmentin, unazine, sultamicillin, ampiksid).
Cephalosporins of the second (cefuroxime, cefaclor), third (ceftibuten, ceftriaxone, cefotaxime, cefazidime) and fourth (cefepime) generations.
Macrolides are currently replacing cephalosporins. More convenient in dosing, course duration and administration forms (tablets, suspension). Treatment of otitis media in children is carried out with azithromycin (azitral, sumamed, chemomycin), clarithromycin.
Aminoglycosides are the drugs of choice if there is staphylococcal suppurative otitis media in a child. Treatment with kanamycin, gentamicin, sisomycin, amikacin is carried out mainly inpatients due to nephrotoxicity.

The peculiarities of antibiotic therapy in children should include the rejection of the use of fluoroquinolones, since they are contraindicated in children under 18 years of age, and also in order to reduce the number of antibiotic-resistant infections.

To the question of antihistamines

Classical treatment regimens for otitis media involve the appointment of antihistamines to reduce the allergic component of inflammation and reduce swelling. Second and third generation agents are recommended that do not cause drowsiness or have a minimal sedative effect: claritin, desloratadine, loratadine, clarisens, cetirizine, ketotifen (see).

However, today a number of specialists (primarily American, who conducted selective clinical trials involving pediatric patients) believe that the use of this group of drugs for otitis media is inappropriate, since no direct relationship has been found between their use and the rate of cure from the disease. To date, the question remains open, since there are still no full-fledged standards for the treatment of acute otitis media in children.

Treatment of labyrinthitis

Since the process can easily be complicated by meningeal inflammation, sepsis, and even cerebrovascular accidents, treatment is carried out in stationary conditions. Antibiotics, anti-inflammatory and dehydrating drugs are used. If necessary, surgical intervention is performed.

Treatment of otitis with folk remedies

Alternative methods of treating otitis in children are quite diverse, but it should be noted that turning a child into a testing ground for experiments is not humane and reckless. Of course, in the field, when a doctor and a pharmacy are not available, a person will resort to any means at hand to alleviate the pain and suffering of a child. Therefore, we will focus on the most adequate and less harmful to children's health folk remedies for combating otitis media (ear inflammation).

External otitis media, which occurs in the form of a boil in the stage of infiltration (with a reddened tubercle without a purulent core), as well as catarrhal otitis media in children, lends itself to folk remedies. You can use a vodka or alcohol compress or lotions:

boric, camphor alcohol or vodka is applied to a gauze napkin, which is applied to the ear area
plastic film or wax paper is laid on top
the bandage is strengthened with a handkerchief or scarf
exposure time from 15 to 30 minutes (the younger the child, the shorter the treatment time)
decently dissolves infiltrates and iodine
also apply and, cutting them in half and applying a slice of a sheet to the abscess

No warming procedures for otitis media are unacceptable. Treatment with alcohol and solutions is strictly prohibited in children under one year old, even for external use. In older children, it is also not desirable, it is especially contraindicated to use undiluted medical alcohol for a compress. It is better to use camphor, boric alcohol or vodka. Instillation of boric or camphor alcohol into the ear is permissible, but only in children over 6 years old - no more than 2 drops.

With a fungal infection of the ear canal, people use wiping it with a solution of soda(not to be confused with instillation or washing). Soda creates an alkaline environment in which fungi do not reproduce well, but they are not able to completely cure a fungal infection.

Sollux (blue lamp) - a thermal procedure indicated for non-purulent otitis media. However, in everyday life it is difficult to distinguish non-purulent otitis from purulent, especially since a bacterial infection cannot be warmed up. Therefore, any folk methods should be agreed with the attending pediatrician.

Prevention of otitis media

Rational ear hygiene. It is unacceptable to clean the child's ears with improvised means, to penetrate deep into the ear canal.
After bathing, the child needs to shake or wet the water from the ear.
Children under one year old should not be in drafts without hats covering their ears.
It is necessary to treat all diseases of the ENT organs (angina, tonsillitis, rhinitis, pharyngitis) in time and fully. Bilateral otitis in a child often develops against the background of a runny nose.

Young children often get sick because the immune system is not yet fully developed and cannot resist all the infections and viruses that it encounters. Otitis in a child is a common disease that almost all parents face. The lack of therapy for otitis is fraught with the development of complications and the transition of the pathology to the chronic stage. In children, otitis occurs in a more severe form, unlike adults, therefore, pathology therapy is started immediately after the first symptoms appear.

Children at a younger age often suffer from otitis media. There are many reasons for its occurrence. But whatever the cause of the pathology, it must be treated in a timely manner without delay.

Factors in the development of otitis in children often become:

Prolonged stay in a draft.
Infection in the middle ear.
Diseases of the upper respiratory tract (pharyngitis, tonsillitis, rhinitis, sinusitis).
Acute viral pathologies.
Incorrect blowing of the nose with stuffy nose.
Mastoiditis.
Allergic reactions that contribute to the development of mucosal edema.
Incorrect structure of the nasal septum.
Decreased immune defense.

In most cases, otitis media develops against the background of other diseases and acts as a complication in the absence of treatment or its ineffectiveness.
As you know, children have weak immunity, so there can be many factors for the development of otitis media.
Types of otitis in a child
Children have different types of otitis media. They are divided into acute and chronic forms. In a mild form, otitis media rarely occurs. The disease affects both the right ear and the left. Sometimes bilateral otitis occurs. Allergic and infectious forms are also isolated.
Otitis externa
The development of otitis externa is associated with the action of external factors. For example, the occurrence of external otitis is associated with insect bites, scratching, ear injuries. As a result of the appearance of wounds, the infection penetrates into the sebaceous glands or hair follicles, affecting the external auditory canal.
When examining the patient, there is reddening of the skin in the area of the auricles, pain, purulent discharge with an unpleasant odor.
Otitis media
Chronic occurs in several stages, each of which is characterized by different symptoms. First, there are pains in the area of the hearing aid, the body temperature rises to high values. The pain increases with the onset of the evening, making it difficult to sleep at night. In the second stage, pus appears. This is due to the fact that the eardrum is torn. In the third stage, the pain subsides, there is practically no pus from the ear, and the eardrum becomes scarred. The child's hearing gradually deteriorates.
otitis media
Internal inflammation of the auditory apparatus is characterized by constant dizziness. Nausea appears, in some cases the pathology is accompanied by vomiting. There is noise in the ears and there is a decrease in hearing function. develops against the background of otitis media or is a consequence of a complication of other diseases.
Symptoms of otitis in a child
One of the most characteristic signs of the disease in children is soreness of the ears. The pains are so severe that they cannot be tolerated without painkillers. Only a doctor can determine the stage and form of the pathology.
At the first sign of a deterioration in the baby's well-being, you need to urgently contact the clinic for help.
1 year
To understand that a one-year-old child has otitis media, it will turn out if you pay attention to a number of signs. First of all, the baby develops insomnia. Irritability appears. The baby cries constantly at night. In the daytime, he often screams and is naughty. Appetite disappears. The baby often turns his head. Body temperature rises to 39 degrees.
2 years
In a small child at the age of 2 years, otitis media is manifested by the following signs:
Temperature increase.
Refusal to eat, because jaw movements bring discomfort to the child.
Constant crying, worse at night.

Small children cannot explain to their parents what exactly hurts them, but it becomes clear from the behavior of the child that it is time to take him to the doctor.
3 years
Otitis media is easier to recognize in children as young as 3 years of age. Many children are talking by this point and may try to say that their ear hurts. Signs of otitis in a baby are a deterioration in appetite, poor sleep, fever, redness of the skin in the ear area. If the child began to cry constantly, you need to contact the pediatrician.
4 years
Symptoms of otitis in children at 4 years old:
The skin flakes and becomes red.
There are painful sensations in the area of the hearing aid.
Appetite disappears.
The body temperature rises.
In some cases, nasal congestion is noted.

Pathology, in addition, is accompanied by vomiting, diarrhea and purulent discharge from the auricles.
5 years
Signs of otitis media in children under 5 years of age are sleep deprivation, loss of appetite and weakness. The child is not as active as before. There is congestion of the hearing aid, vomiting, nausea, soreness in the ears. The pain in the ear often radiates to the head, throat, and temples. Body temperature often rises to 40 degrees.
6 years
At 6 years of age, the signs of otitis media appear in the same way as at 5 years of age. The child cries a lot, becomes capricious. Pain in the ear area does not subside even in sleep. From this, the baby practically does not sleep. Body temperature rises to 39 degrees.
The cause of frequent otitis media in a child
The cause of permanent otitis in children in most cases is associated with the anatomical structure of the auricles. For this reason, viral infections have open access to penetration into the hearing aid.
The eardrum in babies is much denser than in adults, so the inflammatory process in otitis media lasts longer, and the sensations of pain are more intense.
In addition, in children, the mucous membrane has a loose structure. Or amniotic fluid often remains in the nasopharynx after birth.
Diagnosis of otitis in a child
To check if the baby has otitis media, only a doctor can do it after examining the child. If the state of health worsens, first of all they turn to the pediatrician, and then he sends the child, if necessary, to a pediatric otolaryngologist.
The following procedures are assigned:
Audiometry.
CT of the temporal bones.

During an otoscopy, the doctor examines the eardrum and its condition. Often biological material is taken for bacteriological examination. If complications of neighboring organs are suspected, usually the brain, the child is referred to a neurologist.
First aid for otitis media
When otitis begins, and in the near future there is no way to get to the doctor, you urgently need to provide first aid on your own. First of all, you should relieve the pain, which especially torments the child at night. It is recommended to provide first aid quickly.
It will be possible to cure otitis media if turundas soaked in boric alcohol are placed in the ears and left for up to 5 hours. Otipax drops are instilled into the ears. They relieve soreness and inflammation of the hearing aid. At high temperatures, take "Paracetamol" or "Nurofen". To relieve nasal congestion, Tizin, Xilen or any other vasoconstrictor drops are instilled into each nostril. During the inflammatory process, you should limit the use of hot drinks.
Treatment of otitis media in children
Only a qualified doctor can help cure otitis in a child without further complications. Self-medication of the disease in a baby is fraught with the development of complications and hearing loss.
After examining and studying the tests, the doctor will prescribe therapy. Treatment is usually given at home.

Only children under 1 year old need hospitalization. As well as patients in whom the inflammatory process occurs with complications.
Medicines and tablets are prescribed depending on the form of the inflammatory process.
In most cases, doctors prescribe drugs of the following groups:
Antipyretic.
Vasoconstrictor drops to relieve nasal congestion.
Antihistamines.
Painkillers.
Antibiotics.
Antiseptics for washing out pathogenic microorganisms from the auricles.
Physiotherapy procedures.

Antibiotics are taken if the inflammatory process is caused by a bacterial infection. Children under 1 year of age are prescribed antibiotics in the form of syrups, tablets or suspensions. Their use is due to the development of complications, an inflammatory process that affects both ears, or if the disease is severe.
In some cases, if the complications are too severe, surgery may be required.
At home
It is undesirable to engage in otitis therapy on your own. Before use, you first need to consult a doctor. Therapy with folk remedies can be very dangerous.
Alternative methods of therapy for otitis media:
Peel and grate the onion. Squeeze out the juice, soak a cotton ball in it and place it in the ear. Keep it like this for a few hours.
Several leaves of parsley are poured into 300 ml of water and put on fire. Bring to a boil and turn off. Cool to make the broth warm. Dial in a pipette, drip into a sore ear 8-10 drops. Every day, no more than 3 drops are instilled into the ear.
Chamomile inflorescences pour 400 ml of water, put on fire. Boil. Cover the broth with a lid, let it brew for a couple of hours. When it is warm, rinse the affected ear.
Pour calendula flowers with water, put on fire and bring to a boil. Cool to a comfortable temperature. Wash the inflamed ear with the resulting decoction 2-3 times a day.
Chop the sorrel roots. Pour the rhizome with boiling water. Cook on low heat. When the liquid remains about 250 ml, the broth is ready. It is used to wash the inflamed ear, as well as for compresses.

Before using any method of alternative medicine, you need to make sure that there is no allergic reaction to the components of the recipes. Before proceeding with the procedure, you need to lubricate the child's hand with a decoction. If the rash and redness does not appear, you can proceed to the procedure.
Instillation of drops in the ear
With otitis, it is important to follow the rules of instillation. Especially if the procedure is performed on a small child.
Instillation of drops:
Lay the child on its side so that the affected ear is on top.
Pull the earlobe down and back and drip drops.
Before instillation, you need to hold the drops in your hands so that they become warm;
The pipette also needs to be warmed up.
It is dangerous to drip drops directly, especially if the eardrum is damaged. A turunda is first inserted into the ear. Then drops are instilled.

Treatment with only drops for the ears will not bring success. If relief comes, it will be temporary. For the successful treatment of otitis media, it is important to follow all the recommendations that the doctor will prescribe.
Ear compresses
Any do only with the permission of the doctor. Doctors often prescribe warm compresses. The procedure will relieve soreness and improve blood flow in the inflamed ear. For the compress you will need:
Gauze or cotton fabric.
A piece of oilcloth.
Wide bandage.
Scarf made of natural fabrics.

Gauze is folded into six layers. Then a hole is made in it. Soak gauze with a solution of alcohol (alcohol and water are mixed in equal parts). The gauze should be damp, but not wet. Make the same hole in the oilcloth. Attach gauze to your ear and put oilcloth on top. A bandage is applied over the oilcloth, and then the compress is fixed with a scarf. The compress is left for 4 hours.
Ear compresses are made with boric acid. Boric acid acts as an antiseptic. To prepare a compress, water and vodka are mixed in equal parts. Then add 25 ml of boric alcohol. The hand is lubricated with the resulting solution. If within 30 minutes no allergic reactions follow, then proceed to the compress. The procedure is the same as with an alcohol compress.
Ear warming
Another effective procedure with which you can relieve pain. But this procedure, like compresses, is carried out only with the permission of the attending doctor.
Heating is carried out with the help of salt. This is the easiest way. Salt is poured into the pan and put on fire. It is heated up to 45 degrees. When the salt warms up, it is poured into a cloth scarf. Apply a dry compress to the affected ear for 15 minutes. For convenience, you can lie on your side.
Ensuring free nasal breathing
With otitis, cleansing the nasal passages is a necessary procedure. At night, the child is instilled with vasoconstrictor drops so that the baby can fall asleep. From the accumulated mucus, the nose is washed with a solution of sodium chloride. For its preparation 1 tbsp. l. salt is mixed with 250 ml of water. Wash the nose with the resulting solution. The nose is also washed with decoctions of medicinal herbs, for example, sage, chamomile, calendula. For the procedure, ready-made pharmacy solutions are used, for example, Aqua Maris, Dolphin, Aqualor.
The child should be given more warm liquids to drink. Steam inhalation is also effective against nasal congestion. To prepare inhalations, you need to bring water to a boil, add medicinal herbs to it and boil for another couple of minutes. Then let the child breathe over the steam. The main thing is that the steam is not too hot.
To eliminate the accumulation of mucus in the sinuses with otitis media, drops from Kalanchoe or beets are used. A freshly cut leaf of Kalanchoe is grated and the juice is squeezed out. Pour into a pipette and instill 2-3 drops into the nose.
After instillation, the child begins to sneeze often. This is a normal reaction.

Beets are rubbed on a grater, squeezed out the juice and diluted with a small amount of water. No more than 3 drops are dripped into each sinus.
ear toilet
Ear hygiene is an effective prophylactic against otitis media in children. Many parents believe that ear hygiene consists of cleaning them with a Q-tip. But using a cotton swab only pushes the wax deep into the ear. Therefore, first of all, you need to abandon cotton buds. Their use leads to the fact that sulfur accumulates behind the eardrum, and sulfur plugs begin to form.
After any water procedures, the child needs to wipe his ears dry. Cotton turundas regularly need to clean the ears only from the outside. With the onset of cold weather, it is imperative to wear a warm hat. In summer, when it gets dusty outside, after a walk, you need to wipe your ears with a cotton swab from the outside. Houses regularly need to do wet cleaning and ventilate the room.
Antibiotics for otitis media
Antibiotic therapy plays an important role in the treatment of otitis media in children. It is allowed to give antibiotics to a small child only after a doctor's appointment. They are assigned if:
The child is under 2 years of age.
Symptoms of intoxication of the body are pronounced.
Body temperature reached 39 degrees.
The pain gets worse every day.

Among antibiotics, children are prescribed Amoxicillin. For children under 10 years of age, it is recommended to take the drug in the form of a suspension.
The drug "Sofradex" is prescribed for otitis media in acute or chronic form. The drug is available in the form of drops. In a sick ear, a child is instilled 2-3 drops no more than 4 times a day.
How long does otitis media take to treat?
A child's body, unlike an adult, endures all pathologies harder. And therapy is delayed for a longer period. The duration of treatment depends on the form of the disease. The period of treatment is determined by the doctor. If after a while the child does not improve, then the duration of therapy is increased. Different types of otitis need to be treated in different ways.
Most often, if there are no additional diseases, otitis therapy in a child lasts up to 10 days in a serous form. In acute form, the symptoms of otitis media disappear within 5 days.
If the suppuration of the inflamed ear has begun, then the treatment is often delayed for one month.

In most cases, the recovery period depends on the immune defense of the child. The stronger the immune system, the faster the baby will feel better and the disease will recede.
Possible complications and why otitis media is dangerous
Among the possible complications, the most dangerous is hearing loss. In severe otitis media, body temperature can reach 40 degrees. A feverish condition is very dangerous and leads to serious complications.
During the illness, discharge from the nose appears. Nasal congestion becomes more intense in the evening. Because of the pain in the ears and difficulty in breathing, the baby practically does not sleep at night. Such complications arise if otitis media began against the background of SARS.
Purulent inflammation is always difficult, especially if the child has a weak immune system. The occurrence of complications due to the lack of treatment. Otitis media can lead to meningitis, sepsis, and encephalitis. Otitis is not a dangerous pathology, but without treatment, it can cause serious complications.
Prevention of otitis media
The main rule that helps prevent the development of pathology is the care of the nose and ears. With viral and infectious diseases, they must be cured. Even if there are no symptoms of the disease, it is impossible to stop therapy. It is also important to clean the nose from mucus and the ears from sulfur accumulated in them.
Diving into the water is only allowed with a mask. After water procedures, the ears must be wiped dry. When swimming in open water, ear plugs are inserted into the ears. Swimming is recommended only in clean waters.

It is useful for a child to visit the sea every year in the summer. Sea air improves immunity and has a positive effect on the health of the baby as a whole. Regularly you need to give your child a complex of vitamins and minerals with the onset of the cold season. This will help stimulate the immune system and prevent infections and viruses from entering the body.

Otitis is a disease characterized by the presence of an inflammatory process in any part of the ear. Most often it occurs in children. According to statistics, by the age of 5, almost every child has one or even several times this problem. The causative agents of the disease can be viruses, fungi or bacteria. The most common otitis media is bacterial. The inflammatory process in the ear is accompanied by quite severe pain for children and requires the immediate provision of qualified medical care.

outer;
average;
internal (labyrinthitis).

In 70% of cases in children, and in young children in almost 90%, acute otitis media is detected, caused by infection through the auditory tube from the nasopharynx into the tympanic cavity. By the nature of the inflammation, it can be catarrhal, serous or purulent. Catarrhal otitis media is more common than others.

By the nature of the course, ear inflammation can be acute (no more than 3 weeks), subacute (3 weeks to 3 months) and chronic (more than 3 months).

By origin, otitis is infectious, allergic and traumatic. Depending on whether an inflammatory process has developed in one or both ears, unilateral and bilateral otitis media are isolated.

Causes of ear inflammation in children

The main reason for the high incidence of otitis in children is the peculiarity of the structure of their auditory (Eustachian) tube. It is practically not curved, has a larger diameter and shorter length than in an adult, so mucus from the nasopharynx can easily enter the middle ear cavity. As a result, the ventilation of the tympanic cavity is disturbed and the pressure in it changes, which provokes the development of the inflammatory process.

Otitis externa occurs as a result of infection when the skin is damaged during cleaning of the ear canals or combing the hair, as well as when fluid enters and stagnates in the ear after swimming or bathing.

The main causes of acute inflammation in the middle ear can be:

inflammatory processes in the nasopharynx;
hypothermia;
hypertrophy of the pharyngeal tonsils and chronic adenoiditis;
chronic pathologies of the nasopharynx (sinusitis, tonsillitis, rhinitis);
weakening of local immunity against the background of various diseases (rickets, underweight, anemia, exudative diathesis, leukemia, AIDS and others);
frequent allergies, accompanied by swelling of the mucous membranes and runny nose;
improper blowing of the nose;
injuries with penetration of infection into the ear cavity.

Internal otitis develops as a complication of acute or chronic inflammation of the middle ear, as a result of trauma or a common infectious disease. In the latter case, the pathogen enters the inner ear through the blood or meninges (for example, with meningitis).

Symptoms of otitis in a child

The clinical picture characteristic of otitis is determined by the localization of the inflammatory process.

Symptoms of otitis externa

With external otitis in children, there is redness, itching, swelling of the auricle and external auditory canal, accompanied by a sudden rise in temperature and pain. The feeling of pain intensifies when trying to pull the auricle, when opening the mouth and chewing.

Allocate external limited and diffuse (diffuse) otitis media.

Limited otitis externa occurs when the hair follicle and sebaceous gland in the external auditory canal become inflamed. It manifests itself in the form of reddening of the skin, the formation of a boil, in the center of which a purulent core forms, and an increase in the lymph nodes behind the ear. When the mature abscess opens, the pain decreases, and a deep wound remains in its place, which subsequently heals with the formation of a small scar.

With diffuse otitis externa, the inflammatory process affects the entire ear canal. It usually occurs due to an allergic reaction, bacterial or fungal (otomycosis) lesions of the skin. Blisters often appear on the skin of the external auditory canal with this form of the disease. With a fungal infection, peeling of the skin in the ear canal is observed, accompanied by severe itching.

Video: How to treat otitis media in adults and children

Symptoms of otitis media

In acute otitis media in children, the symptoms depend on the form of the disease. For catarrhal inflammation, the following symptoms are characteristic:

throbbing, stabbing or shooting pain in the ear, aggravated by pressing on the tragus, pain may radiate to the temple, throat or cheek;
a sharp increase in body temperature up to 40 ° C;
stuffiness in the ears;
weakness, lethargy;
capriciousness, irritability;
vomiting, loose stool (not always observed).

In the absence of timely therapy, acute catarrhal otitis media can turn into purulent on the next day. Pus is formed in the exudate that has sweated out during catarrhal otitis, which is a favorable environment for the reproduction of pathogenic bacteria. Severe pain is characteristic of purulent otitis media (the higher the pressure in the tympanic cavity, the stronger the pain), hearing loss. When the eardrum ruptures, purulent fluid flows out of the external auditory canal. Pain sensations become less intense.

Serous otitis media is a low-grade inflammatory process that can last from several weeks to several months. It is characterized by the accumulation of fluid of non-purulent origin in the tympanic cavity.

The chronic form of otitis media is characterized by mild symptoms. With it, the hole on the eardrum does not grow in the child for a long time, pus is periodically released from the external auditory canal, tinnitus is noted and hearing loss gradually increases depending on the duration of the disease. There are no severe pains.

Symptoms of otitis media

The inner ear is closely connected with the vestibular analyzer, so the inflammatory process in it affects its functions. In children with this type of disease, in addition to hearing impairment, there is tinnitus, dizziness, impaired coordination of movements and balance, nausea and vomiting.

Features of otitis media in infants

Suspecting otitis media in infants who cannot explain to their parents what exactly hurts them is a difficult task. The main sign of ear inflammation is a sharp anxiety, a strong, seemingly unreasonable piercing cry and crying. They do not sleep well at night, wake up screaming. If you touch the sick ear, then the crying intensifies. There is a marked deterioration in appetite or refusal to eat. The child cannot eat normally, as pain increases during sucking and swallowing. He twists his head and turns away from the bottle or breast.

The child can pull the sore ear with his hand. During sleep, he often rubs his head against the pillow. With unilateral otitis, the baby, in order to reduce pain, tries to take a forced position and lies down so that the sore ear rests on the pillow.

The risk of developing the disease in children of the first year of life increases the fact that most of the time they are in a horizontal position. This makes it difficult for the outflow of mucus from the nasopharynx during a cold and contributes to its stagnation. Also, when feeding a baby in a supine position or when spitting up, breast milk or milk formula sometimes enters the middle ear from the nasopharynx and causes inflammation.

Diagnostics

If you suspect otitis in children, you should contact a pediatrician or an otolaryngologist. In the case of purulent discharge from the ear, it is necessary to urgently call a doctor at home or put cotton wool in the child's ear, put on a hat and go to the clinic on your own.

First, the doctor collects an anamnesis and listens to complaints, and then examines the ear with an otoscope or ear mirror, evaluates changes in the external auditory canal and the condition of the eardrum. The sinuses and oral cavity are also examined.

If otitis media is suspected, a general blood test is prescribed to assess the presence of an inflammatory process in the body and its severity (increased ESR, an increase in the number of leukocytes). Audiometry may be done to check for hearing loss.

If purulent fluid flows out of the external auditory canal, then it is taken for bacteriological examination and antibiotic sensitivity analysis. In particularly difficult situations (for example, with damage to the inner ear), X-ray examination, CT and MRI are additionally used.

Treatment

Timely treatment of otitis in children provides a favorable outcome. Depending on the type of disease and the severity of the course, the recovery process in the acute form can take 1-3 weeks. After the end of therapy in children, on average, up to three months, hearing loss persists.

Treatment of otitis externa

Otitis externa is treated on an outpatient basis. Until the purulent core of the boil matures, it consists in the use of anti-inflammatory drugs and alcohol compresses. After the rod is formed, the doctor opens it, followed by drainage of the resulting cavity and washing it with antiseptic solutions (chlorhexidine, miramistin, 3% hydrogen peroxide solution). After the end of the procedure, a bandage with levomekol is applied, which must be periodically changed until the wound is completely healed.

If there is a high temperature and a strong increase in the size of nearby lymph nodes, antibiotics are used.

With otomycosis of the external ear, the auricle and external auditory canal are cleaned of earwax, desquamated skin, pathological secretions and fungal mycelium. Then they are washed with solutions of antimycotic agents and treated with antifungal ointments or creams (clotrimazole, nystatin ointment, candida, miconazole and others). Tablets are prescribed inside (fluconazole, ketoconazole, mycosyst, amphotericin B), taking into account the admissibility of their use for children of a certain age.

Treatment of otitis media

Treatment of acute otitis media in most cases is carried out at home. Depending on the form and severity of the disease can be used:

antipyretic;
painkillers;
antibiotics;
vasoconstrictor drops;
antiseptics;
antihistamines;
physiotherapy procedures (ultraviolet irradiation, laser therapy, UHF in the nasal passages and external auditory canal);
surgical intervention.

For children older than two years, if the diagnosis requires clarification, the inflammation is unilateral and the symptoms are not too pronounced, expectant management is advisable. Therapy in this case consists in the use of antipyretics based on paracetamol or ibuprofen with an increase in temperature. After some time, a re-examination is carried out to confirm the diagnosis. If the child's condition does not improve during the observation period (24-48 hours), the doctor prescribes antibiotics.

Antibiotic treatment

Antibiotics for otitis are prescribed if the cause of the disease is a bacterial infection. Their use in injection or oral form (tablets, syrup, suspension) is necessary from the first day if:

the disease was detected in a child under one year old;
the diagnosis is not in doubt;
the inflammatory process is localized in both ears;
there are severe symptoms.

With purulent otitis media, antibiotics are usually prescribed by injection, since this method of administration significantly increases their effectiveness.

Of the antibiotics for the treatment of otitis in a child, penicillin preparations (amoxiclav, amoxicillin, ampisid, augmentin and others) and cephalosporin series (ceftriaxone, cefuroxime, cefotaxime), macrolides (azitrox, sumamed, chemomycin, azimed and others) are most often used. The main criteria for choosing a drug are its ability to penetrate well into the middle ear cavity and relative safety for children.

The dosage is calculated exclusively by the doctor, taking into account the weight of the child. The therapeutic course is at least 5-7 days, which allows the drug to accumulate in sufficient quantities in the tympanic cavity and prevent the transition of the disease into a chronic form.

Video: Dr. Komarovsky about the symptoms and treatment of otitis media

Local remedies for purulent otitis media

For the treatment of otitis media, ear drops with anti-inflammatory, antibacterial and analgesic effects and antiseptic solutions are used.

With suppuration from the external auditory canal, the doctor first carefully removes the pus and rinses the ear cavity with disinfectant solutions (hydrogen peroxide, iodinol, furacilin), after which he instills an antibiotic solution (dioxidin, sofradex, otof).

From painkillers and anti-inflammatory drugs, you can use ear drops otipax, otirelax, otinum. They are instilled into the ear cavity directly or soaked in cotton turundas, and then inserted into the ear. Drops in the ear canal are instilled into the child in the supine position with the head turned to the side, slightly pulling the auricle up and back. After that, the child should lie down for 10 minutes without changing the position of the body.

Many pediatricians, including Komarovsky E. O., especially focus the attention of parents on the fact that no ear drops can be used to treat otitis before the ear cavity is examined by a doctor and the integrity of the tympanic membrane is assessed. If, when the tympanic membrane is ruptured, they fall into the middle ear cavity, then damage to the auditory nerve and damage to the auditory ossicles is possible, which will lead to hearing loss.

Vasoconstrictor nasal drops

With otitis media, it is important to ensure that the child breathes freely through the nose. To do this, it is necessary to regularly clean the sinuses from accumulated mucus with cotton flagella soaked in baby oil. If there is dried mucus in the nasal cavity, then 2-3 drops of saline or special preparations (aquamaris, marimer, humer) should be instilled into each nostril, and then after 2-3 minutes very carefully remove the softened mucus using an aspirator.

With otitis media, instillation of vasoconstrictor drops into the nose (Nazivin, Vibrocil, Galazolin, Rinazolin) is indicated, which not only improve nasal breathing, but also ensure the patency of the auditory tube, reducing mucosal edema and normalizing the ventilation of the middle ear.

Surgery

Surgery for acute otitis media is rarely required. It consists in an incision in the tympanic membrane (myringotomy) in order to provide an outlet for the pus or exudate accumulated in the tympanic cavity to the outside. The indication for this procedure is severe pain. It is carried out under anesthesia and allows you to immediately alleviate the condition of the child. A damaged eardrum takes about 10 days to heal. During this time, careful ear care is necessary.

Treatment of labyrinthitis

Treatment of inflammation of the inner ear is carried out in a hospital, since this disease is fraught with the development of quite serious complications in the form of cerebrovascular accidents, the development of meningitis, and sepsis.

For treatment, antibiotics, antiseptic, anti-inflammatory and dehydrating agents, vitamins, as well as drugs that improve blood circulation, normalize the functions of the vestibular apparatus and hearing are used. If necessary, they resort to surgical intervention, the purpose of which is to remove fluid from the cavity of the inner ear and eliminate the purulent focus.

Complications

With untimely or incorrect treatment, as well as with a rapid course, otitis media can become chronic or lead to the development of the following complications:

mastoiditis (inflammation of the mastoid process of the temporal bone);
meningeal syndrome (irritation of the membranes of the brain);
hearing loss;
paresis of the facial nerve;
damage to the vestibular apparatus.

Immunocompromised children are most at risk for complications.

Prevention

Prevention of otitis media in children is aimed primarily at increasing the body's defenses and preventing mucus from entering the auditory tube from the nasal cavity. In this regard, it is recommended:

ensure as long as possible breastfeeding;
take measures to harden the body;
timely and completely cure acute respiratory infections and inflammatory diseases of the nasopharynx;
if you have a runny nose while breastfeeding or from a bottle, do not lay the baby horizontally;
regularly remove mucus from the nasal cavity with a runny nose;
wear a hat that covers the ears in cold and windy weather.

Parents need to ensure that the child correctly blows his nose, alternately each nostril.