More Details on Children and Ear Infections
If a child has possible ear infection signs or symptoms, the doctor will do a physical exam and ask about the child's personal and family medical history. In order to help make an ear infection diagnosis, the doctor will also recommend additional tests that examine the ear or hearing.
As parents and doctors can attest, getting rid of an ear infection can be tricky. Ear infection treatment in most cases involves the use of antibiotics. Depending on the ear infection symptoms that are present, the doctor may recommend waiting for several days before beginning an antibiotic; research has shown that ear infections in children may improve by themselves without the need for antibiotics. Acetaminophen (Tylenol®) can be used to treat any pain or fever caused by the ear infection.
If a child has multiple ear infections, surgery may be recommended as ear infection treatment.
Ear infections (otitis media), represent the sixth most common diagnosis for ambulatory care visits (22.7 million in 1996) and the third most common diagnosis for emergency room visits (3 million in 1995). About one-third of a pediatrician's time is spent diagnosing and managing ear infections.
Approximately $5 billion is spent annually on direct costs of ear infections and a greater amount is estimated to be spent indirectly due to lost work, travel, long-term handicap, and delayed language development.
There are many reasons why ear infections in children are more common than in adults. First, children have more trouble fighting infections because their immune systems are still developing.
Another reason that these infections are more common in children has to do with the child's eustachian tube. The eustachian tube is a small passageway that connects the upper part of the throat to the middle ear. It is shorter and straighter in the child than in the adult. It can contribute to otitis media in several ways. The eustachian tube is usually closed but opens regularly to ventilate or replenish the air in the middle ear. This tube also equalizes middle ear air pressure in response to air pressure changes in the environment. However, a eustachian tube that is blocked by swelling of its lining or plugged with mucus from a cold or for some other reason cannot open to ventilate the middle ear. The lack of ventilation may allow fluid from the tissue that lines the middle ear to accumulate. If the eustachian tube remains plugged, the fluid cannot drain and begins to collect in the normally air-filled middle ear.
One more factor that makes children more susceptible to otitis media is that adenoids in children are larger than they are in adults. Adenoids are composed largely of cells (lymphocytes) that help fight infections. They are positioned in the back of the upper part of the throat near the eustachian tubes. Enlarged adenoids can, because of their size, interfere with the eustachian tube opening. In addition, adenoids may themselves become infected, and the infection may spread into the eustachian tubes.