Otitis

Otitis or more commonly known as an ear infection is the most common illness, affecting babies and young children and is the number one reason for more than 35% of all visits to the paediatrician.

As part of the Government Employees Medical Scheme's (GEMS) ongoing effort to educate our members - and future members - on a range of healthcare topics, we would like to inform you about how an ear infection can affect your family and yourself and what to do about it.

Otitis is classified into two types of ear infection namely Otitis media and Otitis externa.

Otitis media generally known as a middle ear infection, is the type that most commonly affects babies, toddlers and children.

Otitis externa is an infection of the ear canal, also known as ‘swimmers ear'.

Otitis media (middle ear infection)

Infection of the middle ear is a very common illness affecting babies, toddlers and children. Two out of three children will have at least one episode before the age of three. All children will have a middle ear infection by the time they are seven years old. And from time to time adults can also become ill with a middle ear infection.

What is Otitis media (middle ear infection)?

Otitis media (middle ear infection) is when the cells lining the middle ear cavity become inflamed or infected. The middle ear is the area located immediately behind the eardrum. 

What can cause Otitis Media?

The most common cause of an ear infection is an upper respiratory tract viral infection, such as a cold or flu. The same virus infecting the nose and throat can also infect the ear as the Eustachian tube (tube inside the ear) can become inflamed with puss accumulating behind the eardrum.

Babies and young children are more likely to get ear infections because they have shorter, narrower and more horizontal Eustachian tubes which can easily become blocked than that of older children and adults. Their immune systems are lower because they get sick more often. This infection can easily be transmitted in large crowds and among groups of children in schools and day-care centres.

What are the symptoms of Otitis Media?

• A feeling of fullness in the ear
• Earache: either a sharp, sudden pain or a dull, continuous pain, which may be severe
• Babies pull at their ears with their fingers
• Fever
• Drainage from the ear, which is thick and yellow (not normal earwax) and may contain blood, which could indicate that the eardrum has ruptured
• Irritability, difficulty sleeping and decreased appetite in children
• Nausea and diarrhoea
• Nasal congestion
• Dizziness or change in balance
• Hearing loss in the affected ear
• A snapping sensation when swallowing, yawning, or blowing the nose

How can you treat a middle ear infection?

It is often possible to provide considerable symptomatic relief for an infected ear at home, you can try some of the suggestions below, but it doesn't harm to seek medical advice as soon as needed. Up to 80% of children with ear infections get better without treatment. However, most doctors choose to treat ear infections.

• A warm compress against the infected ear.
• Try humidifying the room or steam inhalation to release the pressure build up in the nasal passages and Eustachian tubes.
• Gargling with salt water can soothe a sore throat and clear the Eustachian tubes.
• Sleeping with the head elevated helps drain the middle ear which may help release pressure build up.
• Try using a nasal spray decongestant or a menthol rub on your childs chest to help open up the nasal passages.

Otitis externa (Ear canal infection)

What is Otitis externa?

Otitis externa, or swimmer's ear, is an infection of the outer ear canal and can occur in acute (sudden) and chronic (long term) forms.

What can cause Otitis externa?

Since Otitis externa (ear canal infection) is often associated with excess water in the ear canal, and frequently occurs in children and young adults who swim a great deal, the common name for this inflammation is "swimmer's ear".

It may be caused due to excessive water exposure and insertion of foreign implements (usually earbuds) into the ear canal. This infection may develop when water, dirt or other debris gets into the ear canal.

What are the symptoms of Otitis externa?

Unlike a middle ear infection (otitis media), the pain of an ear canal inflammation or infection is worse when you chew, when you press on the ear, or when you wiggle your earlobe. Other symptoms include:                                                                                                                

• Itching, and a feeling of fullness inside the ear - usually the first sign of infection
• Swelling of the ear canal
• Watery discharge from the ear
• Severe pain and tenderness in the ear - especially when moving the head and jaw, or gently pulling the earlobe.
• A foul-smelling, yellowish discharge from the ear
• Temporarily muffled hearing (caused by blockage of the ear canal)
• Swelling shut of the ear canal and swelling of the side of the face
• Enlarged neck glands - these may make it difficult to open the jaw

How can you treat Otitis externa? 

Otitis externa is usually not dangerous and often clears by itself within a few days. With mild infections you may want to try alternative home treatments first.

• Use a warm compress against the infected ear
• Keep your ear dry, as moisture and further irritation will only prolong the infection. Avoid getting any more water in your ear until the infection clears up. While showering or swimming, use an earplug or cotton wool with vaseline on the outside. Do not use plastic earplugs.
• Make sure there are no foreign objects in the ear. Small insects trapped in the ear can often be washed out with warm water. Removal of an object from the ear can be difficult and should only be attempted by a doctor.
• If you suspect the eardrum is ruptured, do not insert anything (except as prescribed by your doctor) into the ear.
• Try gently rinsing the ear using a bulb syringe and warm saline solution. Or a half-and-half solution of white vinegar and warm water. Make sure the flushing solution is at body temperature.
• Take acetaminophen, nonsteroidal anti-inflammatory drugs or aspirin to relieve pain. Remember not give aspirin to children.
• Avoid scratching the inside of the ear or using ear buds, as this will aggravate the irritated skin, and will often make the condition worse.
• A hearing aid should be left out as much as possible until swelling and discharge stops.

If you are treating at home keep an eye out for the following symptoms that could indicate whether the infection is getting worse:

• Ear pain and itching that persists or worsens after five days of home treatment.
• Any ear discomfort lasting longer than a few days.
• Swelling, redness or extreme pain in the ear canal, the opening to the ear canal, the external ear, or the skin around the external ear.
• Discharge from the ear that does not appear to be ear wax.
• Ear symptoms accompanied by a fever (38 degrees C or higher).
• Dizziness or unsteadiness.
• Increased severity or frequency of symptoms.

Taking care of your ears 
 
In order to steer clear of ear infections do not go overboard when cleaning your ears as ear wax is designed to protect the ears. It is also not advised to listen to loud music too often as this will cause tinnitus (ringing of the ears). Sound is a gift that we all should treasure so do your best to maintain good ear health for your family and yourself!