Treatment of otitis in children at home. Otitis in a child: signs, proper treatment and possible complications complications How to treat acute otitis media in a child

How to treat otitis media in a child And what causes this kind of inflammation in the ear?
Among the various ear diseases, otitis media is the most common - inflammation of any part of the ear. People of any age are susceptible to it, but in most cases children are ill with it. Conventionally, the ear is divided into three sections: outer, inner, middle. According to this principle, three types of disease are distinguished. So, let's look at the main symptoms of this disease, how to recognize otitis in children and what treatment the most efficient nowadays.

Middle ear it becomes inflamed due to excessive cooling or overheating, an unbalanced diet, poor functioning of the immune system can also be the cause. The baby can catch a cold, pathogenic microorganisms accidentally enter the ear, passing through the Eustachian tube (it connects the ear canal and nasopharynx), as a result, the so-called otitis media. Certain anatomical characteristics make infants more vulnerable to disease.

To the kids otitis media comes unexpectedly. The child falls asleep in the evening and is not naughty, and in the dead of night, severe pain in the ear begins to irritate him. Loud crying and nausea are sometimes accompanied by high fever (up to 40 degrees). The child touches the painful ear all the time, and does not allow adults to look at it.

Symptoms of otitis media include: pain characteristic of otitis media (in some cases - external). A yellow or green fluid comes out of the ear, sometimes with blood. The child sucks badly at the breast and is nervous, crying for no reason (crying intensifies if you press the tragus). Turns head frequently when lying on pillow. Possible discharge from the nose.

Important as possible see an otolaryngologist first who, when examining a child, will diagnose and find out the severity of the inflammation. After that, appropriate medications will be prescribed. If you follow the doctor's recommendations, you can easily cure not neglected otitis media at home. Otitis can seriously affect a child's hearing ability, so treatment you need to start as soon as possible and you should definitely consult with a pediatric otolaryngologist, but before that, provide first aid to the child (below you will find information on alternative methods of treating and preventing otitis in children).

The baby will be prescribed antibiotics (syrups or tablets), plus funds to normalize bowel function. Ear and nasal drops will be used.

When the child complains of ear pain, mom needs to perform a certain series of actions. Find out the body temperature and, if necessary, apply an antipyretic. Next, the nose should be instilled with a vasoconstrictor (drip the right nostril with the head tilted to the right and vice versa). Ask the child to lie on one side on a healthy ear, and drip ear drops (5 drops) preheated in the hand into the ear canal of the patient. After a couple of minutes, cover the ear with a piece of cotton and allow the child to stand up.

Despite the fact that otitis media in children and refers to serious diseases, treatment This disease, with the help of modern medicines in combination with folk remedies known since ancient times, quickly helps the child get rid of a sharp pain in the ear, the state of health noticeably improves the very next day. It is important to apply quickly medical assistance when detecting the symptoms of otitis media described above in a child. Now we will tell you in detail about the priority actions of parents when otitis media is detected in a child, we will tell you about what it is acute otitis media, chronic purulent otitis media and exudative otitis media.

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- inflammatory lesion of the external ( otitis externa), middle (otitis media) or inner ear(labyrinthitis). Otitis in children is accompanied acute pain and congestion in the ear, hearing loss, expiration of pus, anxiety of the child, high body temperature. Diagnosis of otitis in children is carried out by a pediatric otolaryngologist on the basis of otoscopy, bacteriological culture from the ear. Treatment of otitis in children may include antibiotic therapy (local and general), physiotherapy, washing the middle ear, if necessary - paracentesis of the tympanic membrane, shunting of the tympanic cavity.

General information

Inflammatory diseases of the ear (otitis media in children) are the most frequent pathology in pediatrics and pediatric otolaryngology. In the early childhood Otitis media is tolerated by about 80% of children, and by 7 years - 90-95%. The course and outcome of otitis in children may be different; Quite often, the disease acquires a relapsing course, and in severe cases leads to dangerous otogenic complications (otoanthritis, facial paralysis, extra- and subdural abscesses, meningitis, encephalitis, sepsis, etc.). In a quarter of cases, otitis media suffered by a child in childhood is the cause of the development of hearing loss in adults.

Causes

Otitis externa in children is caused by infection hair follicles cartilage of the external auditory canal. Abrasions and scratches of the outer ear, diabetes mellitus, suppuration that accompanies otitis media in children predispose to the development of infection. The causative agents of external otitis in children are most often Pseudomonas aeruginosa, Escherichia coli, Proteus, Staphylococcus aureus; in 20% of cases - fungi.

Otitis media usually acts as a complication of SARS in children (adenoviral infection, influenza), childhood infections (measles, scarlet fever, diphtheria). Often, otitis media is a companion of another ENT pathology of childhood: adenoids and adenoiditis, rhinitis, sinusitis, tonsillitis, pharyngitis, ear foreign bodies, choanal atresia, etc. From the side of the external auditory canal, the introduction of infection into the middle ear is possible with an injury to the eardrum . Otitis media can develop even in newborns when infected from a mother who has mastitis, pyelonephritis, endometritis, etc. When microbiological research discharged from the ear, pneumococcus, Haemophilus influenzae, moraxella, hemolytic streptococcus, fungal pathogens are more often sown.

Otitis externa in children most often occurs as a complication of purulent inflammation of the middle ear or other bacterial infections- sinusitis, meningitis, etc.

Immaturity contributes to the frequent occurrence of otitis media in children. natural immunity, prematurity, malnutrition, exudative diathesis, allergies, bronchopulmonary pathology, beriberi, rickets. Local anatomical factors play a special role: the auditory tube in children is shorter and wider than in adults, has practically no bends, and is located horizontally in relation to the nasopharynx.

Classification

Depending on the level of inflammation, otitis externa, otitis media and otitis media (labyrinthitis) in children are distinguished. Often, starting in the outer ear, the inflammatory process spreads to deeper sections, i.e. otitis externa passes into the middle one, and the middle one into the inner one.

Otitis externa in children affects Auricle and outdoor ear canal. External otitis in children can occur in two forms - limited (furuncle of the external auditory canal) and diffuse (inflammation of the outer ear throughout).

The course of otitis media in children can be acute, recurrent and chronic. According to the nature of the resulting inflammatory exudate, acute otitis media in children can be catarrhal or purulent. Acute otitis media in children goes through 5 stages: acute eustachitis, acute catarrhal inflammation, preperforative stage of purulent inflammation, postperforative stage of purulent inflammation and reparative stage.

Forms of chronic inflammation of the middle ear in children are exudative otitis media, purulent otitis media and adhesive otitis media.

Labyrinthitis can be acute or chronic; in the form of serous, purulent or necrotic inflammation; be limited or diffuse.

Symptoms of otitis media in children

Furuncle of the ear and diffuse otitis externa in children are manifested by an increase in body temperature and severe local pain, which is aggravated by talking, chewing food, and pressing on the tragus. On examination, redness of the ear canal is detected, which becomes slit-like narrowed due to edema, regional lymphadenitis.

The onset of acute otitis media in children is accompanied by a sharp pain in the ear, high body temperature (up to 38-40 ° C), hearing loss, and general intoxication. Infants become restless, cry incessantly, shake their heads, press their sore ears against the pillow, rub their ears with their hands. Babies often refuse to eat because sucking and swallowing increase pain. Periods of anxiety in a child may be replaced by a depressed state; in children younger age diarrhea, regurgitation, and vomiting often occur.

After perforation of the tympanic membrane, pain decreases, temperature subsides, intoxication decreases, but hearing loss persists. At this stage of otitis media, children develop purulent discharge from the ear (otorrhea). Following the cessation of exudation, all symptoms of acute otitis media in children disappear, scarring of the perforation occurs and hearing is restored. Acute otitis media in children lasts about 2-3 weeks. In childhood, rapidly flowing and latent otitis media are often encountered.

Recurrent otitis media in children recur several times within one year after complete clinical recovery. Most often, a new episode of the disease occurs against the background of recurrent pneumonia, viral infection, digestive disorders, and decreased immunity. The course of recurrent otitis media in children is milder; accompanied by mild pain, a feeling of congestion in the ear, mucous or mucopurulent discharge from the ear.

Exudative otitis media and adhesive otitis in children occur with mild symptoms: tinnitus and progressive hearing loss.

Chronic suppurative otitis media in children is characterized by the presence of persistent perforation of the tympanic membrane, periodic or constant suppuration and progressive hearing loss. With an exacerbation of otitis media in a child, there is an increase in temperature, the appearance of signs of intoxication, increased discharge from the ear and pain. The disease occurs in half of adults who often had otitis media in childhood.

Complications

Complications of otitis media in children develop with late or incorrect treatment, or in case of extremely severe course infections. In this case, inflammation of the inner ear (labyrinthitis) most often develops, which is accompanied by dizziness, tinnitus, decrease or complete loss of hearing, imbalance, nausea and vomiting, nystagmus.

Complications of otitis media in children include lesions temporal bone(zygomaticitis, mastoiditis), paralysis of the facial nerve. When the infection spreads deep into the skull, intracranial complications may occur - meningitis, encephalitis, brain abscesses, sepsis.

Against the background of the chronic course of otitis media, after a few years, children may develop persistent hearing loss associated with cicatricial processes in the tympanic membrane and the sound-perceiving apparatus. This, in turn, adversely affects the formation of speech and the intellectual development of the child.

Diagnostics

Children with initial manifestations otitis often get an appointment with a pediatrician, so it is extremely important to identify in a timely manner ear infection and redirect the child to a consultation with a pediatric otolaryngologist. Since otitis media is often accompanied by another ENT pathology, children need a complete otolaryngological examination. In a row instrumental methods diagnostics, the main place belongs to otoscopy, which allows you to examine the eardrum, see its thickening, injection, hyperemia, protrusion or perforation and suppuration. With perforative otitis media in children, exudate is taken to bacteriological research.

Treatment of otitis media in children

With otitis externa in children, as a rule, they are limited to conservative treatment: a thorough toilet of the ear, the introduction of turundas with alcohol solutions, local infrared irradiation . If the inflammation does not subside within 2-3 days, they resort to opening the furuncle of the ear canal.

With otitis media, children are prescribed osmotically active (phenazone + lidocaine) and antibacterial (containing rifampicin, norfloxacin, ciprofloxacin) ear drops. To reduce inflammation and relieve pain syndrome analgesics and NSAIDs are used. In order to stop the allergic component, antihistamines. If nasal breathing is difficult, it is necessary to anemize the nasal cavity, instill vasoconstrictor drops into the nose. Systemic antimicrobial therapy with otitis in children, it is most often carried out with penicillins, fluoroquinolones, cephalosporins, macrolides.

shunting of the tympanic cavity, revision tympanotomy. If a conservative treatment adhesive otitis media in children is ineffective, and hearing loss progresses, it is possible to perform tympanoplasty with prosthetics of the destroyed auditory ossicle.

Forecast and prevention

With a typical course of acute external and otitis media in children, as well as timely complex therapy recovery comes with full recovery auditory function. If predisposing causes persist, a recurrent and chronic course of otitis media in children with severe consequences is possible.

Prevention of otitis in children requires an increase in the overall resistance of the body, the exclusion of trauma to the external auditory canal and the tympanic membrane with foreign objects ( cotton swabs, matches, hairpins, etc.), teaching the child to blow his nose properly. When a child is diagnosed concomitant diseases ENT organs need their treatment, including planned surgical intervention (adenotomy, tonsillectomy, nasal polypotomy, etc.).

Do not self-medicate otitis media in children; in case of complaints indicating inflammation in the ear, the child should immediately be consulted by a pediatric specialist.

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 this condition, tells the well-known pediatrician Evgeny Komarovsky.

About the disease

Otitis in children can be of three types. Depending on localization inflammatory process, the ailment can be external, middle 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 is a type of reaction child's body on the 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 more horizontal position, and frequent otitis media become rare or disappear altogether.

Symptoms

External otitis media is hard to miss - 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. Mild hearing loss may occur headache, lack of appetite, dizziness, disorders of the vestibular apparatus, increased body temperature. 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 baby, 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 media 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 strong 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 moms and dads 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 severe - from the transition acute form into chronic, and then the child will be plagued by frequent otitis media, until deafness, paresis of the facial nerve, meningitis, etc. Therefore, instilling heated oil with aloe or walnut juice is a real parental crime.

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

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 at the pharmacy, dosage active substance in which it 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, upon examination, find out if the eardrum. 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. In case of perforation, it is impossible to drip at the ear so that the medicine does not get on auditory nerve, auditory ossicles and did 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 allowed not to wait two days if the otitis in the baby is severe, with a high temperature, very severe pain, besides, 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 prescribed extremely rarely.

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 of age and if he attends Kindergarten, the rate 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 surgical intervention otitis is not required. 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 loud noises. 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 advantages from the compress, since it does not affect either the risk of complications or the duration of the inflammatory process.

Almost every mother of a baby under five years old is familiar with such an unpleasant disease as acute otitis media. It is important to identify and properly help the child before he is examined by a specialist. After all, inflammation of the ear is not only unpleasant pain. With the wrong actions and delayed treatment, the crumbs can develop life-threatening complications. As a result of the disease, the hearing of the baby can be significantly reduced, which will negatively affect its further development. Moms and dads should know what measures to take so that this disease never, or visits the child as rarely as possible.

Pediatrician

Inflammation different parts ear is called otitis media. It can be classified according to several criteria.

If the baby fell ill with otitis media for the first time in his life or did not suffer from it for seven months or more, then otitis media will be acute. If a child has been sick with it more than three times in the past six months, then this is recurrent otitis media.

Ear inflammation almost always occurs against the background of acute or chronic inflammatory processes in the nasopharynx. Most often this is the result of acute respiratory infections - SARS.

According to its structure, the ear is divided into several parts. Inflammation can occur in any of them.

Otitis occurs:

• external, when the ear canal suffers;
• otitis media, when structures behind the eardrum are involved in the process;
• otitis media or labyrinthitis. The components of the organ of hearing located inside the temporal bone suffer.

If one ear hurts, otitis is called unilateral, and if two - bilateral.

If there is no discharge from the ear during otitis media, it is called catarrhal. If they are present, then exudative.

The structure of the ear of a child and an adult is different. The presence of such structural features determines the high incidence of otitis in children.

The ear canal of a young child consists of two-thirds of cartilaginous tissue on the outside and only inside is represented by bone tissue. In older children, only a third of the outer part of the ear canal is formed by cartilage tissue. Throughout its length it is lined with epithelial skin cells. In those places where the canal is formed by bone tissue, it is covered with a thin skin.

But the cartilaginous area is covered with full-fledged skin with numerous follicles, sebaceous and ceruminous glands. Sebaceous glands allocate viscous secret, and ceruminous - liquid, pigmented, brown. Both secrets mix with exfoliating skin cells. As a result, a earwax, which performs a protective and water-repellent function.

The microflora of the outer ear is represented by corynobacteria, micrococci, staphylococci, streptococci, enterobacter, klebsiella and other bacteria. All of them can be attributed to representatives of conditionally pathogenic microflora. Under normal conditions, they coexist peacefully with a person, but under certain circumstances they can cause the development of the disease.

In babies, very often the cause of inflammation of the external auditory canal is excess moisture when the skin loses its protective function and bacteria begin to multiply. It may occur due to a large number water when washing a child or when swimming in a pool, river. Therefore, otitis externa is also called "bather's ear".

The eardrum separates the outer ear from the middle ear. The space behind it is called the tympanic cavity. It is connected to the nasopharynx by a thin canal - the auditory or Eustachian tube. With its help, optimal pressure is maintained in the middle ear cavity, air exchange occurs and mucus is evacuated. In infants and toddlers up to three to five years of age, the eardrum is thick and the Eustachian tube is shorter and horizontal compared to older children.

In the tympanic cavity there are auditory ossicles, which, due to their similarity with the objects of the same name, are called the hammer, anvil and stirrup. They convert the noise coming from outside.

In the nasopharynx, next to the Eustachian tube, there is lymphoid tissue - the nasopharyngeal tonsils. Their growth (hypertrophy) can be physiological in children aged 1-3 years, or pathological in frequently ill children. Hypertrophic lymphoid tissue compresses the Eustachian tube, disrupting ventilation and changing air pressure in the middle ear. For this reason, it becomes inflamed.

When a child has any respiratory infection, they almost always develop acute nasopharyngitis- inflammation in the nasopharynx. The mucous membrane of the Eustachian tubes is also involved in inflammation. In this case, their clearance will narrow and the ventilation function will be impaired. The pressure in the tympanic cavity changes. Due to its small size and location, mucus through the auditory tubes from the nasopharynx easily penetrates into the middle ear cavity. These factors cause the development of acute otitis media.

If a infant often and profusely spit up, the contents of the oropharynx easily enter the nose and through the Eustachian tube into the tympanic cavity. This factor also predisposes to the development of inflammation of the middle ear.

If pus accumulates in the middle ear cavity, it will put pressure on the eardrum until it ruptures. Then the contents of the tympanic cavity will flow out of the ear canal. Perforation of the membrane due to its considerable thickness occurs in the later stages of the disease. And purulent contents are more likely to fall into the inner ear.

Some babies are born with an abnormal development of the hard palate called cleft palate or cleft palate. In such babies, otitis media will recur due to the malfunction of the auditory tubes.

The structures of the inner ear are located in the temporal bone and are connected to the middle ear with the help of numerous holes - windows. The inner ear includes the semicircular canal system and the cochlea. All of them are responsible for sound transmission. The cochlea contains the organ of balance, the organ of Corti.

Otitis media or labyrinthitis is very rare. It develops if the infection penetrates into the cavity of the temporal bone from the middle ear. Labyrinthitis may also occur as a result of complications of bacterial meningitis.

Symptoms of otitis media

1. Ear ache. Will accompany any inflammation of the ear. Babies and babies will be very restless. The equivalent of an earache would be constant plaintive crying, restlessness when sucking, or not eating at all. The baby can restlessly turn his head, pull sore ear. Older children complain of a feeling of fullness in the ear, discomfort, pain of a aching and pulling nature. With inflammation in the inner ear, older children characterize the pain as "deep". Soreness subsides somewhat if the child supports the affected ear with his hand.
2. Deterioration of well-being. Most often, this symptom is expressed in infants. The kid becomes lethargic, whiny, refuses to play and eat. He does not find a place for himself, constantly asks for hands, but this does not bring relief. Vomiting appears, which is not associated with eating and does not bring relief to the child. The deterioration of the condition is associated with intoxication as a result of the development of an infectious process.
3. or subfebrile temperature. In infants and infants, the temperature rises with any inflammatory process in the ear. Older children will respond with fever when purulent inflammation develops in the middle or inner ear.
4. Itching in ear canal. This symptom often accompanies otitis externa. Babies can't scratch. They will restlessly turn their heads, pull their ears. Itching can interfere with your child's sleep.
5. Discharge from ears. Occur in otitis externa and otitis media. In the first case, a clear liquid is released from the ears. With inflammation of the middle ear - a viscous secret of a purulent nature, often a specific smell comes from the ear. Since in babies pus accumulates in the tympanic cavity and does not break out for a long time due to the large thickness of the membrane, then general symptoms- Pain and fever. When it ruptures and pus flows out, pain relief occurs.
6. Hearing loss. Occurs with any localization of otitis media. Otitis externa is accompanied by swelling of the ear canal. Inflammation of the middle and inner ear disrupts the function auditory ossicles, cochlea, semicircular canals. As a result, sound transmission and sound perception deteriorate. Babies begin to react poorly to adult speech and musical toys, and older children themselves complain of hearing loss, or begin to ask their parents again, increase the volume of the sound when watching television.
7. Dizziness, imbalance. These symptoms indicate the development of internal otitis when the organ of balance is affected. You may notice an unsteady gait and falls when the child walks. He himself complains of unusual sensations when changing postures, walking, lying down.
8. Noise in ears. This symptom accompanies inflammation of any part of the ear.
9. Lymphadenitis. This is an inflammation of the lymph nodes located along the outflow of lymph from the ear. Inflammation in such cases parotid, cervical, occipital lymph nodes are susceptible. Parents may notice their increase in any localization of inflammation in the ear. Often the child himself complains about pain in the neck or back of the head.

You can try to determine the presence of ear inflammation in a child by pressing on the tragus. This cartilaginous formation is located opposite the external auditory opening. In case of inflammation of the outer or middle ear, the child will complain of pain when pressed. The baby will worry and pull his hand away from the sore ear. This sign is not reliable. If otitis media is suspected in the crumbs, a mandatory examination by a doctor is necessary.

Complications of acute otitis media

They will occur if left untreated. purulent inflammation middle ear or labyrinthitis. But complications can also occur with inflammation of the auditory canal. Most of them consist in the spread of infection to neighboring and nearby structures, chronic inflammation, or both.

The following conditions can be attributed to complications of otitis media.

1. Infectious eczematous dermatitis. This is an infection of the skin covering the external auditory canal. It occurs if the skin becomes infected with purulent discharge from the tympanic cavity.
2. Chronic suppurative inflammation middle ear structures.
3. Acute mastoiditis. It is characterized by inflammation of the cells of the mastoid process of the temporal bone. In the future, destruction may occur (purulent fusion) bone structure and defeat cranial nerves, eye sockets, cervical muscles on the side of inflammation.
4. Paralysis of the facial nerve(Bell's palsy). This nerve runs between the ear and the mastoid but is rarely affected. As a result of damage to the facial nerve, the child will experience weakness of the facial muscles, skewed mouth, incomplete closure of the eyelids on the side of the lesion, increased salivation, changes in diction.
5. cholesteatoma. This is cystic formation in the middle ear or in the cavities of the temporal bone, which contains dead epithelial cells.
6. Intracranial complications: meningitis, encephalitis, brain abscess.
7. Hearing loss. Occurs due to sclerosis of the tympanic membrane, its strong retraction due to atelectasis, perforation, impaired connection of the auditory ossicles.

How to help a child?

If acute otitis media is suspected in a baby, an examination by an otorhinolaryngologist or pediatrician is necessary. They will examine the ear with a special device - an otoscope and establish an accurate diagnosis. But before a visit to the doctor, mom and dad can alleviate the child's condition on their own.

If the baby has a high temperature, he complains or there is a suspicion of pain, you need to anesthetize. In this case, paracetamol preparations are used: Panadol, Kalpol, Cefekon; or ibuprofen: Nurofen, Ibufen, Maxicold. A single dose of paracetamol is 15 mg per kilogram of the child's body weight, and ibuprofen is 10 mg per kilogram.

For pain relief and lowering the temperature in babies, only the above drugs are used. Aspirin, analgin, nimesulide (Nise) are not used to treat children. Their use can cause the development of life-threatening complications for the child. The analgesic and anti-inflammatory effect is more pronounced in ibuprofen, therefore, in acute otitis media, it is better to give the baby this drug.

To reduce swelling of the mucous membrane of the Eustachian tube, you can drip any vasoconstrictor drops age appropriate. It is best if these are xylometazoline or oxymetazoline preparations (Tizin, Xymelin, Snoop).

Vasoconstrictor drops in babies are used no more than three times a day to avoid side effects drugs.

If the sore ear is dry to the touch, there is no discharge, you can use ear drops with an anesthetic, for example, Otipax. This measure will relieve pain and improve the condition of the baby.

If fluid is released from the ear, drops should be instilled strictly with the permission of the doctor. A discharge can be a sign of perforation of the eardrum, and many drops contain components that are toxic to the structures of the tympanic cavity and can only do harm.

A dry pressure bandage can be applied to the affected ear. In some cases, this measure will also relieve pain. Alcohol compresses do not need to. It is not necessary to warm the sore ear before examining a doctor.

Appointment question antibacterial drugs For oral administration, only the doctor decides. There is no need to self-administer antibiotics.

What should be done to prevent acute otitis media?

Acute otitis often occurs as a complication of respiratory viral infections. In the prevention of this disease, an important role is played by the hardening of the baby and the restriction of contact with strangers during seasonal rises in the incidence. In the family during such periods, you need to follow the rules of personal hygiene: wash your hands after coming home, carry out wet cleaning and airing daily. Avoid passive smoking.

For babies, it is important in the first half of life. Babies suffering from regurgitation should be fed in a semi-vertical position so that food does not flow into the nasopharynx during feeding. After feeding, the baby should stay upright for up to 40 minutes.

Of particular importance is vaccination against hemophilic and pneumococcal infections from a very early age, since it is Haemophilus influenzae and pneumococci that most often cause acute development in children under three years of age.

If the child is still ill with a respiratory infection, he has a runny nose, then you need to prevent thickening of the mucus in the nasal passages. Otherwise, blockage of the auditory tubes will occur and otitis media will develop. At such a moment, the baby should drink a lot - up to 1.5 - 2 liters of fluid per day, depending on age. The room temperature should be maintained within 18 - 22 ºС, and air humidity - 50 - 60%. So that the mucus does not dry out and is quickly evacuated, you can instill a few drops of any isotonic saline solution into the nasal passages every hour and a half.

Isotonic saline solution you can cook it yourself by dissolving a teaspoon of table salt in a liter of boiled water. You can buy a ready-made saline solution at a pharmacy.

The baby needs to carefully remove excess mucus from the nasal passages using an aspirator. And an older child can already be taught to blow his nose correctly. The nasal passages should be cleaned alternately, the mucus should not be pushed out intensively, in short intervals.

You should not frequently rinse the nose of a baby or force an older child to blow his nose intensively. Due to the structural features of the auditory tubes, mucus with pathogens easily penetrate into the middle ear cavity.

During water procedures in babies prone to illness, ears should be protected from moisture. It is necessary to do this when swimming in ponds and pools.

With the right and timely treatment Acute otitis media resolves fairly quickly and almost never leads to complications or hearing loss. And when the eardrum ruptures, a scar forms quite quickly, which does not affect the quality of hearing.

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Content

Inflammation of the middle ear in children is a common ailment in early age. At the same time, the baby cannot always clearly explain what actually hurts him. Already with the first symptoms related to otitis media and similar inflammations, you need to go to the otolaryngologist, because chronic form the inflammatory process is no longer curable.

Otitis in children - symptoms

It is possible to diagnose a possible otitis media in a child according to his complaints and outward signs. initial stage the disease is expressed by symptoms similar to all causes: a feeling of fluid in the ear, shooting or clicking pain, hearing loss. This is already a reason to urgently go to the hospital. The further condition will worsen, and the symptoms of this disease in children will appear as follows:

1. Acute intermittent pain in the ear, extending to the jaw and throat. At the same time, the effect has a wave-like character, which is practically not stopped by painkillers.
2. Discharge of pus and mucus from the ear. This is the first sign that the tympanic membrane has perforated due to exudate pressure. In this situation, the pain decreases or disappears completely, but it forms open wound with suppuration.
3. Heat, which is briefly reduced by medication.
4. Significant hearing loss, the appearance of additional "effects": muffled voices, echo, regular change in the frequency of perception.

Symptoms of otitis media in children infancy much more difficult to define. In this case, parents should carefully monitor the mood and behavior of the baby, the change in his mood and the following signs:

1. Long position of the head on a certain side in bed (the child will try to put the sore ear on the pillow).
2. High body temperature.
3. The baby refuses to feed from one breast. The reason for this choice of position is an attempt to comfortably place the large ear.
4. Painful reaction when pressing on the protrusion of the auricle (tragus).

Otitis media

Inflammation of the ear is divided into three diseases according to localization: internal otitis (labyrinthitis), external and middle. Otitis media in a child is divided into acute and chronic. The last variety of the disease is divided into serous or purulent. There can be several reasons for the inflammatory process and subsequent otitis media:

1. Inflammation localized in the nasopharynx. The Eustachian tube works as an infection-spreading channel.
2. Hypothermia or overheating of the body on the street or at home.
3. For children of age breastfeeding- Wrong posture of the child (lying on his back). In this case, mother's milk can enter through the nasopharynx.
4. Problems with adenoids and their treatment.
5. Low immunity. Often this problem appears with artificial feeding.

Otitis externa

A quarter of all cases of ear disease is otitis externa in a child. Due to the localization of the disease, it is highly treatable. But this happens if the diagnosis is determined correctly and treatment is started. The reasons for the onset of inflammation are the most banal: improper ear hygiene, damage to the integument of the auricle. The results of the disease can be completely different:

• the formation of a boil;
• purulent external otitis;
• inflammation of the cartilage - perichondritis;
• fungal infections- otomycosis;
• eczema on the skin.

Purulent

One of the most common inflammatory processes is suppuration in the tympanic cavity. For the occurrence of the disease, a simple runny nose is enough. Since the baby spends a long time lying on his back, the secretory fluid of the nasal mucosa freely enters the ear canals through the Eustachian tube. Parents need to control the cleanliness of the nasal passages and wash them in a timely manner. The symptoms of the disease have been described above. In severe cases of acute purulent otitis media, children experience bradycardia, clouded consciousness, and vomiting.

Exudative

A severe form of ear inflammation that is difficult to treat. The reason lies in the fact that the disease is often determined on late stages. It is characterized by a violation of the ventilation of the middle ear and the accumulation of exudate. By the time exudative otitis media is diagnosed in a child, the accumulated fluid already consists of pus and mucus. The causes of the development of the disease are respiratory infections, "cleft palate", passive smoking, poor "toilet" of the nasopharynx.

catarrhal

A disease that is quite common among children, which is caused by the incomplete formation of the auditory canal. Catarrhal otitis in a child almost always precedes the development of a purulent variation of the disease. The causes of the onset of the disease are no different from otitis media of other types (except external): SARS, runny nose, accumulation of foreign fluid in the ear. Similar symptoms of two diagnoses can cause improper treatment, so you should contact an otolaryngologist, and not get carried away with self-medication.

double sided

Proper diagnosis of this form of the disease will help to avoid a decrease or total hearing loss at a young age. Features of the structure and process of formation of the auditory apparatus in children provoke the fact that 90% of children under one year old suffer from bilateral inflammation of the ears. Bilateral otitis media in a child is dangerous in that it is sometimes characterized by only a slight decrease in hearing sensitivity. Even with this symptom, you need to go to the hospital.

In an infant

The most difficult thing is to determine any disease in young children, when they still cannot show what hurts them and how. Otitis in an infant is fraught with subsequent complications up to actual complete deafness. A timely visit to the doctor will help to quickly and correctly cure the disease. Therefore, parents should carefully watch the behavior, changes in his mood and the following signs:

1. Long position of the head in the crib on one side (the baby will try to put the sore ear on the pillow).
2. Unmotivated crying, constant anxiety.
3. Heat.
4. The baby refuses to feed from one breast. The reason is the same as when lying on a pillow.
5. Painful reaction when pressing on the protrusion of the auricle.

Treatment of otitis media in children

Otitis in children - the symptoms and treatment for different types are similar, but the main differences lie in the cause of the disease. Standard therapy takes 1-2 weeks, but there are ways to compensate for pain and improve hearing. Treatment of otitis media in children is supported by clearing the nasal passages to ensure normal breathing. The baby's head should not freeze, and walking on the street with the child is allowed after the temperature normalizes and the pain in the ear is relieved. Constant hygienic cleaning of the ear canal from secretions is mandatory.

Treatment of otitis media

With a timely visit to the doctor, the treatment of otitis media in children passes quickly and without consequences. For most diagnoses, conservative treatment with antibiotics (tablets or injections) is used. Vasoconstrictor nasal drops are used to normalize the patency of the Eustachian tube. Purulent discharge removed with disinfectants like chlorhexidine. Next, antiseptics are used - Tsipromed, Normaks, Sofradex. On the recommendation of a doctor, thermal physiotherapy (heating, blue lamp) can be performed.

Treatment of otitis externa

Depending on the type of disease, the doctor will prescribe suitable treatment. Independent application medicines(even if the parents know what the disease is) can aggravate the situation. Treatment of otitis externa in children necessarily occurs in stages and with a complex of selected drugs in order to achieve a full recovery.

• analgesics for pain relief - paracetamol, ibuprofen;
• neomycin, ofloxacin to reduce the inflammatory process (over time, they are replaced by ointments or creams to avoid the development of recurrent otitis media);
• boils are treated with antibiotics.

Otitis media treatment with antibiotics

It is worth recalling that the use of potent drugs should only be prescribed by a doctor. Self-treatment of otitis media in children with antibiotics can lead to a deterioration in the condition and the development of third-party diseases. The most effective pharmaceuticals to date, including for staphylococcal otitis media:

• Sofradex;
• Ceftriaxone (Unazine, Hemomycin);
• Ceftazidime;
• Cefaclor;
• Cephalosporins;
• Cefuroxime;
• Roxithromycin;
• Clarithromycin;
• Amoxicillin (Azitralom, Azithromycin, Amikacin, aminoglycosides, Amoxiclav, Ampiksid);
• Flemoxin Solutab, Sollux.

Otitis in a child - treatment at home

If the inflammation of the ears in children goes away without indications for hospitalization, then home rest and maintenance right conditions help you recover as quickly as possible. To do this, ensure bed rest, maintain dry heat in the room. Treatment of otitis in children at home is possible in the absence of high constant temperature, weak pain symptom and good general condition of the child.

Treatment of otitis with folk remedies

Folk experience in medicine correct application can make the treatment process more effective. In this case, the characteristics of the child, individual intolerance and recommendations of specialists are necessarily taken into account. Treatment of otitis media with folk remedies is quite acceptable at home. Here are some proven recipes for fighting inflammation:

1. Warm compress on the ear. A mixture of vodka (alcohol) and water in a one-to-one ratio is heated to about 40 degrees. Moisten a piece of gauze in it and put it on the ear area (the auricle should remain free). Duplicate the top with waxed paper or plastic wrap. The next layer is cotton. Bandage the compress to the head and close the bandage from above with a non-synthetic scarf or scarf. Leave for 30-60 minutes (You can also use heated salt or baking soda wrapped in a warm cloth).
2. You can use turundas or water-based instillation, medicinal herbs, camphor alcohol, camphor oil, boric alcohol and honey. Before the procedure, the solution needs to be slightly warmed up to avoid hypothermia of the inflamed area.
3. With external otitis, you can put crushed aloe or Kalanchoe leaves on a gauze napkin into the ear.
4. Prevention of the common cold against the background of otitis media is carried out using oxacillin.

Despite the popularity of iodine in the treatment of ear diseases, it is highly discouraged for use in children's treatment. Iodine solutions are aggressive and can cause secondary inflammation skin and mucous even in minimum concentration. Folk methods treatment should be used only with the approval of a specialist and under his supervision.

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Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment, based on individual characteristics specific patient.