Those ear infections

NO matter how careful a parent you are, it is almost guaranteed that ear infections, which are listed among the most common childhood afflictions, will affect your child at some point.

Dr Francis Barnett, consultant otolaryngologist (ENT) at Facial and Oral Surgery Associates and associate lecturer at the University of the West Indies, Mona, said that by age three, 80 per cent of children would have already experienced their first ear infection, pointing out the structure of the middle ear in particular which makes it prone to these infections.

“The ear is divided into three sections – outer, middle and inner ear. In childhood, infection of the middle ear is most common. The middle ear is connected to the back of the nose by a tube called the Eustachian tube. This tube serves several functions but most importantly, it allows for ventilation and pressure equalisation in the middle ear cavity. In the child, this tube is shorter and wider than in the adult. This allows the infection to travel easier into the middle ear,” Dr Barnett explained.

He said until about age eight, the Eustachian tube in children remains underdeveloped, a feature which shows a close association with acute otitis media (a painful type of ear infection) in children. Sixty-five per cent of children are diagnosed with acute otitis media by age two and up to a further 15 per cent more by age three.

“Acute otitis media is a common early childhood disease [which shows signs and symptoms of an acute inflammation] of the middle ear. Not only does it affect the child, but it leads to many sleepless nights and loss of work for the rest of the household,” Dr Barnett said.

He urged parents to revisit their casual treatment of various forms of infections, especially by way of over-the-counter drugs, noting that especially in light of the associated complications, ear infections should be treated with utmost seriousness.

Complications include:

• Meningitis

• Brain abscess

• Permanent hearing loss

• Nerve damage

• Mastoiditis.

He pointed out, however, that these complications are uncommon with the use of antibiotics, noting that temporary partial hearing loss is a common complaint of young children even after the infection has resolved.

“Temporary partial hearing loss is usually due to fluids that may remain in the middle ear (otitis media with effusion) affecting the transmission of sound. This hearing loss is very significant in this age group since hearing at this age is important for language development and learning,” Dr Barnett explained.

He said that there are a plethora of factors that contribute to ear infections in children, noting that common risk factors include:

• Exposure to second-hand smoke

• Preschool, day care, and nurseries

• Not breastfeeding

• Allergies, obesity, and the use of a pacifier may also increase risk.

Dr Barnett said that parents should be concerned when children present frequent occurrences of acute otitis media – defined as three or more episodes within six months or four in a year.

“Myringotomy and grommet insertion, which is the temporary placement of a tube into the eardrum, has been shown to help children with this problem,” he said.

“Engage your ENT doctor to further discuss this procedure with you, and continue to stay clear of any situation that could be potential contributors to the infection.”