Eye and Ear Problems
Ear
Infections
Ear infections can occur in the middle
ear or the ear canal. For information about infections in the ear canal, see
Swimmer's Ear on See Swimmer's Ear.
A middle ear infection (otitis media)
usually develops during a cold. Colds can cause the eustachian tube (which connects
the middle ear to
the throat) to swell and close. When the eustachian tube is closed, air cannot
reach the middle ear. This creates a vacuum that draws fluid into the middle
ear. Bacteria or viruses then grow in the fluid, causing a middle ear infection.
The infected fluid that is trapped
in the middle ear puts pressure on the eardrum. If the ear infection is not
treated, the pressure may continue to build until the eardrum ruptures. A single
eardrum rupture usually
is not serious and rarely causes hearing loss. However, repeated eardrum ruptures
can lead to permanent hearing loss (see "Recurrent Ear Infections and Persistent
Effusion" on See Recurrent Ear Infections
and Persistent Effusion).
Symptoms of a middle ear infection
include ear pain, dizziness, ringing or a feeling of fullness in the ear, hearing
loss, fever, headache, and runny nose. Children who can't yet talk may tug on
their painful ears. Drainage from the ear that is bloody or looks like pus may
indicate a ruptured eardrum. Ear pain usually improves once an eardrum ruptures.
When a person has fluid build-up
in the middle ear, it is called serous
otitis or effusion. Effusion generally occurs after a middle ear infection
has cleared up. There may be no symptoms, or there may be a muffling of sound,
minor hearing loss, and mild discomfort. Effusion is not a cause for concern
and may not require treatment unless it lasts
longer than 3 months or causes significant
hearing loss in both ears. See Recurrent
Ear Infections and Persistent Effusion.
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| Ear infections can occur in the ear canal or
middle ear. Dizziness can be caused by an inflammation of the inner ear. |
Breast-feed your baby. Breast-fed babies have fewer ear
infections.
If you bottle-feed your baby, hold the baby in an upright position to
prevent milk from getting into the eustachian tubes. Do not allow infants
to fall asleep with a bottle (however, it is all right to let a nursing
baby fall asleep at the breast).
Avoid exposing children to cigarette smoke, which is associated
with more frequent ear infections.
If possible, limit your child's contact with other children
who have colds.
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Recurrent
Ear Infections and Persistent Effusion
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If your child has at
least 3 ear
infections in a 6-month period, or
2 ear infections before the age of 6 months, talk to your paediatrician
about preventive antibiotic treatment. This is a low dose of antibiotics
given daily throughout the season when your child is prone to ear
infections. Daily antibiotic treatment may reduce the frequency
of ear infections, but it may not always prevent fluid build-up
(effusion) in the middle ear.
Daily antibiotic treatment
is prescribed less often than it used to be. This is because there
is growing concern that routine use of antibiotics may cause bacteria
to change so that common antibiotics cannot kill them.
If your child has repeated
ear infections (3 in 6 months, or 4 to 6 in a year), your doctor
may suggest
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inserting ear tubes (tympanostomy
tubes) through your child's eardrums to help prevent ear infections.
The tubes remain in the child's eardrums for 6 to 12 months.
In some children, fluid
remains in the middle ear more than 3 months after an ear infection
clears up. If this occurs in your child, he or she should be given
a hearing test because long-lasting effusion can cause hearing loss.
If your child has effusion and significant hearing loss in both
ears at the same time for more than 3 months, your doctor may recommend
ear tubes.
There are no firm guidelines for treating recurrent ear
infections and long-lasting effusion. Ask your doctor about the
long-term risks and benefits of all the available treatment options.
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Wean your child from his or her pacifier at about 6 months
of age. Babies who continue to use their pacifiers after 12 months of
age are more likely to develop ear infections.
Wash your hands often if you have a cold or other upper
respiratory infection to prevent spreading the infection.
Make sure your child is up to date with his or her immunizations.
(Children over 2 years of age who have repeated ear infections need
to get the pneumococcal vaccine. See
Pneumococcal Infection.)
Apply heat to the ear to ease the pain. Use a warm washcloth
or a heating pad set on low. Don't use
a heating pad on an infant, and never leave a child alone with a heating
pad.
Acetaminophen, aspirin, or ibuprofen will help relieve
earache. Do not give aspirin to anyone younger than 20 years of age.
Rest. Let your energy go to fighting the infection.
Drink more clear liquids.
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If an ear infection has caused the eardrum to rupture,
avoid getting water in the ear until the eardrum heals (about 3 to 4 weeks).
If your child has a severe earache and cannot be quieted
even after you apply Home Treatment for several hours.
If ear pain occurs with other signs of serious illness,
such as headache with severe stiff neck, fever,
irritability, or confusion. (See "Encephalitis and Meningitis"
on See Encephalitis
and Meningitis.)
If your baby pulls or rubs his or her ear and appears to
be in pain (crying, screaming).
If ear pain increases despite Home Treatment.
If your child has a fever over 38.9°C (102°F)
with other signs of an ear infection.
If you suspect that the eardrum has ruptured or there is
drainage from the ear that looks like pus or contains blood.
If symptoms do not improve after 48 hours of treatment
with an antibiotic.
If your child has ear tubes and develops an earache or
has drainage from the ear.
If mild ear pain continues for longer than 3 to 4 days.
If there is redness or swelling behind the ear.
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