Symptoms of middle ear inflammation in a child. Otitis in a child: causes, signs and symptoms, treatment and prevention. What to do if your child has frequent otitis media

Children and their parents encounter such a disease as otitis media quite often. Medical statistics say that every child has suffered from ear inflammation at least once in their life, and before the age of three, more than 80% of children have already suffered from this disease. In every eighth child, otitis media is chronic. The famous children's doctor Evgeniy Komarovsky talks about why children's ears become inflamed and how to treat this condition.

About the disease

Otitis media in children can be of three types. Depending on the location of the inflammatory process, the disease can be external, middle or internal. The inflammatory process can be concentrated or diffuse, affecting the eardrum and other structures of the ear. Based on the duration of the disease, otitis is divided into acute and chronic. And the presence or absence of pus divides otitis into two types - catarrhal (without pus) and exudative (with pus).

Inflammation can be caused by bacteria, viruses and allergens. They enter the auditory tube through improper nose blowing, sneezing, and 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 manifests itself as boils in the area of ​​the auricle; this is a completely independent disease that is caused by microbes. Allergic otitis is a type of reaction of the child's body to a protein antigen; it is extremely rarely purulent, but is accompanied by severe swelling. If the inflammation is localized only in the auditory tube, it is called tubootitis.

Some children get otitis rarely, others often. This, according to Evgeny 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 tube “catches up” in length and diameter to normal, takes on a more horizontal position, and frequent otitis media becomes rare or disappears altogether.

Symptoms

External otitis is difficult not to notice - the auricle turns red, sometimes visually without special medical instruments (otoscope and mirror) you can see a boil or abscess, the child develops throbbing pain, characteristic of all abscesses. Hearing may deteriorate somewhat only at the moment when the abscess ruptures and pus enters the auditory tube.

Otitis media manifests itself as “shooting” in the ear, the pain intensifies and then subsides for a short time. There may be a slight decrease in hearing, headache, lack of appetite, dizziness, disorders of the vestibular system, and increased body temperature. A child who, due to his age, can already speak, is quite capable of telling what worries him. A baby who has not yet learned to speak will often touch his ear, rub it, and cry.

The most difficult thing to diagnose at home is otitis media in an infant. But there are signs that will help parents figure out what exactly is bothering the baby:

• During sucking, the baby's anxiety increases.
• If you press on the tragus (the protruding cartilage near the ear canal), the pain will intensify and the baby will cry more.
• If you hold the baby close to you while feeding the sore ear, it will feel a little easier.

If there is any suspicion of otitis media in an infant, even if the illness is not accompanied by fever or fluid discharge from the ears, you should definitely show the baby to a doctor.

Internal otitis in the vast majority of cases 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 with severe sudden dizziness. There is often noise in the affected ear and hearing loss. For diagnosis, you definitely need a doctor who will prescribe an MRI of the brain and pure-tone audiometry.

Treatment according to Komarovsky

Evgeniy Komarovsky warns mothers and fathers that otitis media for a child cannot be treated using folk remedies and alternative medicine, because the complications of the disease can be very severe - from the transition of an acute form to a chronic one, and then the child will be plagued by frequent otitis media, until the onset of deafness, facial paresis nerve, meningitis, etc. Therefore, instilling heated oil with aloe or walnut juice is a real parental crime.

With purulent otitis media, you should absolutely not warm anything up, make warming or alcohol compresses, or instill warm oil, as caring grandmothers and traditional healers may advise. Such heat will only worsen the inflammatory exudative purulent process.

For treatment of acute (suddenly occurring) otitis in a child, Evgeniy Komarovsky recommends starting treatment by instilling vasoconstrictor drops into the nose. They not only reduce the lumen of blood vessels in the nasal mucosa, but also relieve swelling in the area of ​​the auditory tube. “Nazivin”, “Nazivin Sensitive” (if the baby is an infant), “Nazol baby” are suitable for this.

The main thing to remember is that these drops are not used for more than five days, since they cause persistent drug addiction, and you need to choose children’s drops at the pharmacy, the dosage of the active substance in which is lower than in similar adult preparations.

Vasoconstrictor drops are relevant only at the very initial stage of acute otitis, when there is a chance to prevent its further development. If the chance remains unrealized or the attempt was unsuccessful, you should immediately contact an otolaryngologist, who will determine the type of disease and, upon examination, find out whether the eardrum is damaged. If it is intact, you can use ear drops; if it is damaged, which happens quite often, then nothing should be dripped into the ear.

If pus is flowing from the ear, then Komarovsky urges you to abandon self-medication and not drip anything before going to the doctor.

Suppuration most likely indicates a perforation (breakthrough) of the eardrum, through which pus enters the outer ear. If there is perforation, do not drip near the ear so that the medicine does not get on the auditory nerve, auditory ossicles and cause deafness.

If otitis media is accompanied by an increase in temperature, then it is reasonable to use antipyretic drugs and painkillers. To reduce high fever, it is advisable to give Paracetamol or Ibuprofen to children. Both of these medications provide a moderate analgesic effect. Doctors often prescribe a drug such as Erespal. It can be taken by children over two years of age in syrup form. This medicine is not given to children in tablet form.

Are antibiotics needed?

Although most parents believe that antibiotics are necessary in the treatment of otitis media, this is not always the case, says Evgeniy Komarovsky. With exudative otitis media, which occurs without symptoms, caused by the accumulation of fluid in the middle ear cavity, antibiotics will not have any effect on the healing process. Typically, such otitis media goes away on its own as the child recovers from the underlying viral disease - ARVI or influenza.

Otitis media, accompanied by pain and “shooting” in the ear, can be caused by both bacteria (against which antibiotics are effective) and viruses (against which antibacterial drugs are completely ineffective).

Evgeniy Komarovsky advises waiting 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 child’s otitis media is severe, with high fever, very severe pain, and if the child is not yet 2 years old, the doctor will most likely prescribe antibiotics right away. For children under two years of age, it is very important whether they have otitis media - one-sided or two-sided.

When treating external otitis, antibiotics are rarely required; treatment with antiseptics is usually sufficient. Internal otitis requires symptomatic treatment; antibiotics for labyrinthitis are also prescribed extremely rarely.

In any case, a doctor should decide to prescribe 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 Evgeniy Komarovsky, is prescribed individually. If the eardrum is intact, the doctor may recommend drops with antibiotics, but most often they prescribe antimicrobial drugs in tablets, and this is quite enough. There is no need to inject medications into your child.

For treatment to be effective, it is important that the drug accumulates in the problematic sore spot, and therefore for otitis media, antibiotics are taken for a long time and in increased doses. The minimum course is 10 days. If the child is under two years old and if he attends kindergarten, the course is not reduced. If the baby is over 2 years old and does not go to kindergarten, then the doctor may prescribe antibiotics for only 5-7 days. It is very important to follow the timing and dosage to reduce the risk of recurrent otitis.

Otitis media and deafness

In almost all types of otitis, hearing is reduced to one degree or another. Evgeny Komarovsky advises to treat this as an inevitable situation. Otitis media can lead to deafness or persistent hearing loss only if the inflammation was treated incorrectly and the auditory ossicles or auditory nerve are damaged.

Children who have undergone successful treatment for otitis media continue to have reduced hearing for some time. It recovers on its own within 1-3 months from the end of treatment.

Surgery

Typically, surgery is not required for otitis media. The exception is when a child with severe and prolonged pain and suppuration in the ear cavity does not rupture the eardrum. Its strength is individual for each child; in some, otitis flows from the ear already in the initial stage, in others, perforation does not occur. Then there is a risk of purulent masses breaking out anywhere, including the brain. If there is such a threat, doctors make a small incision on the eardrum to ensure the drainage of pus.

Evgeniy Komarovsky reassures that a ruptured eardrum and its incision are not dangerous for a child. Usually it recovers quickly, leaving only a small scar, which in no way subsequently affects a person’s hearing.

Compress for otitis media

The compress should be dry; there is no need to moisten it with anything. To prepare it, just cotton wool and a small piece of polyethylene are enough. Cotton wool is applied to the child's sore 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 and is less damaged, including by loud sounds. In addition, a cotton compress is very useful for the mother of a sick person, she feels calmer this way. Traditional medicine no longer sees any benefits from the compress, since it does not affect either the risk of complications or the duration of the inflammatory process.

Otitis (ear inflammation) is a fairly common disease in children, especially at an early age. Since the main symptom of this disease is excruciating pain in the ear, it is important for parents to know how to alleviate the child’s suffering. All otitis is divided into external, middle and internal (but internal otitis is more often called labyrinthitis). If a child develops symptoms such as severe ear pain, ear discharge, etc., you should immediately consult an otolaryngologist (ENT) to prescribe treatment; self-medication can be dangerous!

Otitis externa

Otitis externa develops when an infection enters the skin of the ear canal, for example, through constant contact with water while swimming. It can occur when performing a hygiene procedure (cleaning your ears). Swelling and redness of the skin appears in the external auditory canal. In some cases, discharge may appear from the ear canal.

Damage to the outer ear can occur with erysipelas, when streptococcus penetrates through microcracks in the skin. The temperature suddenly rises to high levels, this is accompanied by chills, the baby refuses to eat. In addition to redness and swelling, blisters may appear on the skin of the ear and in the external auditory canal.

Otitis externa can also develop with a boil or inflammation of the hair follicle if the child’s body’s resistance is reduced. Upon external examination, the boil is not visible. It causes ear pain that worsens with chewing or touching the tragus (protrusion above the earlobe). Parotid. After several days it ripens and the abscess opens, then the pain decreases. Timely initiation of treatment for otitis externa leads to a favorable outcome of the disease.

Otitis media

According to the nature of the course, otitis media can be acute or chronic. There are serous and purulent acute otitis media.

There are several causes of otitis media:

• inflammatory process in the nasopharynx: infection enters the ear through the wide and horizontally located auditory tube in children (Eustachian tube), connecting the nasopharynx to the ear; the outflow of fluid from the middle ear through the inflamed auditory tube is disrupted, fluid accumulates in the middle ear and becomes infected;
• violation of the temperature regime (hypothermia or overheating of the child);
• improper feeding of the baby (in a supine position): breast milk or formula can enter the middle ear from the nasopharynx;
• Availability ;
• weakness, especially with artificial feeding.

The onset of the disease is acute, sudden, often at night. A small child wakes up from severe pain in the ear and screams shrilly, crying incessantly. The temperature can reach 40˚ C, sometimes vomiting and. The baby turns his head, may rub or cover the sore ear with his palm, preventing him from touching it.

When the child is sleeping, you can try lightly pressing the tragus. If the child moves his head away, winces or cries, this confirms an ear infection and you should consult a doctor immediately.

Attempts by parents to independently treat the child can lead to complications: the spread of infection to the air sinus in the area behind the ear. The timing of the onset of this complication (mastoiditis) varies, soon after the onset of the disease or after some time.

With serous or catarrhal otitis, fluid accumulates in the middle ear, which leads to hearing loss. The main manifestation of catarrhal otitis is severe pain, due to which the child does not sleep and pulls his ear with his hand. If the process is one-sided, then the baby tries to take a forced position: lying on the affected side.

The pain intensifies when swallowing, so the child refuses to eat. During the examination, the doctor sees redness and protrusion of the eardrum. With timely treatment, this inflammation goes away after a few days.

Acute purulent otitis media

Acute catarrhal otitis can quickly (even within the first day) turn into purulent. Purulent discharge from the ear appears, indicating that the eardrum has ruptured and pus is leaking into the ear canal. This reduces ear pain.

The appearance of purulent discharge from the ear is an indication for urgent medical attention. You should put a wick rolled up from a bandage (turunda) in the child’s ear, put on a cap and go to the doctor.

In some cases, the doctor himself makes a puncture (paracentesis, or puncture) of the eardrum to ensure the outflow of pus through the puncture hole. Healing at the puncture site then occurs within 10 days. At this time, careful care of the little patient’s ear is carried out.

Chronic otitis media

The transition of otitis media to a chronic form is most often observed with reduced body resistance as a result of the presence of concomitant pathology (frequent, deviated nasal septum, adenoids, etc.).

The main symptoms of chronic otitis media:

• long-term non-closure of the hole in the eardrum;
• discharge of pus from the ear, recurring periodically;
• hearing loss (the intensity of which increases over a long period of time);
• wave-like course of the disease.

Complications of otitis media

If treatment is not started in a timely manner or the process progresses at lightning speed, serious complications can develop:

• facial nerve paresis;
• hearing loss;
• mastoiditis (inflammation of the mastoid process of the temporal bone);
• (inflammation of the meninges);
• damage to the vestibular apparatus (an organ that responds to changes in the position of the body and head in space).

Features of the course of otitis in children under one year old

Acute respiratory diseases in children under one year of age can often be complicated by otitis media. Since the baby cannot explain what is hurting him, the mother should carefully monitor the sick child so as not to miss the onset of otitis media.

Most often, the main sign of ear inflammation in young children is severe anxiety, seemingly unfounded. The baby becomes capricious and often cries loudly. Crying intensifies when the ear is accidentally touched. Sleep becomes restless: in the middle of the night the baby may wake up screaming.

Appetite also worsens: during feeding, the child, after taking 2-3 sips, suddenly throws the mother’s breast or a bottle of formula and “breaks down” crying. This is due to the fact that when sucking and swallowing, the pain in the ear intensifies.

Sometimes in children under one year of age, vomiting and diarrhea are observed with otitis media; possible .

Features of the treatment of otitis in children under one year old are that ear drops are not prescribed, and only 0.01% Nazivin is instilled into the nose.

Otherwise, treatment is carried out in the same way as for older children (see below).

Treatment of otitis media in children

Contacting an otolaryngologist is mandatory in any case when a child experiences ear pain. If discharge (especially purulent) appears from the ear, you should seek medical help immediately.

Treatment of otitis media is carried out on an outpatient basis. Hospitalization is indicated only in cases of severe disease.

What can you do at home?

Under no circumstances should you self-medicate. Before visiting a doctor, you can only independently give your child an antipyretic drug in an age-appropriate dosage (Paracetamol, Nurofen; for older children - Nimesulide, etc.). These medications will also reduce ear pain.

You should also clear the nasal passages for free breathing (let the child carefully blow his nose, and in younger children, suck out the mucus from the nose with a syringe).

It is dangerous to instill ear drops before a doctor’s examination, since in the event of a rupture of the eardrum, the drops can enter the middle ear cavity and damage the auditory nerve or auditory ossicles, which will lead to hearing loss. It is better, instead of directly instilling drops, to use a turunda from a bandage: insert it carefully into the external auditory canal, and drop 3-4 drops of warm (warmed up) 3% boric alcohol onto the bandage.

After examining the child by a doctor, you need to carry out all medical prescriptions at home:

• instill special drops into the ear;
• give antibiotic tablets if necessary;
• apply compresses to the sore ear;
• warm the ear with a blue lamp or a bag of heated salt;
• clean the child’s nose for free breathing;
• provide proper care for the child.

Putting drops in the ear

After an examination, the doctor will prescribe drops in the child’s ear that have both an analgesic and anti-inflammatory effect (for example, Otipax or Otinum). These drops need to be instilled when heated, otherwise the cold liquid will worsen the pain in the ear.

You can first heat the pipette in hot water, and then draw drops into it. If the bottle with drops has a dispensing pipette, then you need to turn the bottle over, close the cap and heat in hot water only that part of the medicine solution that entered the pipette. Then remove the cap and drip the medicine into the ear or onto a gauze turunda inserted into the ear.

If the doctor has approved direct instillation of the medicine into the ears, then you first need to warm the bottle in your hand, lay the child on his back and turn his head to the side. Slightly pulling the auricle up and back, drop 3-4 drops into the ear canal (auditory canal). It is advisable for the child to lie in this position for several minutes. If this cannot be achieved, then you need to put a piece of cotton wool in your ear.

Compresses on the ear

In case of acute catarrhal otitis, the doctor may prescribe a vodka or semi-alcohol compress (if pus is discharged from the ear, any compresses are contraindicated!).

Rules for applying a compress:

• take a gauze pad in 4 layers, the size of which extends 2 cm beyond the auricle, make a cut in the middle;
• moisten a napkin in a semi-alcohol solution (alcohol half diluted with water) or in vodka, squeeze lightly, apply to the ear area (push the auricle into the cut on the napkin);
• Place compress paper on top of the napkin (its size should be larger than the size of the napkin);
• Apply a layer of cotton wool on top, the size of which is larger than the size of the paper;
• secure the compress with a scarf;
• keep the compress for 3-4 hours.

Other ways to warm up the ear

You can warm up the sore ear of a child with catarrhal otitis using a reflector with a blue lamp. This warming session lasts 10-15 minutes and is carried out 2-3 times a day.

Effective heating is also ensured by a bag of salt preheated in a frying pan. The bag should warm pleasantly, but not burn, so its temperature should be assessed with your hand before applying it to the child’s ear. A bag of salt is also kept near the ear for 10-15 minutes.

Depending on the stage of the disease, the otolaryngologist may prescribe additional physiotherapeutic treatment methods: ultraviolet irradiation (ultraviolet irradiation), electrotherapy (UHF), laser radiation.

Ensuring free nasal breathing

An important point in the treatment of otitis media is to ensure that the child can breathe freely through the nose. You can clear your baby's nasal passages using cotton swabs, moistening them with baby oil. You can use a small syringe to suck out mucus from the nasal passages, but do this very carefully.

With sudden suction, negative pressure is created in the nasal cavity, and this can lead to hemorrhage in the middle ear cavity and detachment of the mucous membrane. Older children should be taught how to properly blow out nasal discharge: you cannot blow your nose into both nostrils at the same time, but only one at a time. As prescribed by the doctor, vasoconstrictor nasal drops are used, which will ensure not only free breathing through the nose, but also patency of the auditory tube.

Toilet ear

With purulent otitis media, it is important to regularly clean the ear. This procedure is performed by a doctor or an experienced nurse; Parents are strictly prohibited from attempting to clean the child’s ear on their own.

The doctor removes pus from the auricle and ear canal using a probe with cotton wool wrapped around it. At the same time, he pulls the child's ear down and back.

When a child's ears begin to hurt, even experienced parents can lose self-control from whims and tears. In order to effectively fight the disease, you need to know the enemy, as they say, “in the face,” forewarned means forearmed.

What is otitis media?

Otitis media means any inflammation of the ear. There are:

• The outer ear (pinna and external auditory canal to the eardrum) inflammation of which will be otitis externa. Here, boils caused by staphylococci and fungal infections of the ear canal come first.
• The middle ear begins behind the eardrum and includes the tympanic cavity, Eustachian tube, mastoid cells and antrum. Inflammation in this department is called otitis media. This is the most common ear pathology in children.
• Internal otitis is also called labyrinthitis. In this case, the inflammation affects the cochlea, its vestibule or semicircular canals.

Who is guilty?

Otitis media develops against the background of a bacterial (less commonly viral) infection. The most common cause of its development is aggressive streptococcal or staphylococcal flora. Most often, the infection enters the ear cavity through the Eustachian tube, which balances the pressure between the ear and the nasal cavity. Therefore, otitis media is very often the result of a runny nose.

A prerequisite for the development of otitis media is a significant decrease in local immunity in the child’s body; children are more susceptible to ear inflammation:

• suffering from rickets (see)
• anemia
• underweight
• chronic pathologies of ENT organs
• exudative diathesis
• Immunodeficiency takes extreme forms in diabetes mellitus, AIDS and leukemia.

But even a child without severe somatic illnesses can become a victim of otitis due to simple hypothermia. The fact is that the external auditory canal of a child, unlike an adult’s, does not have an S-shaped curvature. Therefore, any flow of cold air can provoke otitis in a child; the symptoms of otitis will directly depend on the location of the inflammation.

Manifestations of otitis media

With external otitis, symptoms in children may vary depending on the severity of the process.

The child will also be bothered by fever and intoxication (muscle, joint and headaches, fatigue and weakness).

• In addition to acute otitis media, a chronic inflammatory process can develop, which is divided into exudative otitis media, purulent or adhesive. Exudative and adhesive variants of otitis have mild manifestations in the form of hearing loss. Adhesive (adhesive) otitis media is the result of proliferation of connective tissue and fibrosis of the tympanic cavity and eardrum.
• With a chronic purulent process, periodic leakage from the ear and persistent hearing loss are observed due to permanent perforation of the eardrum.
• Labyrinthitis is manifested by pain, hearing loss, and, since the process involves the organ of balance associated with the inner ear.

How to suspect otitis media at home?

Older children may well complain of pain in the ear and even talk about what kind of pain it is and where it goes. It is much more difficult with children under two years old, who still cannot really talk and simply cry in response to pain (including otitis media). Symptoms in infants with this pathology are nonspecific:

• The child’s anxiety may lead to the idea of ​​inflammation of the middle ear
• his unmotivated crying
• refusal of breast or bottle
• Children may also grab their sore ear with their hands.
• turn your head from side to side
• if you press on the tragus of the sore ear, the child’s anxiety or crying increases due to increased pain

If there is any suspicion of otitis, the child should be immediately shown to a pediatrician or ENT doctor.

How does a doctor determine otitis media?

The otolaryngologist has such a simple and convenient device as an ear mirror. With its help, you can see changes in the external auditory canal and eardrum. Thus, otitis media corresponds to changes in the light cone on the eardrum. For the same purpose, the doctor can use an otoscope.

First aid for otitis media

If a visit to the doctor is postponed for objective reasons (although you cannot delay it), and the child is worried and crying, the first thing you need to do if you suspect otitis media is to numb the ear.

For this purpose, you can use non-steroidal anti-inflammatory drugs that have the property of suppressing inflammation, temperature and pain. Children are allowed derivatives (Tyled, Calpol, Efferalgan, Panadol, Tylenol), (Nurofen, Ibuklin) and naproxen (Cefekon) - see review, with dosages and prices. You can use syrup, tablets or rectal suppositories.

The second remedy for otitis media will be ear drops Otipax (170-250 rubles), Otirelax (140 rubles). This is a combined drug that includes the anti-inflammatory phenazone and the local anesthetic lidocaine hydrochloride. We must remember that Otipax can only be used if the eardrum has not been damaged (the ear is not leaking). For infants, 2 drops are instilled, and for children over two years old, 3-4 drops are instilled into each ear.

How to properly instill drops?

• Before instilling the drops, the bottle with them must be warmed to room temperature. In infants, the temperature can be up to 36 degrees. Alternatively, drops are poured from the bottle into a warm spoon and then pipetted.
• The child should be placed with his ear up and the auricle pulled back and down to straighten the ear canal.
• After the drops are instilled, the child is held with his ear up for at least ten minutes so that the medicine does not leak out.
• In children, drops are instilled into both ears, since the process is usually bilateral.
• If a baby is sucking on a pacifier, it should be removed before the drops are instilled. In combination with a stuffy nose, a pacifier can cause barotrauma to the eardrum.

Treatment of external otitis

A furuncle of the external ear (purulent otitis) is treated according to the classical scheme. At the stage of infiltration (before the formation of the rod) with anti-inflammatory drugs and alcohol compresses for the purpose of resorption. After the rod is formed, surgical opening of the abscess with drainage of the cavity, rinsing with Hydrogen Peroxide or Chlorhexidine, and subsequent ointment dressings with levomekol until the wound is completely healed. In case of intoxication, high temperature, lymphadenitis, antibiotics are added.

Fungal infections of the ear canal are treated with antifungal ointments (clotrimazole, candida, fluconazole) and, if necessary, systemic ointments are prescribed (amphotericin, griseofulvin, mycosist). As a rule, systemic antifungal agents are not used in children under two years of age.

Treatment of otitis media

For the youngest, preference is given to local treatment. For them, systemic antibiotics are too heavy a burden on the immune system and intestines (see). Therefore, very strict indications are given for antibiotics:

• hyperthermia within three days from the start of local therapy
• severe intoxication
• poorly controlled pain that prevents the child from sleeping and eating normally

Drops in the ears are used in a course for seven to ten days. During this period, the child must be examined by an otolaryngologist to ensure the positive dynamics of inflammation or to adjust treatment if the result is unsatisfactory.

For older children (from two years old), therapy also begins with ear drops, supplemented with anti-inflammatory drugs (see First aid for otitis media).

A prerequisite for treating otitis media is getting rid of a runny nose. With untreated rhinitis, there is a risk of recurrent inflammation of the middle ear. For this purpose, antiviral (interferon), antibacterial (drops - isofra, polydex, protorgol) and combined (vibrocil) drops are used.

• Drops in the ears

— Otipax combines anti-inflammatory and analgesic effects.
—Sulfacyl sodium (albucid) is a universal antimicrobial and antiviral agent.
— Otofa– an antibacterial drug based on the antibiotic rifamycin.
Albucid and Otofa are not contraindicated in cases of perforation of the eardrum.
— Polydexa— children over two and a half years old have the opportunity to use Polydexa (a combination of the antibiotics neomycin and polymyxin with the addition of the hormonal anti-inflammatory dexamethasone).

The course of treatment lasts from seven to ten days. During this time, it is quite possible to cure uncomplicated catarrhal otitis media in a child. Treatment should be prescribed and monitored by an ENT doctor.

• Antibiotics in tablets, suspensions or injections

Requirements for these drugs: safety, non-toxicity, achieving sufficient concentrations at the site of inflammation, maintaining therapeutic doses for a long time (at least eight hours for a comfortable frequency of doses per day). The duration of antibiotic therapy is seven days, except for drugs that can accumulate and maintain therapeutic concentrations in the blood for a week or ten days (for example, azithromycin, which is prescribed for three to five days).

• Penicillins. Semi-synthetic (oxacillin, amoxicillin, flemoxin, ampicillin, carbenicillin) and inhibitor-protected ones are preferred, allowing them to resist resistant strains of microbes (amoxiclav, flemoclav, augmentin, unasin, sultamicillin, ampixide).
• Cephalosporins of the second (cefuroxime, cefaclor), third (ceftibuten, ceftriaxone, cefotaxime, cefazidime) and fourth (cefepime) generations.
• Macrolides are currently replacing cephalosporins. More convenient in dosage, course duration and administration forms (tablets, suspension). Treatment of otitis media in children is carried out with azithromycin (azithral, ​​sumamed, hemomycin), clarithromycin.
• Aminoglycosides are the drugs of choice if there is staphylococcal purulent otitis in a child. Treatment with kanamycin, gentamicin, sisomycin, amikacin is carried out mainly in an inpatient setting due to nephrotoxicity.

Features of antibiotic therapy in children include the refusal to use fluoroquinolones, since they are contraindicated in children under 18 years of age, and also in order to reduce the number of antibiotic-resistant infections.

On the issue of antihistamines

Classic treatment regimens for otitis media involve the prescription of antihistamines to reduce the allergic component of inflammation and reduce swelling. Second- and third-generation drugs that do not cause drowsiness or have a minimal sedative effect are recommended: claritin, desloratadine, loratadine, clarisens, cetirizine, ketotifen (see).

However, today a number of specialists (primarily American ones who conducted selective clinical studies involving pediatric patients) believe that the use of this group of drugs for otitis media is inappropriate, since no direct relationship has been identified between their use and the rate of cure for the disease. Today, the question remains open, since there are still no full-fledged standards for the treatment of acute otitis in children.

Treatment of labyrinthitis

Since the process can easily be complicated by meningeal inflammation, sepsis and even cerebrovascular accidents, treatment is carried out in an inpatient setting. Antibiotics, anti-inflammatory and dehydrating drugs are used. If necessary, surgical intervention is performed.

Treatment of otitis media with folk remedies

Traditional methods of treating otitis in children are quite diverse, but it should be noted that turning a child into a testing ground for experiments is inhumane and reckless. Of course, in field conditions, when a doctor and pharmacy are unavailable, a person will resort to any available means to relieve the pain and suffering of a child. Therefore, we will focus on the most adequate and least harmful folk remedies for children’s health to combat otitis media (ear inflammation).

Otitis externa, which occurs in the form of a boil in the infiltration stage (with a reddened tubercle without a purulent core), as well as catarrhal otitis media in children, can be treated with folk remedies. You can use a vodka or alcohol compress or lotions:

• boric, camphor alcohol or vodka are applied to a gauze pad, which is applied to the ear area
• plastic film or wax paper is placed on top
• the bandage is strengthened with a handkerchief or scarf
• exposure time from 15 to 30 minutes (the younger the child, the shorter the procedure time)
• decently resolves infiltrates and iodine
• also used by cutting them in half and applying a cut of a leaf to the abscess

No warming procedures for otitis media are acceptable. Treatment with alcohol-containing solutions and solutions is strictly prohibited in children under one year of age, even for external use. In older children it is also not advisable; it is especially contraindicated to use undiluted medical alcohol for compresses. It is better to use camphor, boric alcohols or vodka. Instilling boric or camphor alcohol into the ear is acceptable, but only in children over 6 years old - no more than 2 drops.

For fungal infections of the ear canal, people use by wiping it with a soda solution(not to be confused with instillation or rinsing). Soda creates an alkaline environment in which fungi do not reproduce well, but it is not able to completely cure a fungal infection.

Sollux (blue lamp) is a thermal procedure indicated for non-purulent otitis media. However, in everyday life it is difficult to distinguish non-purulent otitis from purulent, especially since a bacterial infection cannot be heated. Therefore, any traditional methods should be agreed upon with the treating pediatrician.

Prevention of otitis

• Rational ear hygiene. It is unacceptable to clean a child’s ears with improvised means or to penetrate deep into the ear canal.
• After bathing, the child needs to shake out or blot the water from the ear.
• Children under one year old should not be exposed to drafts without hats covering their ears.
• It is necessary to promptly and fully treat all diseases of the ENT organs (tonsillitis, tonsillitis, rhinitis, pharyngitis). Bilateral otitis in a child often develops against the background of a runny nose.

Ear inflammation is a very common condition in infants and children. Parents can easily recognize the signs in a child on their own at home. The disease is most common in children aged six months to 3 years. But its possibility cannot be ruled out at an older age.

The type of otitis directly depends on which part of the auditory organ is affected by the disease.

There are three types in total:

1. External: appears as a result of injury to the outer part of the ear.
2. Moderate: most often the result of viral or infectious diseases of the respiratory tract. At the same time it is amazed.
3. Internal: occurs mainly as a complication of otitis media. It is very rare, but is considered the most dangerous.

The external form of the disease manifests itself on the part of the auditory organ visible to the eye. In this case, external otitis may be:

• diffuse (damage with the formation of purulent masses)
• purulent limited (boils, pimples and other suppurations on the auricle)

Otitis media accounts for more than 90% of all cases of the disease. With it, the middle ear becomes inflamed, namely the tympanic cavity, which includes 3 sound ossicles.

Usually occurs as a result of the transfer of infection from the nasal cavity, but can appear as a result of injury or enter hematogenously.

It is divided into:

• acute, caused by a viral or bacterial infection and is accompanied by the formation of pus
• exudative, occurs as a result of blockage of the auditory tube
• chronic, lasts a long time, with the formation of a small amount of pus and hearing impairment

Video. Otitis in children: causes and treatment.

Acute otitis is usually a consequence of a purulent form of damage to the middle ear or a general infectious disease. The most severe type of inflammation, in some cases only surgical treatment can help.The course of any type can be chronic or acute.

Causes

Most often, the cause of otitis media in a child is various colds. This occurs due to the structural features of the auditory tube in young children.

They have it very short, but at the same time wide. Because of this, mucus during or another acute respiratory disease can easily penetrate the middle part of the hearing organ and cause its inflammation. This is also facilitated by the lying position of the baby, who does not yet know how to sit.

Diseases or also often provoke otitis media. The cause may also be improper nose blowing, hypothermia and weakened immunity.

Signs

The disease is characterized by an acute onset. The baby may suddenly rise above 39 degrees. He becomes irritable, is constantly capricious or cries, sleeps restlessly, and refuses to eat. The child often turns his head, rubs it against the pillow, and tries to reach his sore ear with his hands.

In children under one year of age, a severe form of the disease may be accompanied by throwing back the head, sometimes vomiting, and loose stools. No leakage of pus from the ear is observed.

Children over 3 years old can already describe it independently. The child has complaints about:

• painful sensations in the ear, radiating to the temple area
• feeling, feeling of pressure
• hearing impairment
• noise in the ear

At the same time, the temperature rises sharply, the child becomes lethargic, experiences weakness, sleeps poorly, and loses appetite.

Treatment

The entire range of measures necessary for treatment of a child must be prescribed by a doctor. Attempts to get rid of the disease on your own lead to the loss of precious time and can only worsen the situation.

Treatment begins with the use of nasal drops that have a vasoconstrictor effect:, and others. An antiseptic solution (for example, boric acid) is instilled directly into the ear. For treatment, drugs such as Otinum, Garazon, Sofradex and others are used. Paracetamol is recommended as a pain reliever. In almost every case, the patient is prescribed antibacterial agents, for example, Amoxicillin, Flemoxin or Biseptol.

Treatment should not be started without consulting a pediatrician or otolaryngologist.

But there are times when it is not possible to immediately show the child to a doctor. Then, before visiting the clinic, you can drop drops with a vasoconstrictor effect (Naphthyzin) into his nose, and Otinum, which has an effect, into the sore ear.

The diseased hearing organ must be kept warm. A scarf, headscarf, scarf or hat is suitable for this purpose. In this case, you cannot use heating pads or, with purulent otitis media, this can lead to serious complications.

Complications and consequences

Complications of inflammatory ear disease in a child do not arise just like that. Most often this happens as a result of late otitis media, untimely or incorrect treatment.

Most often, hearing is impaired, the child suffers, and complete deafness is possible. If treatment is delayed, the disease can develop into labyrinthitis (internal otitis) or take a chronic form.

The consequence of incorrect or delayed treatment of otitis in a child may be the development of paralysis.

More severe consequences occur in cases where the infection penetrates deep into the skull to the meninges - meningitis, encephalitis, sepsis.

Otitis is not one of the dangerous diseases. Its complications and probable complications are much worse. Therefore, it is important not only to start treatment as early as possible, but also to continue it until complete recovery. The disappearance of signs of the disease does not mean complete recovery. On average, otitis lasts about a month.

It should be remembered that otitis media is very serious. It should be treated only under the supervision of a specialist. You cannot try to get rid of this disease on your own using folk remedies and methods.

Most likely, this will only worsen the situation or lead to a chronic course of the disease.

If you suspect otitis or after diagnosing it, it is strictly prohibited:

• warm the sore ear by any means or means
• at high temperatures, resort to compresses, especially those that have a warming effect
• if there is pus, try to remove it with a cotton swab or other objects
• ask the child to blow his nose from both nostrils at once
• pour various alcohol tinctures into the patient’s ears
• pierce purulent formations on your own
• use antibacterial drugs and other medications without a doctor’s prescription.

Prevention

Ear inflammation in a healthy child primarily involves strengthening his immune system.

It is also very important to maintain a normal level of air humidity in the children's room.To do this, you need to systematically ventilate it and carry out wet cleaning as necessary.

If the air is very dry, you can use special humidifiers.

If a child is already suffering from a cold, then to prevent otitis media you need to:

• give your baby plenty of fluids to drink
• bring down high body temperature in a timely manner