Otorhinolaryngological Diseases

Otitis Media

Otitis Media:
Otitis media (inflammation of the middle ear) occurs most often due to a bacterial or viral infection that affects the middle ear, which leads to accumulation of fluid behind the eardrum. This disease is one of the most common diseases among children, as it affects more than adults, and the reason is due to several factors, including:

  • Short Eustachian tube (a thin tube extending from the middle ear to the back of the nose) and thus the ease of transmission of viruses and bacteria from the nose or pharynx to the middle ear and the currence of inflammation.
  • - Weakened immunity in children compared to adults makes them more susceptible to infectious diseases in general.


  • Acute otitis media: It is caused by a bacterial or viral infection in most cases, and it may be due to complications from an infection that affected the upper respiratory tract or sinuses, and these symptoms usually disappear with treatment of the infection causing the disease.
  • Otitis media accompanied by infiltration: The main cause of infection with this type is the accumulation of fluids and secretions of the mucous ear inside it as a result of several reasons, including blockage of the Eustachian tube after infection in the upper respiratory tract, occurrence of filtering and the accumulation of mucous secretions inside the ear.
  • Chronic otitis media: This type occurs as a result of delay in treating cases of acute inflammation in the ear, which leads to accumulation of fluids and secretions for a period of two weeks or more, and thus their abundance may lead secretions come out of the ear.

In children:

  • Ear pain, especially when lying down.
  • Difficulty sleeping.
  • Crying more than usual and pulling at the ear.
  • Not responding to sounds.
  • High temperature (38°C) or higher.
  • Secretions from the ear.
  • Anorexia.

In adults:

  • Pain in the ear.
  • Difficulty sleeping.
  • Secretions from the ear.
  • Hearing impairment.

When to see a doctor:

  • The ear pain does not improve after 3 days.
  • Feeling a severe pain in the ear.
  • Secretions or blood coming out of the ear.
  • Difficulty sleeping when a child has a cold or other upper respiratory tract infection.
  • Hearing loss or a change in hearing.

An ear infection is diagnosed based on symptoms described and an otoscope is likely to be used. The healthcare provider may also check fluid in the middle ear with a pneumatic otoscope (blowing a small amount of air into the eardrum) or acoustic relaxometry (sound response) However, if the child suffers from persistent ear infections or a continuous accumulation of fluid in the middle ear, the doctor may refer him to an audiologist for a hearing test.

Risk factors:

  • Children between the ages of six and 12 months.
  • Breastfeeding an infant or child while lying down.
  • Seasonal diseases (such as colds and influenza).
  • Seasonal allergy sufferers.
  • Exposure to tobacco smoke and polluted air.

Repeated infection and persistent fluid buildup can lead to serious complications:

  • Hearing impairment.
  • A ruptured (perforated) eardrum.
  • Delays in speech or development skills in children.
  • Spread of untreated inflammation to nearby tissues.

Treatment varies according to type, severity and cause of the inflammation, as:

  • If the infection is simple or viral, it is advised to monitor the child and see the doctor constantly until the infection is gone.
  • If the infection is frequent and gets worse with time, and the symptoms are severe, then the patient needs treatment in this case, and the doctor will prescribe antibiotics if the cause of the infection is bacterial, and it must be ensured that the child takes the antibiotic daily and does not stop it before the completion of the treatment period even if an improvement appears in the case.
  • If it's due to allergies, decongestant or antihistamine ear drops may help relieve symptoms.


  • When colds occur, it is preferable to treat the infected person, especially children, and not to neglect their treatment so as not to develop into middle ear infection.
  • Care must be taken to monitor the child's health continuously, especially if he is exposed to frequent infections in the middle ear.
  • Ensure that the child has had routine vaccinations.
  • Not exposing the child to cigarette smoke, shisha, and others (passive smoking).
  • Keep the child away from the injured.
  • Always make sure to raise the head of the infant or child slightly during feeding.
  • Breastfeeding for at least 6 months strengthens immunity and makes the child less susceptible to ear infections.

Preventio9n of otitis externa:

  • Avoid putting cotton wool sticks or fingers in the ears.
  • Use earplugs or a swimming cap over the ear when swimming
  • Avoid getting water or shampoo into the ears when showering.

Last Update : 31 August 2023 08:34 AM
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