So long to sore ears What you need to know about ear infections and grommets
Middle ear infection usually makes your child feel really awful. Is it preventable, and what’s the best route to go with treatment? asks Libbie Joubert
The middle ear consists of an eardrum, an air-filled space and three tiny little interlinked bones that span the space from the outer to the inner ear. At the bottom of the middle ear there’s the Eustachian tube, which ensures fluid that builds up in the space drains to the throat. Ear infection happens when this tube doesn’t work so well and fluid builds up in the middle ear. This fluid can become infected. The Eustachian tube is shorter and more horizontal in children, and for this reason they’re more prone than adults to ear infections.
An upper respiratory tract infection, sinusitis, reflux or allergies can all cause the Eustachian tube to become blocked and fluid and pressure to build up in the ear. This is what causes the pain and discomfort. If the pressure is not relieved, the eardrum bursts and the fluid ends up in the external ear canal. A burst eardrum usually heals itself, but if it happens repeatedly it can leave a permanent perforation that can cause hearing loss.
REPEATED EAR INFECTIONS CAN DAMAGE THE EARDRUM TO SUCH AN EXTENT THAT IT LEADS TO HEARING LOSS
IF YOUR CHILD HAS THREE OR MORE EAR INFECTIONS IN A THREE-MONTH PERIOD, YOU CAN CONSIDER GROMMETS
SYMPTOMS OF EAR INFECTION
Ear and upper respiratory tract infections often go hand in hand, and symptoms such as fever, mucus production, loss of appetite and listlessness are common. If a child also complains of earache, often pulls at or rubs his ears, or if there’s blood or fluid coming out of his ears, he probably has an acute ear infection.
It’s also possible to have an infection without the ear being inflamed, running a fever or experiencing pain. This is called chronic ear infection with discharge and is known colloquially as glue ear. It happens when a glue-like fluid builds up in the middle ear and cannot drain. Often the only symptoms are slight to average hearing loss and subsequent weak listening abilities. In truth it’s an invisible ear infection, and can do lots of damage. The ear ossicles can’t move like they should if they’re constantly covered in thick fluid, and it results in your child not being able to hear properly. The ossicles can also suffer permanent damage from the exposure to acid in the fluid.
MEDS OR GROMMETS?
Antibiotics are usually given, but if your child has three or more ear infections over a three-month period, ventilation tubes or grommets should be considered.
These are small silicon tubes inserted into the eardrum to take over the function of the Eustachian tube.
Before they’re inserted, the source of the infection should be found first. Typically, enlarged adenoids and allergies are the culprits.
Sometimes middle ear infection does not react to antibiotics. This can be the result of a resistant bug or because the concentration of antibiotics reaching the middle ear is not enough to kill the bacteria.
PREVENT EAR INFECTION •
Ensure that your child’s vaccinations are up to date. The haemophilus influenzae type b (Hib) and pneumococcal vaccines help to curb ear infection. • Research shows that children who are breastfed for at least six months are less susceptible to ear infections. •
Keep the little ones away from smoke. There’s a link between upper respiratory tract infection and smoke exposure. • Choosing a daycare centre where there are fewer children per carer can reduce the risk of ear infection. • Control allergies that can cause the Eustachian tube to swell up so much that it closes up. • Ensure that your baby always lies at a 25 to 45 ˚ angle when he takes his bottle. It’s easier for formula to dam up in a baby’s mouth, and some of the milk can flow through the Eustachian tube into the middle ear and cause infection. YB
EAR CANAL EARDRUM A TINY TUBE IS INSERTED INTO THE INCISION OF THE EARDRUM. EUSTACHIAN TUBE