Introduction
Ear infections (also known as episodes of acute otitis media) are one of the most common reasons why children visit a GP or specialist in Australia. They can be very distressing for both children and parents as they are usually very painful and may be associated with high temperatures. They become less common after 7 or 8 years old as the anatomy of the Eustachian tube (connecting the ears to the back of the nose) develops and changes.
Causes
Middle ear infections (behind the ear drums) often follow a cold or upper respiratory tract infection. A congested or runny nose may develop into an ear infection due to the Eustachian tube that connects the ears to the nose. This is especially common in young children attending daycare or preschool.
Most middle ear infections are caused by viruses and bacteria. Rarely, children can also develop outer ear infections from swimming or trauma e.g. from cotton bud use.
Symptoms
Children with ear infections are often very miserable. They are usually in pain and may pull at their ears. As with any infection, they may be off their food and appear tired or a bit lethargic. They may have poor attention and disrupted sleep. In severe cases, they may have pus discharging from their ears.
Hearing will often be down as fluid tends to build up behind the ear drums. When the infection resolves, the hearing usually returns to normal. When there is persistent hearing loss, children will often develop speech delay.
Worrying signs include very high fevers that do not come down with Panadol or Nurofen, pain, swelling or redness in the mastoid area (bone behind the ear) or extreme lethargy.
Diagnosis
The diagnosis is made by carefully inspecting the ear canal, ear drum and middle ear. This can be difficult in young kids due to narrow ear canals and wax build up. Dr Levin fully understands the importance of building a good rapport with children so that a thorough examination can be conducted. He can usually remove any wax blocking the view of the ear drums, which can be difficult for GPs who may not have the necessary equipment. If any discharge is present in your child’s ear canals, Dr Levin will take a swab and send it away for testing.
Audiology (hearing tests) add helpful information, by testing both hearing and Eustachian tube function and assessing whether there is fluid behind your child’s ear drums. Dr Levin has a paediatric audiologist on site in his Macquarie street rooms who is fantastic with children and should be able to perform accurate testing for your child in a stress-free environment.
Rarely, X-rays or CT scans may be ordered if Dr Levin is concerned about the complications of acute otitis media.
Treatment
The usual treatment consists of painkillers and antibiotics if a bacterial infection is suspected. Nasal sprays may be recommended to improve Eustachian tube function.
When the ear infections become very frequent or are associated with hearing loss, then grommets may be beneficial for children.
Dr Levin will be able to assess your child and discuss the treatment options with you.