Cont. from last edition
Complications
Most ear infections don’t cause long-term complications. Ear infections that happen again and again can lead to serious complications:
- Impaired hearing: Mild hearing loss that comes and goes is fairly common with an ear infection, but it usually gets better after the infection clears. Ear infections that happen again and again, or fluid in the middle ear, may lead to more-significant hearing loss. If there is some permanent damage to the eardrum or other middle ear structures, permanent hearing loss may occur.
- Speech or developmental delays: If hearing is temporarily or permanently impaired in infants and toddlers, they may experience delays in speech, social and developmental skills.
- Spread of infection: Untreated infections or infections that don’t respond well to treatment can spread to nearby tissues. Infection of the mastoid, the bony protrusion behind the ear, is called mastoiditis. This infection can result in damage to the bone and the formation of pus-filled cysts. Rarely, serious middle ear infections spread to other tissues in the skull, including the brain or the membranes surrounding the brain (meningitis).
- Tearing of the eardrum: Most eardrum tears heal within 72 hours. In some cases, surgical repair is needed.
Prevention
The following tips may reduce the risk of developing ear infections:
- Prevent common colds and other illnesses. Teach your children to wash their hands frequently and thoroughly and to not share eating and drinking utensils. Teach your children to cough or sneeze into their elbow. If possible, limit the time your child spends in group child care. A child care setting with fewer children may help. Try to keep your child home from child care or school when ill.
- Avoid secondhand smoke. Make sure that no one smokes in your home. Away from home, stay in smoke-free environments.
- Breast-feed your baby. If possible, breast-feed your baby for at least six months. Breast milk contains antibodies that may offer protection from ear infections.
- If you bottle-feed, hold your baby in an upright position. Avoid propping a bottle in your baby’s mouth while he or she is lying down. Don’t put bottles in the crib with your baby.
- Talk to your doctor about vaccinations. Ask your doctor about what vaccinations are appropriate for your child. Seasonal flu shots, pneumococcal and other bacterial vaccines may help prevent ear infections.
Diagnosis
Your doctor can usually diagnose an ear infection or another condition based on the symptoms you describe and an exam. The doctor will likely use a lighted instrument (an otoscope) to look at the ears, throat and nasal passage. He or she will also likely listen to your child breathe with a stethoscope.
Pneumatic otoscope
An instrument called a pneumatic otoscope is often the only specialized tool a doctor needs to diagnose an ear infection. This instrument enables the doctor to look in the ear and judge whether there is fluid behind the eardrum. With the pneumatic otoscope, the doctor gently puffs air against the eardrum. Normally, this puff of air would cause the eardrum to move. If the middle ear is filled with fluid, your doctor will observe little to no movement of the eardrum.
Additional tests
Your doctor may perform other tests if there is any doubt about a diagnosis, if the condition hasn’t responded to previous treatments, or if there are other long-term or serious problems.
Cont. in next edition