Otitis in a child: symptoms, treatment,prevention

Update: October 2018

When a child’s ears begin to hurt, even experienced parents can
lose composure from whims and tears. In order to
to effectively fight the disease, you need to know the enemy that
called “in the face”, forewarned is forearmed.

What is otitis media?

By otitis means any inflammation of the ear. There are:

  • The outer ear (ear and ear canal to
    eardrum) inflammation of which will be external otitis.
    Here on the first place are the boils caused
    staphylococci and fungal lesions of the ear canal.
  • The middle ear, starting behind the eardrum and including
    tympanic cavity, Eustachian tube, mastoid cells
    and antrum. Inflammations in this section are called otitis media. it
    the most common ear pathology in children.
  • Internal otitis is also called labyrinthitis. With этом
    inflammation affects the cochlea, its vestibule or the semicircular
    channels.

Who is guilty?

Otitis media develops on the background of bacterial (less viral)
infections. The most common cause of its development is
aggressive streptococcal or staphylococcal flora. More often
she infection penetrates the ear cavity through the Eustachian tube,
balancing pressure between the ear and the nasal cavity. therefore
very often, otitis media is the outcome of a runny nose.

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

  • rachitis sufferers (see the symptoms and treatment of rickets in nursing
    children)
  • anemia
  • lack of weight
  • chronic pathology of ENT organs
  • exudative diathesis
  • extreme forms of immunodeficiency takes in diabetes,
    AIDS and leukemia.

But even a child without severe somatic diseases can become
victim of otitis with banal hypothermia. The fact is that
the outer ear canal of a child, unlike an adult, does not have
S-shaped curvature. therefore любой поток холодного воздуха может
provoke otitis in a child, otitis symptoms will be directly
depend on the location of the inflammation.

Manifestations of otitis

With наружном отите, симптомы у детей могут разниться в
depending on the severity of the process.

  • Отит у ребенка: симптомы, лечениеAuricle furuncle or
    the ear canal will manifest redness, swelling,
    the appearance of an inflammatory tubercle that will gradually change
    color from red to bluish. In the center of inflammatory education
    a purulent rod will form. Until the fabric is
    melted to pus, the pain will be very intense. After dying off
    receptors, it will be a little less. After the boil
    the necrotic rod will open, and a deep one will remain
    a wound that will heal with scar formation.
  • Fungal otitis externa is characterized by the appearance of crusts and
    шелушения в ушном проходе на фоне грибковой infections. Also
    itching is noted.
  • Otitis media can be divided into catarrhal otitis and purulent.
    Qatar is when microbial inflammation manifests itself in
    a form of redness, swelling and unstable pain stabbing or
    shooting character. Depending on the severity of inflammation,
    the intensity of the pain varies, from mild to unbearable. Pain
    may be located inside the ear or given to the cheek, temple, throat.
    it связано с общим нервом, который снабжает барабанную полость и
    oropharynx. Pain can be combined with congestion of the ear.
  • From the moment of formation on the eardrum of the abscess,
    speak of purulent otitis. In addition to pain, it is characterized by lowering.
    hearing If an abscess breaks, a purulent effusion with
    an admixture of blood. Subsequently, the eardrum heals with
    образованием рубца, после чего слух восстанавливается. With
    a significant defect in the membrane can not heal completely, and then
    there will be hearing problems.

Also ребенка станут беспокоить подъемы температуры и
intoxication (muscle, joint and headaches, fatigue and
weakness).

  • In addition to acute otitis media, chronic
    inflammatory process that is divided into exudative middle
    Otitis, purulent or adhesive. Exudative and adhesive options
    otitis have mild manifestations in the form of tinnitus
    (причины) и снижения hearing Adhesive (adhesive) otitis media – result
    growths of connective tissue and fibrosis of the tympanic cavity and
    eardrum.
  • With хроническом гнойном процессе наблюдается периодическое
    ear leakage and persistent hearing loss due to constant
    существующей перфорации eardrum.
  • Labyrinthitis is manifested by pain, hearing loss and
    головокружениями (причины), так как в процесс вовлекается
    organ of balance associated with the inner ear.

How to suspect otitis at home?

Older kids may well complain about earache and even
tell about what it is pain and where it gives. Much harder
with babies up to two years old who are still unable to speak and
just crying in response to pain (including otitis media). Symptoms
infants with this pathology are not specific:

  • on thought about inflammation of the middle ear can push
    child anxiety
  • his unmotivated crying
  • denial of breast or bottle
  • Also, children can grasp the sore ear
  • turn your head from side to side
  • если нажать на козелок больного уха, child anxiety или
    crying intensifies due to increased pain

With любом подозрении на отит, ребенка нужно незамедлительно
show pediatrician or ENT doctor.

How does the doctor determine otitis media?

The otolaryngologist has such a simple and convenient device,
like an ear mirror. With it, you can see the changes in outdoor
слухового прохода, eardrum. So, otitis media
correspond to changes in the light cone on the eardrum. WITH
The doctor can use an otoscope for the same purpose.

First Aid for otitis

If a visit to the doctor is postponed for objective reasons (although
you can’t delay with it), and the child worries and cries, the first
in case of suspicion of otitis media, it is necessary to numb the ear.

WITH этой целью можно воспользоваться нестероидными
противовоспалительными средствами, обладающими свойством
inhibit inflammation, temperature and pain. Children are allowed
paracetamol derivatives (tayled, calpol, efferalgan, panadol,
Tylenol), ibuprofen (nurofen, ibuklin) and naproxen (cefecon) –
see an overview of all antipyretic drugs for children, with dosages and
prices. You can use syrup, pills or rectal
candles.

The second tool for otitis media will be ear drops Otipaks
(170-250 руб), Отирелакс (140 руб) it комбинированный препарат, в
composition of which includes anti-inflammatory phenazone and local
lidocaine hydrochloride anesthetic. We must remember that you can
use only if the drum was not damaged
membrane (ear not flowed). In infants buried in 2 drops, and
children over two years old with 3-4 drops in each ear.

How to properly drop the drops?

  • Before digging in the drops, it is necessary to warm the bottle with them until
    room temperature. Infants may have a fever of up to 36
    degrees As an option, the drops are poured from the vial into a warm spoon, and
    then dial with a pipette.
  • The child should be put ear up and put off the ear.
    back and down to straighten the ear canal.
  • After the drops are dripped, the child is held up with the ear not
    less than ten minutes for the medication not to leak out.
  • In children, the drops are buried in both ears, since the process is like
    usually bilateral.
  • Have baby, sucking a pacifier, it must be removed before instillation
    drops. In combination with a stuffy nose, a dummy can become
    причиной баротравмы eardrum.

Treatment наружного отита

The boil of the outer ear (purulent otitis) is treated according to the classical
pattern. At the stage of infiltration (before the formation of the rod)
anti-inflammatory drugs and alcohol compresses to
resorption. After the core is formed – surgical
opening of the abscess with the drainage of the cavity, washing with peroxide
hydrogen or Chlorhexidine, Miramistin and subsequent ointment
bandages with levomekol to complete healing of the wound. With
intoxication, high temperature, lymphadenitis connect
antibiotics.

Fungal lesions of the ear canal are treated with antifungal
ointments (clotrimazole, candid, flucanazole), if necessary
prescribe systemic antifungal agents in pills
(amphotericin B, griseofulvin, Mikosist). As a rule, children
two years systemic antifungal agents are not used.

Treatment среднего отита

The smallest preference is given to local treatment. For
systemic antibiotics are too heavy on the immune system
system and intestines (see the list of probiotics, analogs of Linex).
therefore для антибиотиков выставляются очень строгие показания:

  • hyperthermia for three days from the start of local therapy
  • severe intoxication
  • ill-treated pains that prevent a child from sleeping well and
    eat

Drops in the ears are used by the course for seven to ten days.
For thatт период ребенка обязательно осматривает отоларинголог, чтобы
make sure the positive dynamics of inflammation or adjust
treatment if the result is unsatisfactory.

Older (from two years old) babies therapy also begins with
ear drops, supplemented with anti-inflammatory drugs (see
First Aid for otitis).

A prerequisite for the treatment of otitis media is to get rid of
from a cold With невылеченном рините есть риски повторного развития
inflammation of the middle ear. WITH этой целью применяют противовирусные
(interferon), antibacterial (drops – isofra, polydex,
protorgol) and combined (vibrocil) drops.

  • Drops in the ears

Отипакс совмещает противовоспалительный и
analgesic effects. — WITHульфацил натрия
(альбуцид
) – универсальное противомикробное и
antiviral agent. — Отофа
antibiotic drug based on antibiotic rifamycin.
Albucid and otofa are not contraindicated in the case of perforation of the drum
membranes. — Полидекса — у детей старше двух с
half a year it is possible to use polydex (a combination of
antibiotics neomycin and polymyxin supplemented hormonal
противовоспалительного дексаметазона).

Course treatment is carried out from seven to ten days. For that
time it is possible to cure uncomplicated catarrhal otitis in
baby Treatment must 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 multiplicity of receptions per day). Duration
antibiotic therapy is seven days other than drugs
which are able to accumulate and maintain therapeutic concentrations in
blood for a week or ten days (for example, azithromycin,
which is appointed within three to five days).

  • Penicillins. Semisynthetic (oxacillin,
    Amoxicillin, Flemoxin, Ampicillin, Carbenicillin) and
    inhibitor, allowing to resist resistant strains
    microbes (amoxiclav, flamoklav, augmentin, unazin, sultamicillin,
    ampixid).
  • Cephalosporins second (cefuroxime, cefaclor) third
    (ceftibuten, ceftriaxone, cefotaxime, cefazidim) and fourth
    (цефепим) поколений.
  • Macrolides are currently being supplanted by cephalosporins. More
    convenient in dosing, the duration of the course and forms of administration
    (tablets, suspension). Treatment of otitis media in children is carried out
    azithromycin (azitral, sumamed, hemomycin),
    clarithromycin.
  • Aminoglycosides are the drugs of choice if present.
    стафилококковый гнойный отит у baby Kanamycin treatment
    gentamicin, sizomycin, amikacin is carried out mainly
    permanently due to nephrotoxicity.

The features of antibiotic therapy in children should include the rejection of
use of fluoroquinolones because they are contraindicated in children before
18 years, as well as to reduce the number of antibiotic-resistant
infections.

On the issue of antihistamine drugs

Classic otitis media treatment regimens suggest
administration of antihistamine drugs to reduce
allergic component of inflammation and reduce swelling.
Recommended means of the second and third generations that do not cause
drowsiness or having minimal sedative effect:
Claritin, desloratadine, loratadine, clarisens, cetirizine, ketotifen
(see allergy medications).

However, today a number of specialists (first of all,
American, who conducted selective clinical studies with
involving patients-children) considers that the use of this group
medication for otitis is inappropriate because
revealed a direct relationship between their use and speed
cure of the disease. Today the question remains
open, as there are still no full standards for treatment
acute otitis media in children.

Labyrinthitis Treatment

Since the process can easily be complicated by meningeal
inflammation, sepsis and even cerebral circulation,
treatment is carried out in stationary conditions. Antibiotics are used,
противовоспалительные и дегидратирующие препараты. With
need to perform surgery.

Otitis treatment with folk remedies

Traditional methods of treatment of otitis media in children are quite diverse,
but it should be noted that turning a child into a testing ground for
The experiments are not humane and reckless. Course in the field
conditions when a doctor and a pharmacy are not available, a person will resort to any
подручным средствам, чтобы облегчить боль, страдания baby
Therefore, we will focus on the most adequate and less harmful for
child health folk remedies for otitis media (inflammation
ear).

External otitis flowing in the form of a boil in stage
infiltration (with a reddened tubercle without a purulent rod), and
also, average catarrhal otitis in children is amenable to folk remedies
treatment. You can use a vodka or alcohol compress or
gadgets:

  • Boric, camphor alcohol or vodka are applied to gauze
    a napkin that is applied to the ear area
  • on top fit polyethylene film or waxed
    paper
  • bandage is strengthened by a handkerchief or scarf
  • exposure time from 15 to 30 minutes (the younger the child, the
    shorter procedure time)
  • decently absorbs infiltrates and iodine
  • Aloe leaves are also used, cutting them in half and
    applying to the boil cut sheet

No warm-up procedures for otitis are unacceptable. Treatment
спиртосодержащими растворами категорически запрещено у детей
up to a year even for external use. Older children have it
also not desirable, especially contraindicated to use for
compress with medical alcohol undiluted. It is better
apply camphor, boric alcohols or vodka. Burying
boric or camphoric alcohol in the ear is acceptable, but only in children
старше 6 лет  – не более 2 drops.

With грибковом поражении слухового прохода в народе пользуются
wiping it with a solution of soda (not to be confused with instillation or
washing). Soda creates an alkaline environment in which mushrooms are bad.
multiply but completely cure the fungal infection is not in
condition.

Solux (blue lamp) – thermal procedure, shown at
purulent otitis. However, in life, non-purulent otitis from purulent distinguish
difficult, especially since the bacterial infection can not be warmed up.
Therefore, any popular methods should be coordinated with the treating
pediatrician.

Otitis prevention

  • Rational ear hygiene. Do not brush the ears of the child
    improvised means to penetrate deep into the ear canal.
  • After bathing the child must shake out or get wet
    from the ear.
  • Children under one year should not be in drafts without head
    caps covering the ears.
  • It is necessary to treat all diseases in full and on time.
    ENT organs (sore throats, tonsillitis, rhinitis, pharyngitis). Double sided
    Otitis in a child often develops against the background of a cold.

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