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Otitis Media and Barotitis Media
Otitis media refers to inflammation of the middle ear space which occurs secondary to a bacterial infection. The middle ear is a small cavity just to the inside of the eardrum. When this area becomes infected, painful swelling and irritation develops in the middle ear. The middle ear space is connected to the throat by the eustachian tube. Under normal conditions, this tube allows the air pressure to equalize across the eardrum. Colds, upper respiratory infections, high altitudes, scuba diving, and air travel often lead to congestion and collapse of the eustachian tube. The congestion, or collapse, is perceived by the patient as a pressure pain in the ear(s). The pressure may occasionally be eliminated by yawning, chewing gum, blowing air out a pinched nose, or taking decongestants. Continued pressure across the eardrum is known as barotitis media, and can result in otitis media if left unresolved. Common symptoms of otitis media include a dull, throbbing ear pain that is uninfluenced by any motion of the external ear as seen in otitis externa. Fever and nausea are common. Children and infants will often have cold symptoms and a fever of 101 degrees F., or more. A sudden decline in hearing, accompanied by a pus-like discharge out of the ear, can indicate rupture of the infected eardrum. Evaluation is by history and physical examination. Diagnosis is confirmed by the physical examination which will show a red, dull eardrum. Ear drum rupture will require close follow-up by an ENT physician to make sure hearing is not permanently affected. In most cases, ear drum rupture heals without any hearing deficit.
Treatment of otitis media is with oral antibiotics and decongestants (pseudoephedrine hydrochloride, phenylpropanolamine). In some situations it may be helpful to use a decongestant nasal spray (e.g. Afrin) prior to flying; check with your doctor first if you are a heart or high blood pressure patient. The decongestant can relieve pressure problems on the middle ear. Delaying treatment can result in spontaneous perforation (rupture) of the eardrum. Perforation is heralded by a SUDDEN decline in hearing and pain; it is OFTEN accompanied by a pus-like discharge out of the ear canal. Permanent
hearing disability may occur in cases of protracted (untreated) otitis media. An ENT specialist is expert in the follow-up care of these patients. Patients (usually children), with recurrent otitis media, may have "tubes" placed through their eardrums to allow drainage of the middle ear space and to reduce the frequency of ear infections. Necessity for tubes is decided on a case to case basis. Tubes usually remain in the ear for 9-12 months, at which time they often fall out by themselves. Fever control can be accomplished with acetaminophen.
Hope this article will provide you information about otitis media and barotitis media.
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