Earache is common in growing children. It may be due to wax,acute otitis media, otomycosis, and airplane ear. Earache due to Acute otitis media is one of the commonest conditions children come to me with. But what exactly is Acute otitis media or AOM?

Whenever doctors say it’s an acute condition, we mean that the duration of the illness is possibly less than three months or 12 weeks old. In case something is more than 12 weeks in duration, it becomes chronic.

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Acute otitis media is a condition in which the mucosal lining of the middle ear gets inflamed and can cause earache, blocked feeling in the ear, decreased hearing, and fever.

When the inflammation increases, then there may be fluid accumulating in the middle ear. This infected fluid causes the eardrum to bulge outside, increasing the severity of pain and is often accompanied by high-grade fever. If the condition is not reviewed by an ENT surgeon, then the eardrum can burst under pressure giving rise to discharge of mucopurulent discharge from ear, This is often followed by a decrease in earache.

When something like this happens, it’s called ASOM or Acute suppurative Otitis Media. This condition is common in children and in lower socio-economic conditions. With increasing age as the tendency of repeated URI and ear infections decreases. But maybe in those with Allergic Sinusitis and Allergic Rhinitis the problem may persist even as adults.

The eustachian tube in children is shorter and at a lesser angle to the horizontal than that in adults. This causes more secretion to accumulate. That’s why children are more at risk of developing Acute otitis media. Also, breastfeeding in a supine position can cause regurgitation of milk into the middle ear through the eustachian tube and can aggravate the problem.

What you need to know if your child has ear discharge for the first time.

You must consult an ENT surgeon for an opinion regarding the Tympanic membrane. One episode of ASOM and a proper course of antibiotics will help in the healing of the eardrum. But in the case of recurrent cold, the same ear may discharge repeatedly.

The plan is to stop recurrent URI and improving the child’s immunity goes a long way in helping with this. In the case of a runny nose for more than five days, the same problem can recur. Remember, if you have a cold, your child can catch it too.

What do you need to do?

Prevent cold and flu s as far as possible Visit a doctor if cold for more than 2 days. Avoid breastfeeding in the supine position and always have the head end elevated while feeding. In case of persistent or recurrent Acute otitis media a full battery of tests may be needed.

Why does the mucous discharge occur in Otitis media?

Your middle ear (the part of your ear behind the eardrum, containing ear ossicles ) has plenty of mucous-secreting glands.

Otitis(ear) media(middle) is the condition when there is inflammation of the middle ear. It can be acute, chronic, or another variant called secretory otitis media. Mucoid discharge from the ear occurs, when there is inflammation of the middle ear mucosa, associated with a defect in the tympanic membrane. Typically this condition may be associated with Allergic Rhinitis.

Why does negative intratympanic pressure occur in the stage of tubal occlusion of AOM?

The eustachian tube connects your middle ear with the nasopharynx (the part of your throat behind the nose), and gets blocked during cold/URI, due to edema. The mechanism of maintaining air pressure inside the middle ear gets hampered, causing negative middle ear pressure. The negative pressure causes inward bowing of the tympanic membrane known as retraction; This causes pain in the ear.

Due to the inflammation in the middle ear mucosa as the cells start secreting fluids, the air in the middle ear gets progressively reduced. But as more and more mucous gets accumulated, the eardrum then starts bulging outward with severe pain.That happens in AOM or acute otitis media. The eardrum looks like a pus-filled balloon that can burst if not appropriately treated.

How quickly can a perforated eardrum recover from damage?

Traumatic ear perforation can heal by 7 to 10 days—the latest by three months. The ear meanwhile needs to be dry with appropriate medicines, prevent water entry strictly..

Ear perforation due to infection like Chronic Otitis media, however, need surgery. Initially, ear drops, but the definitive treatment is surgery for chronic otitis media.

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