What Is Otitis Media?

Otitis media is the inflammation or infection of the middle ear, the space behind the eardrum where the small ossicles responsible for conducting sound are located. This condition is very common in children, but it can also affect adults. Recognizing the signs early and seeking specialized guidance is essential to avoid hearing sequelae and prolonged discomfort.

Symptoms

The presentation of otitis media varies according to age and the type of case. The most frequent symptoms include ear pain that can be intense, a sensation of pressure, decreased hearing, tinnitus, and, in some cases, fever and irritability in children. Yellowish or greenish discharge may occur when there is perforation of the eardrum. In infants, persistent crying, difficulty sleeping, pulling or rubbing the ear, and a reduced response to sounds are also important signs.

Risk Factors

Several factors contribute to the development of otitis media. Genetic predisposition, respiratory viral infections, and allergies increase the chance of obstruction of the Eustachian tube. Children in daycare or shelters, exposure to passive smoking, prolonged use of a bottle while lying down, and a cold, dry climate are conditions that favor the retention of secretions in the middle ear. In adults, gastroesophageal reflux and anatomical variations of the Eustachian tube can be determining factors.

Warning Signs

In addition to pain and ear discharge, signs that indicate the need for immediate evaluation include persistent high fever, sudden deafness, dizziness, and imbalance. In cases of high pressure in the middle ear, there may be associated rhinitis or sinusitis, along with intense ear pain that does not subside with common analgesics. In children, a delay in speech or in the development of hearing skills deserves attention.

Complications

When not treated properly, otitis media can progress to more serious conditions. Tympanic perforation can lead to chronic otitis media with mastoiditis, an infection of the mastoid bone, and the risk of a brain abscess in extreme situations. Otosclerosis and sensorineural hearing loss can occur due to prolonged damage to the ossicles. In the long term, the change in hearing quality can affect communication and academic and professional performance.

Types of Otitis Media

Acute otitis media is characterized by rapid onset, intense pain, and inflammatory signs.

Otitis media with effusion, or serous otitis media, involves the accumulation of fluid without active infection, causing a sensation of a blocked ear and mild hearing loss.

Chronic suppurative otitis media is marked by persistent perforation of the eardrum and continuous discharge, requiring specialized management.

Treatment

Treatment is determined by the type and severity of the condition. In acute cases, analgesics and anti-inflammatories relieve pain and discomfort. Antibiotic therapy is indicated when there is a confirmed or suspected bacterial infection in young children, with close monitoring of the progression. In cases with persistent effusion, the placement of ventilation tubes may be recommended to drain the accumulated fluid. Tympanotomy surgery with insertion of a ventilation tube (tympanostomy tube) restores normal pressure to the middle ear, promotes hearing, and prevents recurrent episodes.

Prevention

Preventive measures include breastfeeding in a proper position, avoiding bottle-feeding while lying down, reducing exposure to passive smoking, vaccination against influenza and pneumococcus, regular nasal hygiene, and early treatment of respiratory infections and allergies. In children with repeated episodes, assessing the need for the placement of a ventilation tube can prevent hearing complications.

At our practice, Dr. José Eduardo Marcondes and his team combine more than twenty years of experience in otolaryngology with a humanized approach for accurate diagnosis and effective treatment of otitis media. Schedule your appointment in São Paulo or Alphaville and take care of the hearing health of your entire family.