Acute middle ear infection In the worst case, a loss of hearing threatens

"Mom, it pokes so hard in the ear!" If children complain about an unpleasant feeling, stinging or pulling in the ear, this should be taken seriously. Because behind the complaints could be a middle ear infection. This often starts with a harmless cold, but the pathogens from the nasopharynx to the middle ear can cause a painful inflammation with characteristic symptoms such as severe earache, hearing loss, and fever. If the illness is not treated in time, complications or even acute hearing loss are imminent. Accordingly, in case of persistent earache and / or decreased hearing, the family doctor or an ENT expert should be consulted promptly.
Inflammation can cause serious damage
Just wait and see is usually the wrong medicine when the ears hurt. If a middle ear infection is not treated in time, sequelae such as an acute hearing loss can threaten. At first it is usually a harmless cold. But then strong and usually stinging pain in the ear is noticeable. Also, the hearing performance may be impaired. At the latest then patients should go to the doctor.

With middle ear inflammation serious complications can occur. Image: Klaus Eppele - fotolia

Almost every toddler is affected
About 90 percent of all children fall ill until the age of three at least once in a middle ear infection. Such inflammations can occur up to four times a year without causing any consequential damage. With recurring middle ear infections, however, there is a risk that fluid accumulates in the middle ear or adhesions and defects of the eardrum and ossicles occur. This leads to childish hearing disorders, which also disturb the language development. Often, enlarged tonsils favor such recurring otitis media, according to the HNOnet-NRW, an association of established ENT doctors.

After removal or reduction of enlarged tonsils - most common in children between the ages of 3 and 6 years - many children develop middle ear infections. "The so-called polyps block the trumpet-shaped connection between the pharynx and the middle ear," notes Dr. Uso Walter, CEO of HNOnet-NRW. As a result, middle ears are no longer adequately ventilated and it forms inflammatory secretion behind the eardrum, a so-called Paukenerguss. "Temporary effusions are not a problem, but if they persist for several months, speech development may be delayed due to chronic hearing loss," explains Drs. Walter. Since certain time windows are optimal for learning age-appropriate linguistic competence, the academic success of primary school children may also be endangered. If children develop middle ear infections, it is important that ear, nose and throat doctors get to the root of the problem to prevent possible long-term consequences.

Redness is an indication of bacterial infections
ENT specialists examine the diseased ear using a microscope. You get a good look into the ear canal and the eardrum. Redness indicates bacterial infections, bulges on accumulations of fluid or even pus in the middle ear. Using tympanometry, middle ear pressure can be measured objectively even in very young children. ENT specialists initially prescribe decongestant nasal sprays to treat middle ear access swelling and restore ventilation and pressure balance. If no improvement occurs after a few days, or if there is already a marked suppurative inflammation at the initial examination, antibiotics may also be necessary in individual cases. Tympanic tubes are only used for chronic, tenacious fluid accumulation in the middle ear. In doing so, doctors place a tube in the eardrum, which helps drain fluids. After a few months, the body rejects it by itself.

Bacteria or viruses migrate into the middle ear
An acute middle ear infection arises when viruses or bacteria migrate from the nasopharynx into the middle ear. If you have a severe runny nose, sufferers will feel that the ear is closing. "Symptoms of an acute otitis media are primarily severe earache, which can also be associated with a hearing loss," explains Michael E. Deeg, spokesman for the German Professional Association of Otolaryngology.

The nasopharynx and the ear are connected via the Eustachian tube. The typical development of the disease explains Professor Holger Sudhoff, chief physician of the Department of Otorhinolaryngology at the Klinikum Bielefeld: "You get a viral infection, it swells up the mucous membrane in the Eustachian tube, and it sits on a bacterial superinfection, because the Middle ear is no longer adequately ventilated. "

If the cause is viral, analgesics and anti-inflammatory drugs can help. If bacteria are the cause, usually an antibiotic is prescribed. Today, however, doctors wait two to three days before receiving antibiotics to see if the body can do it for themselves. But then it is time, otherwise complications can threaten.

Chronic otitis media
A chronic otitis media usually develops on the floor of a persistent tube ventilation disorder. (Dysfunction of the tuba auditiva) - especially in patients who have often suffered from acute middle ear infection. Also, a disturbed physiology in the area of ​​the middle ear can lead to the development of the chronic form. In addition, genetic factors are also discussed as a possible cause of the disease. In general, two types of otitis media chronica can be distinguished. A so-called chronic bone suppuration caused by a cholesteatoma and a chronic mucosal suppuration.

Life-threatening complications
Both forms are associated with tympanic perforation and are associated with recurrent suppurative secretion. In addition, a cholesteatoma is at risk for the causal ingrowth of multilayer keratinizing squamous cell epithelial cells into the middle ear also leading to damage to the surrounding bone structure. In the worst case, this can lead to complications ranging from destruction of the ossicles to life-threatening diseases such as brain inflammation (meningitis), brain abscess or blood poisoning.

It can also threaten your life, as explained Professor Roland Laszig, Director of the University of Otolaryngology in Freiburg. The inflammation can also spread to the organ of balance, damage the facial nerve or lead to an abscess in the mastoid. Doctors call this mastoiditis, which usually requires surgery. If the inflammation penetrates into the inner ear, this can lead to the loss of hearing. Breakthrough to the brain is life threatening. Too long should not be expected with antibiotic therapy, warns the expert. "We see mastoiditis in our clinic at least once a week because middle ear infection was inadequate, under-dosed or mistreated.".

Home remedies for middle ear infections like onion sachets make sense. But as long as the cause was not found exactly, a doctor should always be turned on. "If it hurts, you do not know why it hurts. A reddened, protruding tympanic membrane with a purulent secretion indicates bacterial inflammation. Only the doctor can see that when he looks into his ear. "(Sb, nr)