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Otitis Media

Overview :

A little knowledge of the basic anatomy of the middle ear will be helpful for understanding the development of otitis media. The external ear canal is that tube which leads from the outside opening of the ear to the structure called the tympanic membrane. Behind the tympanic membrane is the space called the middle ear. Within the middle ear are three tiny bones, called ossicles. Sound (in the form of vibration) causes movement in the eardrum, and then the ossicles. The ossicles transmit the sound to a structure within the inner ear, which sends it to the brain for processing.

The nasopharynx is that passageway behind the nose which takes inhaled air into the breathing tubes leading to the lungs. The eustachian tube is a canal which runs between the middle ear and the nasopharynx. One of the functions of the eustachian tube is to keep the air pressure in the middle ear equal to that outside. This allows the eardrum and ossicles to vibrate appropriately, so that hearing is normal.

By age three, almost 85% of all children will have had otitis media at least once. Babies and children between the ages of six months and six years are most likely to develop otitis media. Children at higher risk factors for otitis media include boys, children from poor families, Native Americans, Native Alaskans, children born with cleft palate or other defects of the structures of the head and face, and children with Down syndrome. Exposure to cigarette smoke significantly increases the risk of otitis media as well as other problems affecting the respiratory system. Also, children who enter daycare at an early age have more upper respiratory infections (URIs or colds), and thus more cases of otitis media. The most usual times of year for otitis media to strike are in winter and early spring (the same times URIs are most common).

Otitis media is an important problem, because it often results in fluid accumulation within the middle ear (effusion). The effusion can last for weeks to months. Effusion within the middle ear can cause significant hearing impairment. When such hearing impairment occurs in a young child, it may interfere with the development of normal speech.

In adults, acute otitis media can lead to such complications as paralysis of the facial nerves. Recovery from these complications may take from two weeks to as long as three months.

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