Children and Hearing Loss

child-ear-exam

Now, in adults, the Eustachian tubes are relatively large and tilted downwards slightly. So, fluid from the middle ear can still drain into the nose to be eliminated, despite the swelling. Children, on the other hand, have narrower Eustachian tubes, which are level to the nasal passages. Thus, when the tubes swell, the fluid cannot drain efficiently and builds up behind the eardrum. As fluid fills the middle ear, it can become infected itself and result in an ear infection. This is known as otitis media or more commonly as glue ear.

Ear infections are among the most common illnesses in childhood and are frequently found in children with influenza, even if there is no flu symptom per se.

Here are some interesting facts:

Up to 80 percent of children with a cold develop ear infections.
Seventy five percent of children suffer from at least one episode of ear infection before they reach the age of three.
30 to 40 percent of children, who suffer from ear infection once, will have it again.
Ear infections usually stop by the age of four or five, in most children.

Signs and symptoms

Pain and a fever of 100°F (37.7°C), or above, are the symptoms commonly associated with ear infections. However, if your child is too young to talk, you may also need to look for other clues, as well.

For example:

Rubbing or pulling of the ears.
Failing to respond to noises, or when called.
Clear fluid draining from the ears.
Excessive crying.
Loss of appetite.
Difficult sleep; and
Irritability.

Complications

Temporary hearing loss may occur because fluid build-up makes it difficult for the eardrum and the small bones of the middle ear to move freely, which, in turn, prevents sound vibrations travelling from the outer ear to the inner ear.

Normally, the problem disappears on its own, as the fluid clears up. In about 70 percent of cases, this occurs two weeks after the infection has gone. If fluid build-up persists for months, the eardrum and the bones in the middle ear may become damaged, which may lead to permanent hearing loss.

Treatment

In approximately 80 percent of cases ear infections don't normally need antibiotic treatment and resolve spontaneously within a few days. Experts recommend the 'wait-and-see' approach, also called 'watchful waiting'. This involves the careful monitoring of the child’s symptoms, without using any medication, to see whether or not the infection clears up on its own. This approach is typically used during the first three days of the infection.

However, since ear infections are generally very painful, your doctor may recommend:

An over-the-counter pain medication (e.g., ibuprofen or acetaminophen). This will also help control the fever.
Antihistamines, especially if the child suffers from a respiratory allergy, as this may increase the production of fluid.
Eardrops; and
Warm compresses applied over the affected ear.

grommit In the small number of cases in which the infection does not resolve spontaneously, antibiotic treatment (usually with amoxicillin or Ceftin) may be tried. Surgery, whereby new drainage tubes (grommets) are inserted in the child’s ears under general anaesthesia (myringotomy), may be required with recurrent infections that don’t respond to antibiotic treatment.

You may want to know…

If you are bottle-feeding your child, it may help if you hold them upright. Research shows that infants who drink their bottle lying down have an increased risk of developing ear infections.

The same goes for children

exposed to cigarette smoke,
with allergies, or
who are in day care.

What about vaccines?

The journal Pediatrics reports the results of a study by scientists at the University of Texas showing that, in children aged six months to four years, who received the vaccine for pneumonia, PCV7, the incidents of middle ear infections due to the bacterium Streptococcus pneumoniae was reduced by 34 percent. The incidents of middle ear infections from all causes were also reduced, although by a modest six to eight percent.