Inflammation of the ears in a child can be triggered by many causes caused by external or internal damage to the ear, small objects getting into the ear canal, or an infection of the hearing organ. The most common ENT disease in preschool children is called otitis media. The main causes of ear inflammation in a child, symptoms and treatment of pathology are described in detail in the article.
Causes of Otitis
The features of the anatomical structure of the ear canal of the child is such that any fluids falling into the short and slightly deformed passages of the middle ear, for the most part, remain in the cavities behind the eardrum. The created moist environment is favorable for the development of bacterial flora. Any inflammatory process of the respiratory tract, associated with swelling of the ENT system and copious nasal secretions, by default becomes the main risk factor for the formation of an acute condition called otitis media.
A runny nose in children, if it is not a consequence of allergic rhinitis, most often occurs in the off-season, therefore, an increase in the statistics of ear diseases is noted mainly in the autumn-spring period. Inflammation of the ears of a child - under the general name "otitis media" - is divided into several forms:
- External otitis is provoked by a microbial medium, the focus of which is located on the surface of the mucous membrane of the ear canal. Pathological flora penetrates the ear through microdamage, but actively develops only in case of a reduced immune response of the body, which must be taken into account when drawing up a treatment regimen.
- Inflammation of the middle ear in a child is the result of respiratory diseases or severe hypothermia. Acute inflammation in half the cases is characterized by purulent formation with the release of exudate from the ear canal.
- Internal inflammation of the ears in a child occurs in the event of complications caused by purulent otitis media of the middle ear. The disease develops in the absence of treatment or in the case of using the wrong treatment tactics in the acute form of otitis media.
Other causes of middle ear inflammation in children are the following provoking factors:
- improper position of the baby when feeding or bathing, during which liquid food and water get into the child’s ears;
- low immunity;
- clothes for a newborn out of season;
- lack of breastfeeding in early infancy;
- adult smoking in the presence of the baby.
The elimination of these factors reduces the likelihood of ear inflammation in the child several times.
Symptoms and treatment of otitis externa
The onset of the disease can go unnoticed, because with external otitis media there is no strong pain, but parents should pay attention to the fact that from time to time the child pulls himself by the ear and keeps his head slightly to the side. If you press on the disturbing area with your finger, the baby is anxious.
Other possible symptoms of ear inflammation in children:
- redness of the auricle or skin around the ear;
- with a thorough examination in the ear canal, tubercles and swelling are noticeable;
- inflammation of the lymph nodes behind the ear in a child is noted.
If the child is capricious while eating or tries to swallow food without first chewing, and at the same time he has a stable subfebrile body temperature (in some cases it may not be), that is, a reason to suspect the presence of an ear boil. It is possible to notice inflammation with the naked eye if a dense brown boil is located near the auricle. A boil, far located in the ear canal, is not diagnosed at home. You should be aware that latent ear furunculosis can cause inflammation of the lymph nodes behind the ear in a child.
It is necessary to begin treatment of furunculosis before the condition of the child is alleviated by independent breakthrough of the boil. The contents of the abscess spreads deep into the auditory canal and can cause a secondary inflammatory process. The treatment of ear inflammation in a child with external otitis media caused by furunculosis follows the traditional scheme:
- treatment of the inflamed area with antiseptic ointments until the tip of the purulent rod appears on the head of the boil;
- applying alcohol compresses to the abscess (if necessary);
- opening the boil after its complete formation with subsequent disinfection treatment;
- application with a regenerating ointment (for example, Levomekol) with a frequent change of compresses.
When diagnosing a purulent lesion of the lymph nodes and the presence of staphylococcal or streptococcal pathogens in the body, a course of antibiotics is mandatory. In parallel - for a long course - a child is prescribed immunomodulatory drugs of plant origin (for example, Immunal containing echinacea).
Signs, treatment and consequences of otitis media
Inflammation of the middle ear in a child is accompanied by vivid symptoms, in the bouquet of which acute, paroxysmal pain (this is called “shooting”) can be called the most distinctive sign. The suffering of the baby intensifies when swallowing, so he can cry when feeding; older children will refuse food and drink. Sometimes you may notice lymphatic inflammation under the ear in a child. The size of the node may be insignificant, but pain is felt during palpation.
The peak of the acute condition with otitis media occurs at night and is accompanied by a sharp rise in body temperature. In rare cases, the child opens up vomiting, and traces of pus yellowish can be seen in the auricle. Most often, purulent exudate is reserved in the middle ear of a child, and inflammation is not so noticeable externally. In addition, the presence of pus with otitis media is debatable.
Treatment of middle ear inflammation in a child is based on the use of anti-inflammatory and antibiotic agents, as well as drugs whose action is aimed at stopping acute symptoms:
- decongestant nasal drops;
- antipyretic drugs;
- analgesics.
Otitis media of any kind is dangerous complications. Its most difficult form is purulent, which, with inappropriate treatment or ignoring symptoms, can lead to irreversible hearing loss and deformation of the ear canal tissues. This happens when the exudate - instead of leaving the ear canal, accumulates in the cavity of the middle ear and starts the adhesive process (reservation of thick pus).
Another critical complication of middle ear inflammation in children, the symptoms of which repeat the second, most severe stage of the disease after a long pause of remission, is mastoiditis. Stagnation of pus with mastoiditis in the absence of surgical intervention threatens the development of irreversible processes such as brain abscess, deafness (complete or partial), and paralysis of the facial nerves.
Chronic otitis media
Most often, chronic otitis media is a consequence of a poorly cured form of acute inflammation, but in rare cases, the disease develops independently and in a matter of days. In early childhood, the formation of chronic otitis media often occurs against a background of severe scarlet fever. Other causes of pathology may be recently transferred or present in a constant sluggish mode of the disease (condition):
- diabetes;
- meningitis;
- congenital pathologies of the auditory canal;
- the presence of another focus of infection in the nasopharyngeal apparatus;
- low immunity.
Symptoms of chronic ear inflammation in a child (pictured below) are implicit. She may be completely absent. At moments of relapse, the disease abruptly, without any transition, replaces a sluggish position with an acute one, which lends itself well to therapy, and the illusion of a complete cure is created.
Chronic otitis media is of two types:
- benign - the disease does not extend beyond the middle ear cavity and can last for many years without obvious complications;
- malignant - the pathological process spreads to the bone walls of the ear canal, deforming and destroying them.
Even the release of purulent exudate in chronic otitis media is almost never accompanied by discomfort or pain. Parents only notice over time that the child is hearing worse. They turn to a specialist when it is no longer possible to reverse the process.
How to treat ear inflammation in children with exacerbation of a chronic form? The same medications that are used in the treatment of otitis media are suitable. It is very important - especially in case of repeated relapse - to consult an immunologist with a sick child and follow all his instructions.
First aid for otitis media
Children under three years of age are practically not able to correctly describe their feelings and indicate exactly where they have pain, but even a small child with otitis media will cry a lot, toss his head restlessly, pull his ear, rub his neck or temporal region. To clarify the diagnosis and provide the baby with emergency assistance before the doctor arrives, the mother needs to take the baby in her arms, and when he calms down, press the protruding cartilage in the front of the child’s ear (tragus) with a finger. With otitis media, the baby will cry or be anxious with a sudden movement.
The sequence of actions of parents with suspected ear inflammation in a child should be as follows:
- instillations with nasal vasoconstrictor drops (preferably those that were previously used);
- if the baby cries without interruption or has a strong fever, then it is necessary to give a drug from the group of antipyretics with an analgesic effect ("Nurofen", "Ibuprofen");
- when purulent substance is extracted from the ear, it is necessary to moisten the cotton wool with 3% hydrogen peroxide, curl it with a flagellum and carefully remove the exudate without introducing turunda deep into the ear canal;
- after taking emergency measures, a thin woolen hat or a cotton scarf is put on the child’s head (if it’s warm at home).
Other ways to help a child before being examined by a doctor are strictly prohibited. In no case can you do the instillations yourself with ear drops or apply warm compresses to the affected area. With a purulent course of the disease, this will only strengthen the inflammatory process and worsen the condition of the child.
Alternative methods of treating otitis media in children
Many parents, after coordinating this issue with the pediatrician, try to speed up the process of recovery of the child with the help of alternative methods of treating otitis media. The use of home remedies is not an alternative to traditional drugs, but can significantly reduce the likelihood of complications.
A few recipes from the national piggy bank:
- If the child is not allergic to bee products, it is recommended to use propolis, insisted on alcohol in a proportion of 1:15. Aged for 10 days, the tincture is diluted with refined vegetable oil (1: 6), cotton turunds are moistened with this composition and laid in the patient's ears for 12-18 hours.
- A child over 5 years old can be placed in the ear cotton swab dipped in fresh onion juice.
- Dry wormwood color (1 teaspoon) is filled with a quarter glass of vodka and the infusion is kept for 7-10 days. Cotton turunds are soaked with the finished medicine and laid in the baby’s ears for 2-3 hours to reduce pain.
- Take 10 whole bay leaves, grind them with your hands into crumbs and pour raw materials with a liter of boiling water. After half an hour, the resulting infusion can be used for drinking and for instillation in the ears.
- Juice with pulp is squeezed out from the intact aloe-three-year-old leaf, passed through 4 layers of gauze and the resulting liquid is injected into the child's ears 1 drop three times a day.
After carrying out instillations, it is recommended to warm the child's head and ears with a hat. You can not use drugs based on alcohol, aloe or onion if the child has damage to the ear canal or deformation of the tympanic membrane is diagnosed.
Treatment of otitis media according to Komarovsky
Speaking about the treatment of otitis media in children, Dr. Komarovsky is opposed to using the same methods of therapy for all forms of this many-sided disease. He also strongly disagrees with the spontaneous prescription of antibiotics after the initial diagnosis of the pathology and before the pediatrician receives the results of the tests on hand. What is the reason for this?
The fact is that antibiotics help only if the disease has a bacterial origin. They are absolutely useless, even harmful if the pathogenic flora of the inflammation does not contain a bacterial infectious agent. What types of otitis media prescribe antibacterial drugs:
- catarrhal (prescribed "Sumamed", "Augmentin");
- purulent;
- external, with a furuncle formation.
Antibiotics are prescribed if the condition of the child is not very serious, for 2-3 days from the onset of the disease.
A well-known pediatrician recommends that parents insist on the hospitalization of a preschool child in case of diagnosis of purulent otitis media. Often, for complete extraction of a viscous substance from the middle ear cavity, a surgical puncture is required, which must be done in a timely manner. It is almost impossible to determine the relevance of this procedure when the child is at home treatment. Thus, time favorable for surgery may be missed.
Recommendations of Dr. Komarovsky on the prevention of otitis media
According to Dr. Komarovsky, ear inflammation in a child in 8 out of 10 cases can be prevented by reasonable prevention. If the baby often catches a cold, it is necessary to make an appointment with an immunologist twice a year - in the spring and autumn - and carefully adhere to his appointments.
Every day, the child needs to walk in the fresh air in clothes appropriate to the weather and season. Walking should be active and take place before, not after eating. In dangerous periods of viral epidemics, the time of festivities must be reduced, but at the same time more often aerated living space.
Prevention of otitis media includes more specific advice from an authoritative doctor:
- daily cleaning of the ears should be done with dry cottonworms, and not with ear sticks;
- when feeding or drinking, the baby's head should be significantly higher than the level of his abdomen;
- from the age of three, the child must already be taught to blow his nose properly;
- during games, it is necessary to ensure that the baby does not stick small objects, pencils into his ears.
If a child attends kindergarten, attentive parents should make sure that the airing of the group is carried out by the teachers strictly according to the established schedule and only in the absence of children. Of great importance is the ability of a preschooler to dress independently, since this process is rapidly occurring in kindergarten. Such a detail as a poorly knitted hat in a child may go unnoticed.
Recovery treatment after otitis media
After curing a neglected or purulent form of otitis media, parents may notice that the child has become worse hear. This is manifested in the fact that during a conversation he tries to turn a healthy ear to the speaker, often asks again or speaks louder than usual. As a rule, this condition is temporary and goes away less than a month after defeating the disease. If this does not happen, the otolaryngologist after the examination may recommend the following procedures:
- purging the auditory canals;
- impact on the eardrum with air currents of variable force;
- electrophoresis;
- iontophoresis;
- oxygenobarotherapy.
Well-proven therapeutic gymnastics, which can be turned into a fun game, has no contraindications. All manipulations should be performed 7-10 times in children under 5 years old and 10-15 times in preschool children and primary school children. Exercises are performed in the following sequence:
- with bent and slightly strained fingers, tap on the outside of the auricle;
- firmly press your palms to your ears, count to 10 and sharply remove your hands;
- With your index fingers, close the ear canals of the ears, and then sharply release, while opening your mouth in the soundless pronunciation of the sound “o”.
"Charging for the ears" can be repeated many times during the day. There will be no harm from such a frequency.
In early childhood, even slight hearing loss can have serious consequences. Poor-hearing children are less likely to perceive information, develop more slowly, have a lower reaction rate, so the restoration of auditory functions of a child after otitis media should be a priority for parents.
Inflammation of the behind the lymph nodes and earlobes
Inflammation of the lymph nodes behind the ear in a child can occur in older preschool age, when the lymphatic system of a small person has already completed its formation. It must be understood that the phenomenon of subcutaneous protrusion of the peripheral organ itself is not an independent disease and always implies a reaction of the body to latent pathogenic processes. The causes of inflammation of the lymph nodes behind the ear in a child are diverse:
- proliferation of pathogenic tissues;
- the body's immune response to the penetration of foreign cells;
- the penetration of streptococcal or staphylococcal pathogens through microtrauma;
- brucellosis and others
Often, this symptom is reinforced by fever, headache, nausea, and weakness. If a combination of these signs is observed, then it is most likely a suppuration of the lymph node. The completion of home diagnostics in this case will be palpation. When probing a tubercle on the skin, fossae from the fingers will be clearly indicated. The appointment of therapeutic measures for suppuration of the lymph nodes is carried out by an infectious disease specialist.
Another often voiced problem in the office of a pediatric ENT doctor is inflammation in a child's earlobe. If the appearance of painful sensations was preceded by a visit to the cosmetology office and a puncture of the lobe, the doctor will advise several times during the day to treat the injured area with local antiseptics. In addition, experts recommend abandoning the earrings from the child’s ears with cheap materials that oxidize quickly and cause an immediate reaction in the form of a painful rash and suppuration.