2021-08-31 17:12:40
ear pain et fever are the main symptoms, but in babies the signs are misleading. If you think your child has an ear infection, it is necessary to consult your doctor or pediatrician, indicates Health Insurance (source 1).
Definition: what is otitis?
The term Plague means a inflammation and/or infection that can affect the different compartments of the ear: outer, inner or middle. Acute otitis media (AOM) is an extremely common condition in babies and children, especially before the age of six. It is also the second infectious disease following rhinopharyngite ! About 50-80% of children have at least one episode of AOM before the age of one year and 80-90% before the age of three years, with the peak incidence between six and fifteen months of life .
Little anatomy of the ear
Did you know that the ear is made up of three main parts?
- L’outer ear which corresponds to the visible part of the auditory apparatus with the pavilion and the external auditory canal which directs the sounds picked up towards the eardrum;
- L’inner ear which includes the cochlea, responsible for hearing, and the organs of balance;
- Et the middle ear, behind the eardrum, cavity in which we find the three smallest bones of the human body: the hammer, the anvil, the stirrup. It is also made up of the Eustachian tube and the mastoid.
The different types of otitis
Otitis mainly affects the outer ear or the middle ear.
otitis externa
External otitis is a inflammation that affects the external ear canal. This can occur following swimming, when there is still water in the ear canal, or following repeated contact with an object (for example by cleaning the ears with a cotton swab). It most often results in pain – exacerbated when the pavilion is pulled – itching and discharge from the ear.
There are very few external otitis in babies, says Professor Nicolas Leboulanger.
Acute otitis media
Acute otitis media (AOM) is an extremely common pathology in babies. She may be congestive (inflammatory) or purulent (infectious). “On examination, the eardrum is pink or red and very painful. When there is no infection, symptomatic treatment is prescribed and monitoring is carried out. In the absence of improvement or when you are faced with acute purulent otitis media, with a bulging eardrum, permanent and throbbing pain, you treat with antibiotics”.
Serous otitis
Very common in young children – 12 to 18% of them will present this pathology in the first five years of their life –serous otitis is often asymptomatic (in 95% of cases) and therefore more difficult to diagnose. “It is characterized by a serous fluid effusion behind the eardrum and is not painful,” explains Prof. Leboulanger. “In general, serous otitis often heals on its own following two or three weeks. On the other hand, when it is long-term, it can be responsible for a hearing loss and then requests a consultation with an ENT”. Does your child have speech difficulties? Does he delay speaking or make you repeat sentences often? It may be appropriate to speak to a specialist.
Symptoms: how do I know if my baby has an ear infection?
The symptoms are very different depending on the type of otitis: if they are noisy in acute purulent otitis with severe pain and fever, they can pass totally unnoticed in the context of serous otitis.
Know how to spot the signs of acute otitis media
The symptoms of acute otitis media are quite characteristic: sharp pain in the ear sometimes with decreased hearing and fever. “In the baby the signs are diverse: unexplained crying, loss of appetite, agitation, sleep disturbances, high fever, etc., recalls the ENT specialist. This one can possibly touch the ear but it is not systematic. One thing is certain: in front of this clinical picture, we consult our doctor”.
Know how to spot the signs of serous otitis
Mainly asymptomatic, serous otitis is more difficult to diagnose. Especially with babies! Also, in the face of language acquisition difficulties, articulatory disorders or a lack of reaction to noise, it is prudent to consult your pediatrician or an ENT doctor. When the child is old enough to express himself, he may have a feeling of pressure or popping in the ear when swallowing and a decrease in hearing.
Causes: how do you get an ear infection?
Acute otitis media is caused by a virus or bacteria. She often occurs following nasopharyngitis. Bacteria that reside in the nasopharynx colonize the middle ear via the Eustachian tube, multiply and cause infection. “You should know that babies are particularly prone to ear infections”, recalls the ENT. “Their Eustachian tube is shorter and straighter, so nasopharyngeal secretions tend to flow up towards the ear and their immune system is still immature.”
Serous otitis, on the other hand, appears following a cold, viral ENT infection or ear infection. “Immunological immaturity but also anatomical factors such ashypertrophy of the adenoids or a malformation of the face (cleft palate) can also be risk factors”.
Treatments: what should I do when my child has an ear infection?
Medication
Faced with otitis, the doctor will prescribe painkillers of the paracetamol type to relieve pain and reduce fever. In the case of acute purulent otitis media, the treatment may possibly be supplemented by antibiotics. « Aspirin should not be administered to children without medical advicedue to the risk of occurrence of a rare but serious disease, Reye’s Syndrome, ”recalls the Health Insurance.
Paracentesis
In case of very painful otitis or with a high fever, the specialist can perform a paracentesis. This involves piercing the eardrum with a fine instrument to drain the pus accumulated in the middle ear. It is performed under local anesthesia.
Paracentesis is indicated in a context of hyperalgesic or hyperthermic otitis, confirms the ENT. It relieves the children a lot.
The pose of yoyos
Faced with repeated ear infections, the specialist may suggest the installation of yoyos. “A serous otitis that extends over time can become a real substrate for the development of infections, confirms the ENT. It is then advisable to carry out a small surgical intervention under general anesthesia to place tympanic aerators also called ‘yoyos’. We incise the eardrum and we insert small silicone tubes so as to create a passage to ventilate the middle ear”.
While waiting for the consultation with the pediatrician, how to relieve a baby who has an ear infection?
While waiting for the consultation with your pediatrician, it is possible to relieve your baby with a few simple gestures. Be sure to blow his nose, if he has a fever give him paracetamol respecting the dose corresponding to his age and raise his head a little when he is lying down. “Just slide a pillow or a folded towel under the mattress, at the headboard,” says the ENT. “A bit like for babies who suffer from gastric reflux”.
What are the potential complications ?
Complications of otitis are relatively rare with appropriate treatment. “However, sometimes the infection degenerates into acute mastoiditis. Otitis comes out of its natural compartment and creates an infection behind the ear. We then observe a bulge under the skin above the pavilion which may require surgery to drain the infectious focus”, specifies Professor Leboulanger. “Otitis can also progress to a purulent meningitis. But it’s extremely rare and well prevented by vaccinations…”.
When to go to the emergency room for an ear infection in babies?
The Insurance recommends consulting urgently if:
- Your child has less than three months and he has fever ;
- Whatever his age, he has a temperature of 40°C or more ;
- Your child has difficulty breathing ;
- the sleeper, answer wrong when you stimulate him and his crying is weak;
- Your child is very pale or has purplish spots on his skin;
- He has severe headachesof the vomitingof the unexplained cryingeven in the absence of fever;
- Your child has diarrhea severe or vomiting which can lead to dehydration.
How to prevent ear infections?
Even if otitis is a very common and generally benign condition in babies, it is possible to prevent it or at least prevent it from recurring. For example, by favoring home childcare rather than childcare. Contaminations are indeed legion in the community. But also taking care of clean your child’s nose properly using saline or saline solution to drain secretions.
“It is also important to treat serous otitisto do vaccines the child once morest theHaemophilus influenzae and pneumococci but also to correct iron deficiency or severe acid reflux from the stomach. Passive smoking is also one of the risk factors on which it is imperative to act. concludes Prof. Leboulanger.
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