Hearing management

Updated 08 January 2014

Ear infection can disrupt a child’s life

Has your child had ongoing problems with ear infection? If so she is not alone; a number of children suffer from this problem.

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Has your child had ongoing problems with ear infection? If so she is not alone; a number of children suffer from this problem. However, you should get her to a doctor as ongoing ear infection can cause temporary hearing loss and severe earaches.

Dr I Patel, an Ear, Nose and Throat (ENT) specialist at the Netcare Garden City Hospital, says that infection of the middle ear, or otitis media as it is often called, is the most common cause of temporary hearing loss and earache in children. He notes that otitis media often follows a bout of flu or a cold in children, usually a few days after the nose becomes blocked up.

In by far the majority of cases the otitis media will resolve itself on its own, but a doctor may prescribe a painkiller and a decongestant, which can be useful in opening up a blocked nose. If necessary a course of antibiotics will also be prescribed to help clear the infection up.

Grommets might be the answer

According to Dr Patel, in cases where the condition is ongoing and will not resolve, it may be necessary for the doctor to surgically put grommets into a child’s ear to allow the inner ear to be able to drain and ‘breathe’ properly.

Dr Patel explains that otitis media is simply a build up of fluids in the middle ear. The middle ear is connected to the nose by the tiny Eustachian tube, which helps keep air pressure equalised between the middle ear and the environment. The Eustachian tube also allows fluids to drain from the middle ear.

 “A cold or a bout of flu can cause the Eustachian tubes to block up,” he points out. “This may cause pressure to build up and an accumulation of fluids in the middle ear. The pressure may cause the child painful earaches. Parents should therefore be patient when dealing with a child that has otitis media. The child could be in a lot of pain and be suffering temporary hearing loss.”

Hearing loss can hamper schooling

Dr Patel points out that the hearing loss can be severe enough to hamper schooling. The good news is that the hearing loss is nearly always returned to normal once the infection is treated and the ear heals.

Otitis media is quite common in babies and children under the age of seven years. Children are far more vulnerable because they have shorter Eustachian tubes than adults. They also tend to be more susceptible to catching colds and flu, which are among the most important triggers of ear infections.

Myringotomy best for ongoing cases

In cases of severe recurring or ongoing otitis media a GP is likely to refer a patient on to an ENT surgeon for a procedure known as a myringotomy. This involves the surgeon making a small cut in the eardrum so that the inner ear can drain of fluids and pressure is relieved on the eardrum.

This procedure may be done in conjunction with the insertion of a grommet, which is a minute tube inserted through the eardrum that acts as a ‘breathing’ pipe for the inner ear. In other words the grommet acts as a properly functioning Eustachian tube and allows the middle ear to recover from the infection.

According to Dr Patel a myringotomy must be performed under general anaesthesia because while it is a relatively quick and easy procedure it is intricate and requires the child being operated on to be kept very still. Myringotomy is the most common reason for young children to be anaesthetised, he says.

The operation itself takes between 15 and 30 minutes. The surgeon will make a small cut into the eardrum and use a small tube to allow the fluid to drain. The grommet is then fitted into the eardrum. Usually both ears are infected and they can be operated on at the same time. Your child should probably be kept at home from school for a couple of days while the ear heals and to minimise her chance of picking up an infection.

The grommet is usually naturally pushed out of the ear within four to six months. Very occasionally it has to be removed by the ENT surgeon. Usually the child’s Eustachian tube will have opened up by this time, but in some cases it can take longer for the problem to resolve and a further grommet may be recommended by the doctor.

It can sometimes take many months and even years for the Eustachian tubes to open up and remain clear of mucous. Parents can rest assured, however, that even if their children have the most stubborn of infections, he or she will almost certainly go on to eventually outgrow the problem.

Dr Patel concludes that otitis media is very rarely a major medical problem, but it must be treated if it fails to resolve itself. This will ensure that the impact of a chronic case of the condition is kept to a minimum and the child does not suffer any possible setbacks in her development.

(Press release issued by Netcare Garden City Hospital, September 2010)

 

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Hearing Expert

Francis Slabber is a Speech & Language Therapist and Audiologist who has owned and run The Hearing Clinic in Wynberg, Cape Town for the last 17 years. Francis and her team have extensive experience in fitting and supplying hearing aids as well as assistive living devices. Francis has served as the Western Cape Chairperson for the South African Association of Audiologists for three years and has given many talks on the topic of hearing loss and amplification. The Hearing Clinic has a special interest in adult and geriatric hearing impairment, hearing aid fittings and hearing rehabilitation.

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