How to clean the ear?
Ear can be cleaned
by itself because of migratory capacity of skin
of ear canal. If you scratch ear often you will
get more wax and sometimes you may injured the eardrum.
Q. Why do children get ear
A. Young children
are prone to ear infections (called "otitis
media") because of their developing head and
neck structures. One of these developing structures
is the eustachian tube, a small connection between
the back of the ear and the back of the nose. This
structure allows for the regulation of air pressure,
ventilation, and drainage from the middle ear space
into the back of the nose. Unfortunately, the eustachian
tube is not very well developed in some children.
Reflux (or back-up) of infected fluid from the nose
into the ear may occur. Likewise, the eustachian
tube sometimes does not drain well and allows material
to build up in the ear.
There are several
other reasons why children get ear infections. Children
are much more prone to upper respiratory infections
of all kinds. Other risk factors include young age,
day care attendance, smoking in the household, and
lack of breast feeding. A combination of these risk
factors, plus a poorly developed eustachian tube,
often leads to otitis media in a young child. Most
children will have had one to two cases of otitis
before age two.
children develop and grow. The eustachian tube usually
reaches adequate function between the ages of 5
and 7, which coincides nicely with a dramatic decrease
in the frequency and severity of ear infections
in children. The peak incidence of otitis media
is in the age range of 12-24 months. Some children
begin their history of ear infections at an earlier
age, before their first birthday. This may indicate
a longer and more severe history of otitis media.
are caused by bacteria and viruses. The usual scenario
is for the young child to get an upper respiratory
infection caused by a virus. This leads to seeding
of bacteria in the back of the nose and the ear,
through the eustachian tube. Most middle ear infections
are caused by bacteria. Unfortunately, bacteria
are beginning to develop resistance to the more
commonly prescribed antibiotics. Resistant rates
for infection are specific to different communities
in different areas of the country, depending upon
the type and variety of the usual bacterial flora
in a particular area.
How common are ear infections?
infections are becoming much more commonly diagnosed.
Between 1975 and 1990, the number of ear infections
diagnosed in doctors' offices tripled to about 25
million. Treatment for an ear infection is the second
most common reason for a child's visit to a physician's
office, after the well child exam. Ear infections
also occur with upper respiratory infections, including
tonsillitis, pharyngitis, sinusitis, and bronchitis.
are ear infections treated?
of different treatments have been tried; some controversy
still exists over the use of different types of
medications and when surgical intervention may be
remain the most frequently prescribed medications
for otitis media. Different types of antibiotics
are used, and new ones are being developed. This
is important because of the newer resistant bacteria
that have come to the forefront. Some of the newer
antibiotics may be slightly more effective than
older ones in treating otitis media.
Antibiotics are generally used for 5-14 days of
therapy, depending on the clinical situation and
the severity of illness. Dosing schedules are becoming
shorter as we gain more knowledge about the natural
history of otitis media. Some medications are used
as initial therapy, and others have been chosen
for more broad-spectrum use to help treat persistent
infections and resistant bacteria. Physicians generally
make choices about the type of antibiotic to use
based on several factors, such as a patient's history
(including any allergies), safety issues, and cost.
It is not unusual for ear infections to be treated
with many different types of antibiotics over a
long period of time, perhaps several months, in
an effort to clear the infection and fluid in the
and antihistamines, in conjunction with antibiotics,
were commonly used in the past for the treatment
of otitis media. It has been well documented that
decongestants and/or antihistamines are of little
benefit for the treatment of routine ear infections
in children who do not have allergies.
have been tried, on occasion, for the treatment
of middle ear infections and fluid. These medications
decrease swelling of tissues. It has been difficult
to determine exactly which group of patients might
benefit from these medications. The use of steroids
for new or acute ear infections is not indicated.
Likewise, treatment with steroids in the patient
who has had chronic otitis and fluid in the middle
ear for many months is of little benefit.
of tympanostomy tubes (ear tubes) is the most commonly
performed surgical procedure in young children.
It is generally reserved for children whose infections
have not responded to multiple courses of antibiotics
or when complications occur, such as severe retraction
of the eardrum, scarring of the eardrum, hearing
loss, and intermittent perforation of the eardrum.
Placement of the tubes is usually an outpatient
is sometimes indicated in the treatment of chronic
otitis media. This is done in conjunction with placement
of ear tubes as an outpatient procedure. The indications
for adenoidectomy remain controversial. Generally,
this procedure is suggested when initial placement
of ear tubes has failed and reinsertion is being
considered. It is recommended in older children
(above age 4) and when there is documented nasal
obstruction, sinusitis, or recurring upper respiratory
infections. In general, tonsillectomy is not recommended
for the treatment of otitis media.
What about hearing loss in the child with recurring
Whenever there is fluid in the middle ear space,
there is a high likelihood for hearing difficulties.
Fortunately, this is treatable with the use of antibiotics
or by placing ear tubes to drain the middle ear
space. It is important to have hearing evaluated,
especially when considering a recurring history
of ear infections and the possibility of placement
of tympanostomy tubes. Most hearing loss caused
by ear infections and middle ear fluid is readily
treatable. On rare occasions, children with recurrent
ear infections develop permanent hearing loss.
The paranasal sinuses
are air-filled pockets located within the bones
of the face and around the nasal cavity. Each sinus
is name for the bone in which it is located:
(one sinus located in each cheek)
(approximately 6-12 small sinuses per side, located
between the eyes).
(one sinus per side, located in the forehead)
(one sinus per side, located behind the ethmoid
sinuses, near the middle of the skull)
Each of these pockets has an opening that connects
to the nose. This opening is called an ostium. The
paranasal sinuses are covered with a special lining
(or epithelium). The lining secretes mucus, a complex
substance that keeps the nose and sinuses moist.
The sinus epithelium is ciliated; that is, each
cell on its surface has a cilium, which is a relatively
long structure that has the capacity to push sinus
mucus. This movement of mucus (which is known as
mucociliary clearance) is not random; rather, it
is programmed so that the mucus moves along in a
specific pattern. The sinus do not ‘drain’
by gravity-it is an active process.