Otitis Media

Otitis media is a set of inflammatory conditions of the middle ear cavity and its organs. It is a common cause of infection among infants and young children. Otitis media occurs in multiple forms and carries an excellent prognosis with appropriate treatment.

If you find your child to be more irritable than usual or crying hysterically with symptoms indicative of an ear infection, we recommend you visit an ENT Specialist in Karachi to avoid potential complications.

What Causes It?

There are a number of hosts, infectious, environmental, and genetic factors that contribute to the development of this condition.


Middle ear inflammation can be of any origin; bacterial or viral and the most common etiological agents are Streptococcus pneumonia, Haemophilus influenza, and Moraxella catarrhalis. The aforementioned microorganisms account for more than 95% of the bacterial OM cases while some of the viral agents responsible are respiratory syncytial viruses (RSV), influenza viruses, parainfluenza viruses, rhinovirus, and adenovirus.

Tympanic Tube Dysfunction

The most common cause of OM is the dysfunction of the Eustachian tube. It could either be due to developmental defects of the Eustachian tube or the weak immune system of children. The tympanic tube, in children, tends to be narrower and horizontal thus clogging the middle ear cavity and making drainage difficult. This is often preceded by any viral upper respiratory tract infection, allergic reactions, flu, strep throat, or infected sinus or adenoids that inflame the nasopharyngeal mucous membranes.

Environmental Triggers & Lifestyle

The risk factors include a cold climate, changing climates, or changes in altitude. Using a pacifier, attending daycare, exposure to cigarette smoke, and polluted air can put children at risk of infection. Children in the age window of 6 to 36 months have a greater risk of contracting ear infections. Bottle-fed infants are particularly susceptible especially because they drink while lying down. Some of the other host factors that accelerate the advancement of otitis media include impaired immunity, vitamin A deficiency in children, and obesity in adults.

Clinical Features

An inflamed middle ear can present with an earache that may interrupt a child’s sleep and cause irritability. One can experience a feeling of fullness in the ear and loss of appetite as well due to the altering internal pressures while swallowing that exacerbate the pain. The presence of white, yellow, or brown exudate may indicate a ruptured tympanic membrane (eardrum). The accumulation of fluid may irritate the middle ear contents (bones and nerves) that can interfere with the transmission of nerve signals to the brain hence the auditory problems and transient hearing loss at times.

Some of the other non-specific clinical features of otitis media are headache, neck pain, fever, vomiting, diarrhea, and distorted balance.


The treatment of otitis media comprises the use of eardrops, painkillers, and antibiotics in severe cases with concomitant use of conventional home-based therapies to relieve the symptoms such as using a hot pad. Amoxicillin has been approved as the first-line anti-microbial agent to treat OM. A doctor may eventually recommend surgical intervention in refractory cases. The surgeries involve either the removal of enlarged or infected adenoids or the placement of tiny tubes in the child’s ear so that the air and fluid can be drained from the middle ear cavity through the tubes.


Some of the preventive measures to avoid otitis media and its complications include training the children rightly to maintain hygiene by washing hands constantly and covering their mouths while sneezing and coughing. It is essential to provide your children with a smoke-free atmosphere and preferentially breastfeed them as breast milk provides the infants with protective antibodies for 6 months at a minimum. It is also helpful to maintain an upright position while feeding a child to avoid ear infections. It is best to get a child vaccinated against seasonal flu and other bacterial infective agents as per medical recommendations.

If you are struggling with a recurrent infection, your doctor may eventually recommend surgical intervention in refractory cases and redirect you to an ENT Specialist in Islamabad for the best consultation.

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