Ear Infections (Otitis Media) in Children

Description

Alternative Names

Prognosis

There has been some concern that ear infections in infants less than three months old may indicate more serious infections, such as meningitis. A reassuring 2002 study reported, however, that only 4% of infants with ear infections had any bacterial infections. Still, any indication of infection in a baby warrants prompt medical attention.

Hearing Loss and Its Consequences

Evidence strongly suggests that severe cases of recurrent acute otitis media and persistent otitis media with effusion (OME) impair hearing. The effect of long-term hearing problems may have the following effects:

• Learning Delays. Hearing loss in children slows down language development and reading skills. Children with even mild hearing loss may miss spoken words and have trouble making sense out of a conversation or a lesson in school. It is not clear, however, even after years of research, if OME and its attendant reduced hearing have any significant and long-term effects on learning. Some research suggests that these effects may last into the teens. Other studies, however, indicate that any effect on learning is temporary and that children catch up later on. And some evidence suggests that lower learning scores reported in children with OME may actually be due to the fact that such children tend to be in lower socioeconomic groups and so have less home attention.
• Behavioral and Social Problems. Children with impaired hearing may appear to be distracted, inattentive, and unintelligent. Some have even been inaccurately diagnosed as having attention deficit hyperactivity disorder. As with learning, however, studies have been mixed on the significance of long-term effects of OME on behavior. Considering the increased usage of medications for attention deficit disorder and the social burdens carried by children diagnosed with emotional and learning disabilities, more research is essential for clarifying this relationship.
• Speech Problems. A few small studies have found speech problems in some young children with OME.

Physical and Structural Injuries in the Face and Ears

Serious complications or permanent physical injuries from ear infections are very uncommon, but may include the following:

• In severe or recurrent otitis media, certain children may be at risk for structural damage in the ear.
• Cysts in the ear known as cholesteatomas are an uncommon complication of recurrent or severe ear infections.
• In rare cases, even after a mild infection, certain children, possibly because of immune abnormalities, develop calcification and hardening in the middle and, occasionally, in the inner ear.

Mastoiditis

Before the introduction of antibiotics, mastoiditis, an infection in the bones located in the skull, was a major and serious complication of otitis media. This condition is difficult to treat and requires intravenous antibiotics and drainage procedures. Surgery may be required. If pain and fever persist in spite of antibiotic treatment of otitis media, the physician should check for mastoiditis. Even without antibiotics this is a rare complication. At present, cases of mastoiditis are generally not associated with ear infections.

An infection of the mastoid air cells that cannot be controlled with antibiotics may call for surgical treatment.

Other Possible Complications

Impaired Balance. Some studies have indicated that children with chronic OME have problems with motor development and balance.

Facial Paralysis. Very rarely, a child may develop facial paralysis, which is temporary and relieved by drainage surgery.