Acute Otitis Media

It is more common especially in infants and children of lower socioeconomic group. The cause of AOM is related to childhood anatomy and immune function. Typically, the disease follows viral infection of the upper respiratory tract but soon the pyogenic organisms invade the middle ear.

The common cause of all forms of otitis media is

1. Dysfunction of the Eustachian tube.

This is usually due to inflammation of the mucous membranes in the nasopharynx, which can be caused by a viral upper respiratory tract infection (URTI), strep throat, or possibly by allergies.

2. By reflux or aspiration,

of unwanted secretions from the nasopharynx into the normally sterile middle-ear space, the fluid may then become infected — usually with bacteria.

3. upper respiratory infection:

The virus/bacteria that caused the initial upper respiratory infection can itself be identified as the pathogen causing the infection. Bacteriology. Most common organisms in infants and young   children are Streptococcus pneumoniae (30%), Haemophilus influenzae (20%) and Moraxella catarrhalis (12%). In addition, Other organisms include Streptococcus pyogenes, Staphylococcus aureus and sometimes Pseudomonas aeruginosa. In about 18–20%, no growth is seen. Many strains of H. influenzae and M. catarrhalis are β-lactamase producing.

Predisposing factors:

Anything that interferes with normal functioning of eustachian tube predisposes to middle ear infection. It could be:

1.Recurrent attacks of common cold, upper respiratory tract infections also exanthemata’s fevers like measles, diphtheria or whooping cough.

2.Infections of tonsils also adenoids.

3.Chronic rhinitis also sinusitis.

4.Nasal allergy.

5.Tumours of either nasopharynx, packing of nose or nasopharynx for epistaxis.

6.Cleft palate.

Otitis media begins as an inflammatory process following a viral upper respiratory tract infection involving the mucosa of the nose, nasopharynx, middle ear mucosa, and Eustachian tubes. Due to the constricted anatomical space of the middle ear, the edema caused by the inflammatory process obstructs the narrowest part of the Eustachian tube leading to a decrease in ventilation.

This leads to a cascade of events resulting in an increase in negative pressure in the middle ear, increasing exudate from the inflamed mucosa, and build up of mucosal secretions, which allows for the colonization of bacterial and viral organisms in the middle ear. The growth of these microbes in the middle ear then leads to suppuration and eventually frank purulence in the middle ear space.

This is demonstrated clinically by a bulging or erythematous tympanic membrane and purulent middle ear fluid. This must be differentiated from chronic serous otitis media (CSOM), which presents with thick, amber-colored fluid in the middle ear space and a retracted tympanic membrane on otoscopic examination. Both will yield decreased TM mobility on tympanometry or pneumatic otoscopy.

Several risk factors can predispose children to develop acute otitis media. The most common risk factor is a preceding upper respiratory tract infection. Other risk factors include male gender, adenoid hypertrophy (obstructing), allergy, daycare attendance, environmental smoke exposure, pacifier use, immunodeficiency, gastroesophageal reflux, parental history of recurrent childhood OM, and other genetic predispositions.

[1] Acute otitis media (AOM),

It is an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Additionally, Decreased eating and a fever may also be present.

[2] Otitis media with effusion (OME),

It is typically not associated with symptoms, although occasionally a feeling of fullness is described; also it defined as the presence of non-infectious fluid in the middle ear for more than three months. It is characterized by insidious onset of hearing loss, sometime delayed and defective speech in children of school going age and mild earache.

[3] Acute Necrotizing otitis media:

It is a variety of acute suppurative otitis media, often seen in children suffering from measles, scarlet fever or influenza. Causative organism is β-hemolytic streptococcus. In addition, There is rapid destruction of whole of tympanic membrane with its annulus, mucosa of promontory, ossicular chain also even mastoid air cells. There is profuse otorrhea. In these cases, healing is followed by fibrosis or ingrowth of squamous epithelium from the meatus (secondary acquired cholesteatoma).

[4] Recurrent Acute otitis media:

Infants and children between the age of 6 months and 6 years may get recurrent episodes of acute otitis media. Such episodes may occur four to five times in a year. Usually, they occur after acute upper respiratory infection, the child being free of symptoms between the episodes. In addition, Recurrent middle infections may sometimes be superimposed upon an existing middle ear effusion. Sometimes, the underlying cause is recurrent sinusitis, velopharyngeal insufficiency, hypertrophy of adenoids, infected tonsils, allergy also immune deficiency. Feeding the babies in supine position without propping up the head may also cause the milk to enter the middle ear directly that can lead to middle ear infection.

The primary symptom of acute otitis media is like:

• Ear pain
• Fever
• Reduced hearing during periods of illness
• Tenderness on touch of the skin above the ear
• Purulent discharge from the ears
• Irritability and diarrhea (in infants)

Since an episode of otitis media is usually precipitated by an upper respiratory tract infection (URTI), there are often accompanying symptoms such as,

• Cough and nasal discharge.

• Feeling of fullness in the ear

Discharge from the ear can be caused by acute otitis media with perforation of the eardrum, chronic suppurative otitis media, either tympanostomy tube otorrhea, or acute otitis externa. Trauma, such as a basilar skull fracture, can also lead to cerebrospinal fluid otorrhea (discharge of CSF from the ear) due to cerebral spinal drainage from the brain and its covering (meninges).

Otoscopic examination should be the first and most convenient way of examining the ear and will yield the diagnosis to the experienced eye. In AOM, the TM may be erythematous or normal, and there may be fluid in the middle ear space. In suppurative OM, there will be obvious purulent fluid visible and a bulging TM.

The external ear canal (EAC) may be somewhat edematous, though significant edema should alert the clinician to suspect otitis externa (outer ear infection, AOE), which may be treated differently. In the presence of EAC edema, it is paramount to visualize the TM to ensure it is intact.

If there is an intact TM and a painful, erythematous EAC, ototopical drops should be added to treat AOE. This can exist in conjunction with AOM or independent of it, so visualization of the middle ear is paramount. If there is a perforation of the TM, then the EAC edema can be assumed to be reactive, and ototopical medication should be used, but an agent approved for use in the middle ear, such as ofloxacin, must be used, as other agents can be ototoxic.

Laboratory Studies

Laboratory evaluation is rarely necessary. A full sepsis workup in infants younger than 12 weeks with fever and no obvious source other than associated acute otitis media may be necessary. Laboratory studies may be needed to confirm or exclude possible related systemic or congenital diseases.

Imaging Studies

Imaging studies are not indicated unless intra-temporal or intracranial complications are a concern.

• When an otitis media complication is suspected, computed tomography of the temporal bones may identify mastoiditis, epidural abscess, sigmoid sinus thrombophlebitis, meningitis, brain abscess, subdural abscess, ossicular disease, and cholesteatoma.
• Magnetic resonance imaging may identify fluid collections, especially in the middle ear collections.

Tympanocentesis

It may be used to determine the presence of middle ear fluid, followed by culture to identify pathogens.

Tympanocentesis can improve diagnostic accuracy and guide treatment decisions but is reserved for extreme or refractory cases.

Other Tests

Tympanometry and acoustic reflectometry may also be used to evaluate for middle ear effusion.

As its typical symptoms overlap with other conditions, such as acute external otitis, symptoms alone are not sufficient to predict whether acute otitis media is present; it has to be complemented by

[A] Physical examination of the tympanic membrane

Examiners may use a pneumatic otoscope with a rubber bulb attached to assess the mobility of the tympanic membrane.

• To confirm the diagnosis, middle-ear effusion and inflammation of the eardrum have to identify; signs of these are fullness, bulging, cloudiness also redness of the eardrum.
• After that, it is important to attempt to differentiate between acute otitis media and otitis media with effusion (OME), as antibiotics are not recommending for OME. It has suggesting that bulging of the tympanic membrane is the best sign to differentiate AOM from OME, with a bulging of the membrane suggesting AOM rather than OME.
• Viral otitis may result in blisters on the external side of the tympanic membrane, which call bullous myringitis (myringa being Latin for “eardrum”).

[B]Tympanometry

[C] Reflectometry or hearing test

In more severe cases, such as those with associated hearing loss or high fever

[D] Audiometry

[E] Tympanogram

[F] Temporal bone CT and MRI 

can be used to assess for associated complications, such as mastoid effusion, subperiosteal abscess formation, bony destruction, venous thrombosis or meningitis.

The following conditions come under the differential diagnosis of otitis media i.e.

• Cholesteatoma

• Fever in the infant and toddler

• Fever without a focus

• Hearing impairment

• Pediatric nasal polyps

• Nasopharyngeal cancer
• Otitis externa
• Human parainfluenza viruses (HPIV) and other parainfluenza viruses
• Passive smoking and lung disease
• Pediatric allergic rhinitis
• Pediatric bacterial meningitis
• Pediatric gastroesophageal reflux
• Pediatric Haemophilus influenzae infection
• Pediatric HIV infection
• Pediatric mastoiditis
• Pediatric pneumococcal infections
• Primary ciliary dyskinesia
• Respiratory syncytial virus infection
• Rhinovirus (RV) infection (common cold)
• Teething

Discover Powerful Homeopathic Relief for Acute Otitis Media

Acute Otitis Media (AOM) is a common condition, particularly in children, characterized by the inflammation of the middle ear. While conventional treatments like antibiotics are often prescribed, many individuals seek alternative therapies such as homeopathy for effective and holistic management.

Understanding Acute Otitis Media: AOM typically presents with symptoms such as ear pain, fever, irritability (especially in children), and sometimes even ear discharge. It occurs when the Eustachian tube, which connects the middle ear to the back of the nose and throat, becomes blocked, leading to fluid buildup and subsequent infection.

Benefits of Homeopathic Treatment:
Homeopathy offers a natural and gentle approach to managing AOM. By addressing the underlying causes of the condition and stimulating the body’s innate healing mechanisms, homeopathic remedies aim to not only alleviate symptoms but also prevent recurrent infections. Unlike conventional treatments that may have side effects, homeopathy is safe for all age groups, including infants and pregnant women.

Key Homeopathic Remedies:
Several homeopathic remedies are commonly used for AOM, including:

Belladonna: For sudden onset of intense ear pain with fever.
Pulsatilla: When the ear pain is accompanied by a thick, yellowish discharge.
Chamomilla: Particularly effective in children who are extremely irritable and have severe ear pain.
Hepar Sulph: Useful when the ear pain is associated with a sensation of something being stuck in the ear.
Consultation and Treatment Process:
At Spiritual homeopathy, we offer personalized consultations with experienced homeopathic practitioners who specialize in treating AOM. During the consultation, our experts will conduct a thorough evaluation of your symptoms, medical history, and individual constitution to prescribe the most suitable remedy tailored to your specific needs.

Why Choose Us:

Experienced Homeopathic Practitioners: Our team comprises highly skilled and best homeopathy doctors in india dedicated to providing the highest quality of care.
Holistic Approach: We focus on treating the root cause of AOM rather than just masking the symptoms, ensuring long-term relief and overall well-being.
Patient-Centric Care: Your health and comfort are our top priorities, and we strive to create a warm and supportive environment for all our patients.

If you or your loved one is struggling with Acute Otitis Media and seeking a safe, effective, and natural treatment option, Spiritual Homeopathy is here to help. Contact us today to schedule a consultation and take the first step towards optimal ear health and wellness.

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AOM is far less common in breastfeeding infants than in formula-fed infants, and the greatest protection is associating with exclusive breastfeeding (no formula use) for the first six months of life. A longer duration of breastfeeding is correlating with a longer protective effect.

• Breastfeeding protects young infants from OM and GI tract illness. don’t feed your child while they’re lying flat on their back
• After that, Avoid exposing your child to smoky environments (passive smoking)
• Wear mask
• Avoid sweets, cold food also drinks
• Avoid inserting anything in ears or care should take while cleaning the ear
• Keep clean discharging ear
• Avoiding contact with other children who are unwell may also help reduce your child’s chances of catching an infection that could lead to a middle ear infection.

What is Acute Otitis Media

Otitis media is a group of inflammatory diseases of the middle ear. where’s acute otitis media [AOM] is an infection of rapid onset that usually presents with ear pain.

Homeopathic Medicines use by Homeopathic Doctors in treatment of Acute Otitis Media

• Aconite
• Belladonna
• Hepar Sulphur
• Mercurius
• Pulsatilla
• Plantago
• Sulphur

What are the sign and symptoms of Acute Otitis Media

• Ear pain

• Fever

• Reduced hearing
• Tenderness on touch
• Purulent discharge
• Irritability and diarrhea (in infants)

What is the treatment of Acute Otitis Media

• Decongestant nasal drops.
• Oral nasal decongestants.
• Analgesics and antipyretics.
• Ear toilet.
• Dry local heat
• Incising the drum to evacuate pus.

[1]https://en.wikipedia.org/wiki/Otitis_media

[2] Therapeutics from Zomeo Ultimate LAN

[3]https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/middle-ear-infection-otitis-media

[4] Disease of EAR, NOSE, AND THROAT&HEAD AND NECK SURGERY 6^TH EDITIONS BY P.L Dhingra, Shruti Dhingra.

[5]https://www.ncbi.nlm.nih.gov/books/NBK470332/

[6]https://pubmed.ncbi.nlm.nih.gov/11869231/